2017 Children’s Mental Health Report

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Psychosis and Intervention

The gene variant that contributes to schizophrenia is the same gene that, in all likelihood, is used by the brain to prune synapses and thus enable cognition and adaptive learning.– Siddhartha Mukherjee

Late adolescence and early adulthood are the peak years for the onset of psychotic disorders, including schizophrenia and bipolar disorder. The complex genetic, environmental and neuroanatomical causes are just beginning to be understood.

100,000 young people

each year experience first episode psychosis, with peak onset between 15 and 25 years of age.¹ ²

  • Genetic research into schizophrenia suggests that the disorder is linked to the process of pruning in the developing brain. There are higher levels of pruning-related proteins in the brains of individuals with schizophrenia, and the onset of schizophrenia matches up closely with when pruning is occurring in the part of the brain linked to schizophrenia. Adults with schizophrenia have been shown to have fewer connections between neurons in these brain areas than typical people.³
  • Early Treatment for First Episode Psychosis: While traditional treatment for psychotic disorders involved only medication, treatment that includes other services, provided within two years of the first psychotic episode, has been shown to reduce the risk of recurring episodes by 50%.
  • 52% of those with a first episode psychosis make a full or partial functional recovery with early intervention, vs. just 15% receiving typical treatment.

[1] McGrath, J., Saha, S., Chant, D., & Welham, J. (2008). Schizophrenia: A Concise Overview of Incidence, Prevalence, and Mortality. Epidemiologic Reviews, 30(1), 67-76. doi:10.1093/epirev/mxn001

[2] NIMH. Evidence-Based Treatments for First Episode Psychosis. Retrieved from www.nimh.nih.gov/health/topics/schizophrenia/raise/evidence-based-treatments-for-first-episode-psychosis-components-of-coordinated-specialty-care.shtml

[3] Sekar, A., Bialas, A. R., De Rivera, H., Davis, A., Hammond, T. R., Kamitaki, N., … McCarroll, S. A. (2016). Schizophrenia risk from complex variation of complement component 4. Nature, 530(7589), 177-183. doi:10.1038/nature16549

[4] Fowler, D., Hodgekins, J., Howells, L., Millward, M., Ivins, A., Taylor, G., … Macmillan, I. (2009). Can targeted early intervention improve functional recovery in psychosis? A historical control evaluation of the effectiveness of different models of early intervention service provision in Norfolk 1998-2007. Early Intervention in Psychiatry, 3(4), 282-288. doi:10.1111/j.1751-7893.2009.00146.x

[5] Fowler (2009).