https://doi.org/10.4081/ripppo.2020.434
Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service
Submitted: October 17, 2019
Accepted: March 4, 2020
Published: May 20, 2020
Accepted: March 4, 2020
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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Outreaching activities decrease prognostic accuracy of at-risk mental state defining tools, over-attracting subjects who are not at increased risk of mental illness. The setting was a mental illness primary indicated prevention outpatients service embedded within the Psychiatry Unit of Padua University Hospital, Italy. Help-seeking patients accessing the service between January 2018 and December 2018 were evaluated with validated tools assessing functioning, at-risk mental state, schizotypal personality features, depressive and anxious symptoms, together with medical and family history collection. The primary outcome was the prevalence of drop in functioning at presentation according to the Social and Occupational Functioning Assessment Scale (SOFAS). Secondary outcomes were diagnoses according to DSM-5 criteria and meeting criteria for at-risk mental state. Fifty-nine patients accessed the service, mean age was 18.8 (2.12) years old, 54.2% were females. Virtually all subjects (97.7%) had a drop in functioning. Baseline primary diagnoses were depressive episode in 33%, anxiety disorder in 21%, personality disorder in 17%, adjustment disorder 9%, conduct disorder 7%, schizophrenia spectrum disorder 5%, bipolar disorder 5%, eating disorder in 1.7%, dissociative disorder 1.7%. Overall, 59.1% met at-risk mental state criteria. Lower functioning was associated with anxious symptoms (p=0.031), a family history of mental illness (p=0.045) and of suicide (p=0.042), and schizotypal personality traits (p=0.036). Subjects accessing a prevention service embedded within the mental health department already present a trans-diagnostic drop in functioning, mainly due to a non-psychotic mental disorder, with at-risk mental state in one patient out of two, and schizophrenia or bipolar disorder already present in only 10% of subjects. Prevention service within mental health facility setting appears to properly detect subjects in need of treatment with a drop in functioning, at risk of developing severe mental illness, without any outreaching activity in the general population.
Birrell L, Newton NC, Teesson M, Tonks Z, Slade T. Anxiety disorders and first alcohol use in the general population. Findings from a nationally representative sample. J Anxiety Disord. 2015;31:108-113. doi:10.1016/j.janxdis.2015.02.008
DOI: https://doi.org/10.1016/j.janxdis.2015.02.008
Thorup A, Petersen L, Jeppesen P, et al. Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study. J Nerv Ment Dis. 2007;195(5):396-405. doi:10.1097/01.nmd.0000253784.59708.dd
DOI: https://doi.org/10.1097/01.nmd.0000253784.59708.dd
Goodwin RD, Hamilton SP. The early-onset fearful panic attack as a predictor of severe psychopathology. Psychiatry Res. 2002;109(1):71-79. doi:10.1016/S0165-1781(01)00357-2
DOI: https://doi.org/10.1016/S0165-1781(01)00357-2
Hudson JI, Hiripi E, Pope HG, Kessler RC. The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61(3):348-358. doi:10.1016/j.biopsych.2006.03.040
DOI: https://doi.org/10.1016/j.biopsych.2006.03.040
Atladottir HO, Gyllenberg D, Langridge A, et al. The increasing prevalence of reported diagnoses of childhood psychiatric disorders: a descriptive multinational comparison. Eur Child Adolesc Psychiatry. 2014;24(2):173-183. doi:10.1007/s00787-014-0553-8
DOI: https://doi.org/10.1007/s00787-014-0553-8
Penttilä M, Jaä̈skel̈ainen E, Hirvonen N, Isohanni M, Miettunen J. Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: Systematic review and meta-analysis. Br J Psychiatry. 2014;205(2):88-94. doi:10.1192/bjp.bp.113.127753
DOI: https://doi.org/10.1192/bjp.bp.113.127753
Ghio L, Gotelli S, Marcenaro M, Amore M, Natta W. Duration of untreated illness and outcomes in unipolar depression: a systematic review and meta-analysis. J Affect Disord. 2014;152-154:45-51. doi:10.1016/j.jad.2013.10.002
DOI: https://doi.org/10.1016/j.jad.2013.10.002
Compton MT, Gordon TL, Goulding SM, et al. Patient-Level Predictors and Clinical Correlates of Duration of Untreated Psychosis among Hospitalized First-Episode Patients. J Clin Psychiatry. 2011;72(2):225-232. doi:10.4088/JCP.09m05704yel
DOI: https://doi.org/10.4088/JCP.09m05704yel
Compton MT, Gordon TL, Weiss PS, Walker EF. The “doses” of initial, untreated hallucinations and delusions: A proof-of-concept study of enhanced predictors of first-episode symptomatology and functioning relative to duration of untreated psychosis. J Clin Psychiatry. 2011;72(11):1487-1493. doi:10.4088/JCP.09m05841yel
DOI: https://doi.org/10.4088/JCP.09m05841yel
Hung CI, Liu CY, Yang CH. Untreated duration predicted the severity of depression at the two-year follow-up point. PLoS One. 2017;12(9). doi:10.1371/journal.pone.0185119
DOI: https://doi.org/10.1371/journal.pone.0185119
Medeiros GC, Senço SB, Lafer B, Almeida KM. Association between duration of untreated bipolar disorder and clinical outcome: Data from a Brazilian sample. Rev Bras Psiquiatr. 2016;38(1):6-10. doi:10.1590/1516-4446-2015-1680
DOI: https://doi.org/10.1590/1516-4446-2015-1680
Parellada M. Why psychogeriatrics starts right after adolescence. Eur Child Adolesc Psychiatry. 2013;22(7):391-393. doi:10.1007/s00787-013-0434-6
DOI: https://doi.org/10.1007/s00787-013-0434-6
Fusar-Poli P, Estradé A, Spencer TJ, et al. Pan-London Network for Psychosis-Prevention (PNP). Front psychiatry. 2019;10:707. doi:10.3389/fpsyt.2019.00707
DOI: https://doi.org/10.3389/fpsyt.2019.00707
McGorry PD, Hartmann JA, Spooner R, Nelson B. Beyond the "at risk mental state" concept: transitioning to transdiagnostic psychiatry. World Psychiatry. 2018;17(2):133-142. doi:10.1002/wps.20514
DOI: https://doi.org/10.1002/wps.20514
Fusar-Poli P, Palombini E, Davies C, et al. Why transition risk to psychosis is not declining at the OASIS ultra high risk service: The hidden role of stable pretest risk enrichment. Schizophr Res. 2018;192:385-390. doi:10.1016/j.schres.2017.06.015
DOI: https://doi.org/10.1016/j.schres.2017.06.015
Fusar-Poli P, Davies C, Rutigliano G, Stahl D, Bonoldi I, McGuire P. Transdiagnostic individualized clinically based risk calculator for the detection of individuals at risk and the prediction of psychosis: Model refinement including nonlinear effects of age. Front Psychiatry. 2019;10(MAY). doi:10.3389/fpsyt.2019.00313
DOI: https://doi.org/10.3389/fpsyt.2019.00313
Fusar-Poli P, Oliver D, Spada G, et al. Real world implementation of a transdiagnostic risk calculator for the automatic detection of individuals at risk of psychosis in clinical routine: Study protocol. Front Psychiatry. 2019;10(MAR). doi:10.3389/fpsyt.2019.00109
DOI: https://doi.org/10.3389/fpsyt.2019.00109
van Os J, Guloksuz S. A critique of the “ultra-high risk” and “transition” paradigm. World Psychiatry. 2017;16(2):200-206. doi:10.1002/wps.20423
DOI: https://doi.org/10.1002/wps.20423
Fusar-Poli P, Schultze-Lutter F, Cappucciati M, et al. The dark side of the moon: meta-analytical impact of recruitment strategies on risk enrichment in the clinical high risk state for psychosis. Schizophr Bull. 2016;42(3):732-743. doi:10.1093/schbul/sbv162
Yung AR, Yung AR, Pan Yuen H, et al. Mapping the Onset of Psychosis: The Comprehensive Assessment of At-Risk Mental States. Aust New Zeal J Psychiatry. 2005;39(11-12):964-971. doi:10.1080/j.1440-1614.2005.01714.x
DOI: https://doi.org/10.1080/j.1440-1614.2005.01714.x
Goldman HH, Skodol AE, Lave TR. Revising axis V for DSM-IV: A review of measures of social functioning. Am J Psychiatry. 1992;149(9):1148-1156. doi:10.1176/ajp.149.9.1148
DOI: https://doi.org/10.1176/ajp.149.9.1148
Pirkis JE, Burgess PM, Kirk PK, Dodson S, Coombs TJ, Williamson MK. A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures. Health Qual Life Outcomes. 2005;3. doi:10.1186/1477-7525-3-76
DOI: https://doi.org/10.1186/1477-7525-3-76
Gowers SG, Harrington RC, Whitton A, et al. Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). Br J Psychiatry. 1999;174(MAY):413-416. doi:10.1192/bjp.174.5.413
DOI: https://doi.org/10.1192/bjp.174.5.413
Wing JK, Beevor AS, Curtis RH, Park SBG, Hadden S, Burns A. Health of the nation outcome scales (HoNOS): Research and development. Br J Psychiatry. 1998;172(JAN.):11-18. doi:10.1192/bjp.172.1.11
DOI: https://doi.org/10.1192/bjp.172.1.11
Fonseca-Pedrero E, Lemos-Giráldez S, Paino M, Sierra-Baigrie S, Muñiz J. Relationship between Schizotypal and Borderline Traits in College Students. Span J Psychol. 2012;15(1):306-314. doi:10.5209/rev_sjop.2012.v15.n1.37337
DOI: https://doi.org/10.5209/rev_SJOP.2012.v15.n1.37337
Fonseca-Pedrero E, Paíno-Piñeiro M, Lemos-Giráldez S, Villazón-García Ú, Muñiz J. Validation of the Schizotypal Personality Questionnaire-Brief Form in adolescents. Schizophr Res. 2009;111(1-3):53-60. doi:10.1016/j.schres.2009.03.006
DOI: https://doi.org/10.1016/j.schres.2009.03.006
HAMILTON M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62. doi:10.1136/jnnp.23.1.56
DOI: https://doi.org/10.1136/jnnp.23.1.56
HAMILTON M. THE ASSESSMENT OF ANXIETY STATES BY RATING. Br J Med Psychol. 1959;32(1):50-55. doi:10.1111/j.2044-8341.1959.tb00467.x
DOI: https://doi.org/10.1111/j.2044-8341.1959.tb00467.x
Hung C, Yu NW, Liu CY, Wu KY, Yang CH. The impact of the duration of an untreated episode on improvement of depression and somatic symptoms. Neuropsychiatr Dis Treat. 2015;11:2245-2252. doi:10.2147/NDT.S89498
DOI: https://doi.org/10.2147/NDT.S89498
Dagani J, Signorini G, Nielssen O, et al. Meta-analysis of the Interval between the Onset and Management of Bipolar Disorder. Can J Psychiatry. 2017;62(4):247-258. doi:10.1177/0706743716656607
DOI: https://doi.org/10.1177/0706743716656607
Van Meter AR, Burke C, Youngstrom EA, Faedda GL, Correll CU. The Bipolar Prodrome: Meta-Analysis of Symptom Prevalence Prior to Initial or Recurrent Mood Episodes. J Am Acad Child Adolesc Psychiatry. 2016;55(7):543-555. doi:10.1016/j.jaac.2016.04.017
DOI: https://doi.org/10.1016/j.jaac.2016.04.017
Albert U, Barbaro F, Bramante S, Rosso G, De Ronchi D, Maina G. Duration of untreated illness and response to SRI treatment in Obsessive-Compulsive Disorder. Eur Psychiatry. 2019;58:19-26. doi:10.1016/j.eurpsy.2019.01.017
DOI: https://doi.org/10.1016/j.eurpsy.2019.01.017
Benatti B, Camuri G, Dell’Osso B, et al. Which factors influence onset and latency to treatment in generalized anxiety disorder, panic disorder, and obsessive-compulsive disorder? Int Clin Psychopharmacol. 2016;31(6):347-352. doi:10.1097/YIC.0000000000000137
DOI: https://doi.org/10.1097/YIC.0000000000000137
Kisely S, Scott A, Denney J, Simon G. Duration of untreated symptoms in common mental disorders: Association with outcomes. Br J Psychiatry. 2006;189(JULY):79-80. doi:10.1192/bjp.bp.105.019869
DOI: https://doi.org/10.1192/bjp.bp.105.019869
Fusar-Poli P, Schultze-Lutter F, Cappucciati M, et al. The Dark Side of the Moon: Meta-analytical Impact of Recruitment Strategies on Risk Enrichment in the Clinical High Risk State for Psychosis. Schizophr Bull. 2016;42(3):732-743. doi:10.1093/schbul/sbv162
DOI: https://doi.org/10.1093/schbul/sbv162
Fusar-Poli P, Sullivan SA, Shah JL, Uhlhaas PJ. Improving the Detection of Individuals at Clinical Risk for Psychosis in the Community, Primary and Secondary Care: An Integrated Evidence-Based Approach. Front psychiatry. 2019;10:774. doi:10.3389/fpsyt.2019.00774
DOI: https://doi.org/10.3389/fpsyt.2019.00774
Fusar-Poli P, Werbeloff N, Rutigliano G, et al. Transdiagnostic Risk Calculator for the Automatic Detection of Individuals at Risk and the Prediction of Psychosis: Second Replication in an Independent National Health Service Trust. Schizophr Bull. 2019;45(3):562-570. doi:10.1093/schbul/sby070
DOI: https://doi.org/10.1093/schbul/sby070
Green AC, Hunt C, Stain HJ. The delay between symptom onset and seeking professional treatment for anxiety and depressive disorders in a rural Australian sample. Soc Psychiatry Psychiatr Epidemiol. 2012;47(9):1475-1487. doi:10.1007/s00127-011-0453-x
DOI: https://doi.org/10.1007/s00127-011-0453-x
Kamaradova D, Latalova K, Prasko J, et al. Connection between self-stigma, adherence to treatment, and discontinuation of medication. Patient Prefer Adherence. 2016. doi:10.2147/PPA.S99136
DOI: https://doi.org/10.2147/PPA.S99136
How to Cite
Solmi, M., Campeol, M., Gentili, F., Favaro, A., & Cremonese, C. (2020). Clinical presentation and need for treatment of a cohort of subjects accessing to a mental illness prevention service. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(1). https://doi.org/10.4081/ripppo.2020.434
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