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Psychosis and bipolar disorder risk in child and adolescent mental health services in the UK: population cohort study
,
Ulla Lång,
Colm Healy,
Ioanna Kougianou,
Animesh Talukder,
Robin Murray,
Stephen M. Lawrie ,
Ann John ,
Ian Kelleher
The British Journal of Psychiatry, Pages: 1 - 7
Swansea University Author:
Ann John
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© The Author(s), 2025. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence.
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DOI (Published version): 10.1192/bjp.2025.48
Abstract
Background: Current approaches to identifying individuals at elevated risk for psychosis capture only a small proportion of future psychotic disorders. Recent Finnish research suggests that a substantial proportion of individuals at risk of psychosis attend child and adolescent mental health service...
| Published in: | The British Journal of Psychiatry |
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| ISSN: | 0007-1250 1472-1465 |
| Published: |
Royal College of Psychiatrists
2025
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa68827 |
| Abstract: |
Background: Current approaches to identifying individuals at elevated risk for psychosis capture only a small proportion of future psychotic disorders. Recent Finnish research suggests that a substantial proportion of individuals at risk of psychosis attend child and adolescent mental health services (CAMHS) earlier in life, creating important opportunities for prediction and prevention. To what extent this is true outside Finland, however, is not known. Aims: To establish the proportion of all psychotic and bipolar disorder diagnoses that occurred in individuals who had, at some stage in childhood and adolescence, attended CAMHS in Wales (United Kingdom). We also wished to identify whether, within CAMHS, certain risk markers were associated with increased psychosis risk.Method: We examined healthcare contacts for individuals born 1991-1998 (n=348,226), followed up to age 25-32 years. Using linked administrative healthcare records, we identified all psychotic and bipolar disorder diagnoses in the population and then identified the proportion of cases where the individual had attended CAMHS. Regression analyses were used to examine associations between sociodemographic and clinical risk markers with psychotic and bipolar disorder outcomes.Results: Of all individuals diagnosed with a psychotic or bipolar disorder by the study endpoint, 44.78% had, at some point in childhood or adolescence, attended CAMHS (HR = 6.28, 95% CI = 5.92-6.65). Low birthweight (OR = 1.33, 95% CI = 1.15-1.53), out-of-home care experience (OR = 2.05, 95% CI = 1.77-2.38), inpatient CAMHS admission (OR = 1.49, 95% CI = 1.29-1.72), and attending CAMHS in childhood (in addition to adolescence; OR = 1.16, 95% CI = 1.02-1.30) were all within-CAMHS risk markers for psychotic and bipolar disorders.Conclusions: A substantial proportion (45%) of future psychotic and bipolar disorder cases emerge in individuals who had attended CAMHS. This demonstrates important opportunities for early intervention and prevention at a greater scale than current strategies allow. |
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| Keywords: |
Child and adolescent psychiatry; bipolar type I or II disorders; psychotic disorders/schizophrenia; big data; epidemiology |
| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This project was funded by awards to IK from the Health Research Board (ECSA-2020-005), the Academy of Medical Sciences (APR8\1005), and the UK Department for Business, Energy and Industrial Strategy. |
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7 |