Familial High-Risk for Psychosis and Bipolar Disorder Amongst Youth in an Academic Healthcare System: A Real-World Assessment of Clinical Characteristics and Implications for Clinical Care

IF 2.1 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2025-02-10 DOI:10.1111/eip.70019

Halide Bilge Türközer, Perihan Esra Guvenek-Cokol, Zachary B. Millman, Daniel Dickstein, Dost Öngür

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引用次数: 0

Abstract

Objective

Family history is amongst the most significant risk factors for psychotic and bipolar disorders. Despite being clearly defined, easily and early identifiable, familial high-risk status is minimally accounted for in mainstream prevention paradigms. This study reports on the demographics and clinical characteristics of youth with a first-degree relative affected by psychotic or bipolar disorders within a large academic healthcare system.

Method

In this quality improvement study, using electronic medical records, the authors examined demographics, psychiatric and medical diagnoses, substance use, service utilisation, and psychotropic medication use in children, adolescents and young adults (age 24 or younger) with and without a family history of psychotic or bipolar disorders within the Mass General Brigham (MGB) healthcare system.

Results

Family history-positive (FHP) youth demonstrated markedly higher rates of psychiatric problems (57.8%) compared to family history-negative (FHN) youth (8.5%), including higher rates of psychotic and bipolar disorders, as well as anxiety disorders and depression. FHP youth also had more frequent psychotropic medication use and medical problems. Additionally, FHP youth reported higher cannabis and alcohol use, along with higher rates of suicidal ideation and trauma. Despite this, only 4% of FHP youth visited an MGB psychiatry or psychology department within the six months preceding the analysis.

Conclusion

FHP youth constitute a distinct and practically identifiable risk cohort within a large academic healthcare system. Increased psychiatric and medical problems coupled with more prevalent risk factors amongst familial high-risk youth highlight the need for tailored clinical programmes to achieve both primary and secondary prevention.

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在学术医疗保健系统中，青少年精神病和双相情感障碍的家族性高风险：临床特征和临床护理意义的真实世界评估

家族史是精神病和双相情感障碍最重要的危险因素之一。尽管定义清楚、容易和早期识别，但在主流预防范式中，家族性高危状态很少被考虑在内。本研究报告了在一个大型学术医疗保健系统中患有精神病或双相情感障碍的青少年一级亲属的人口统计学和临床特征。方法：在这项质量改进研究中，作者使用电子病历检查了在麻省总医院（MGB）医疗保健系统中有或没有精神或双相障碍家族史的儿童、青少年和年轻人（24岁或以下）的人口统计学、精神病学和医学诊断、物质使用、服务利用和精神药物使用情况。结果家族史阳性（FHP）青年的精神问题发生率（57.8%）明显高于家族史阴性（FHN）青年（8.5%），包括精神病和双相情感障碍、焦虑症和抑郁症的发生率较高。FHP青年也有更频繁的精神药物使用和医疗问题。此外，FHP青年报告了更高的大麻和酒精使用率，以及更高的自杀意念和创伤率。尽管如此，在分析之前的六个月内，只有4%的FHP青年去过MGB精神病学或心理学系。结论：在一个大型学术医疗体系中，FHP青年构成了一个独特的、实际可识别的风险群体。精神和医疗问题的增加，加上家族高风险青年中更普遍的风险因素，突出表明需要有针对性的临床方案，以实现初级和二级预防。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.