Researchers have found a more precise way to predict when young people are at risk of experiencing psychosis. Psychosis causes a (usually brief) break with reality, during which someone has hallucinations or delusions. Sometimes it’s triggered by a neurological illness or heavy drug use, but it’s usually a symptom of a mental illness like schizophrenia. (Contrary to popular myth and some pop culture, someone experiencing psychosis is rarely a danger to others.)
It usually first occurs around the age of 21 but milder symptoms can appear three or four years earlier. In 30-40% of cases, people with early signs of psychosis (such as difficulty handling stress, or a loss of inhibition) will go on to develop a psychotic illness. It’s important to diagnose patients as quickly as possible so they can access the treatment they need. But medications for psychotic illnesses are strong and can have unpleasant side effects, so it’s preferable to use them only in confirmed cases.
According to Psych Central, a group of researchers from universities including Yale and Harvard and from different disciplines, including neuroendocrinology and psychiatry, worked together on a project to understand which young people are most at risk. After studying more than 800 people in their teens and early twenties who had early signs of psychotic illness as well as a control group of 200, they found that young people in the first group who had higher levels of the stress hormone cortisol, plus some inflammation in the brain, were more likely to become psychotic within one year.
This enabled the researchers to develop a risk-prediction algorithm that doctors can use, and means that in future those patients who are high-risk could be monitored using a simple saliva test to measure cortisol levels. They also discovered a decline in grey matter in the brain in the year prior to diagnosis, which correlated with a rise in cortisol. They’re now working on an even more advanced blood-biomarker algorithm which will enable doctors to monitor stress, inflammation, hormones, and metabolism so people can be diagnosed ever more accurately.
Dr Elaine Walker, a professor of psychology and neuroscience at Emory and one of the team’s leading investigators, said, ‘Psychosis is extremely complex, there is no doubt about it, and we’re learning that it’s even more complex than we previously realised. But if we’re ever going to make progress in prevention and treatment, we’re going to have to come to grips with that complexity and fully understand it.’
Image by Ed Uthman via Wikimedia Commons.
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