Citation

Mongan D, Healy C, Power E, Byrne JF, Zammit S, Kelleher I, Cannon M, Cotter DR. World Psychiatry 2023; 22(3): 481-483.

Copyright

(Copyright © 2023, World Psychiatric Association, Publisher John Wiley and Sons)

DOI

10.1002/wps.21125

PMID

37713572

Abstract

Early intervention for youth mental disorders has received increasing attention in recent decades. For psychosis, this is exemplified by the clinical high-risk (CHR) paradigm, which has been highly successful in defining a subpopulation at enhanced risk. However, the subpopulation captured by CHR services represents a small proportion of all psychosis cases1, highlighting the need for additional approaches to early detection of at-risk individuals.

Thoughts of self-harm are common in youth populations and are associated with several psychiatric outcomes. A recent Finnish registry study found that 18% of young people in Finland who presented to hospital with self-harm were diagnosed with a psychotic disorder by age 282, suggesting that hospital presentation with self-harm may be a system-based risk marker for psychosis. However, most individuals with self-injurious thoughts or behaviours do not present to hospital, and only a small proportion (4%) of future psychosis cases were captured in that study.

Expanding on this approach, we examined whether having thoughts of self-harm in late adolescence (irrespective of hospital presentation) was a risk indicator for development of psychotic disorder, as well as depressive disorder and generalized anxiety disorder (GAD), in early adulthood. In exploratory secondary analyses, we also examined whether telling a general practitioner (GP) about thoughts of self-harm was a risk marker for these disorders...

Language: en