The psychosis risk timeline: can we improve our preventive strategies? Part 2: adolescence and adulthood

2019 ◽  
Vol 25 (05) ◽  
pp. 309-320
Author(s):  
Karen Romain ◽  
Alexandra Eriksson ◽  
Richard Onyon ◽  
Manoj Kumar
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young People ◽  
Substance Misuse ◽  
Learning Objectives ◽  
Current Evidence ◽  
Psychotic Symptoms ◽  
List Type ◽  
Preventive Strategies ◽  
Psychosis Risk

SUMMARYCurrent understanding of psychosis development is relevant to patients' clinical outcomes in mental health services as a whole, given that psychotic symptoms can be a feature of many different diagnoses at different stages of life. Understanding the risk factors helps clinicians to contemplate primary, secondary and tertiary preventive strategies that it may be possible to implement. In this second article of a three-part series, the psychosis risk timeline is again considered, here focusing on risk factors more likely to be encountered during later childhood, adolescence and adulthood. These include environmental factors, substance misuse, and social and psychopathological aspects.LEARNING OBJECTIVES:After reading this article you will be able to: •understanding the range of risk factors for development of psychotic symptoms in young people and adults•understand in particular the association between trauma/abuse and subsequent psychosis•appreciate current evidence for the nature and strength of the link between substance misuse and psychosis.DECLARATION OF INTEREST:None.

The psychosis risk timeline: can we improve our preventive strategies? Part 3: primary common pathways and preventive strategies

2019 ◽  
Vol 25 (05) ◽  
pp. 321-332
Author(s):  
Karen Romain ◽  
Alexandra Eriksson ◽  
Richard Onyon ◽  
Manoj Kumar
Keyword(s):  
Risk Factors ◽  
Psychiatric Disorders ◽  
Recent Literature ◽  
Learning Objectives ◽  
List Type ◽  
Preventive Strategies ◽  
Psychosis Risk ◽  
Preventive Work ◽  
Key Aspects ◽  
Inflammatory Changes

SUMMARYPsychosis is a recognised feature of several psychiatric disorders and it causes patients significant distress and morbidity. It is therefore important to keep knowledge of possible risk factors for psychosis up to date and to have an overview model on which further learning can be structured. This article concludes a three-part series. It gives a review of evidence regarding common pathways by which many risk factors come together to influence the development of psychosis and finalises our suggested overview model, a psychosis risk timeline. The three primary pathways considered are based on the major themes identified in this narrative review of recent literature and they focus on neurological, neurochemical and inflammatory changes. We link each back to the factors discussed in the first and second parts of this series that alter psychosis risk through different mechanisms and at different stages throughout life. We then consider and summarise key aspects of this complex topic with the aim of providing current and future clinicians with a model on which to build their knowledge and begin to access and understand current psychosis research and implications for future preventive work.LEARNING OBJECTIVESAfter reading this article you will be able to: •give an overview of common pathways thought to link identified risk factors with psychosis development•understand neurochemical, neurostructural and inflammatory changes associated with psychosis•demonstrate increased knowledge of possible preventive strategies.DECLARATION OF INTERESTNone.

The psychosis risk timeline: can we improve our preventive strategies? Part 1: early life

2019 ◽  
Vol 25 (05) ◽  
pp. 299-308
Author(s):  
Karen Romain ◽  
Alexandra Eriksson ◽  
Richard Onyon ◽  
Manoj Kumar
Keyword(s):  
Risk Factors ◽  
Early Life ◽  
Clinical Utility ◽  
Learning Objectives ◽  
List Type ◽  
Preventive Strategies ◽  
Wide Range ◽  
Psychosis Risk ◽  
Key Aspects

SUMMARYPsychosis is a complex presentation with a wide range of factors contributing to its development, biological and environmental. Psychosis is a feature present in a variety of psychiatric disorders. It is important for clinicians to keep up to date with evidence regarding current understanding of the reasons psychosis may occur. Furthermore, it is necessary to find clinical utility from this knowledge so that effective primary, secondary and tertiary preventative strategies can be considered. This article is the first of a three-part series that examines contemporary knowledge of risk factors for psychosis and presents an overview of current explanations. The articles focus on the psychosis risk timeline, which gives a structure within which to consider key aspects of risk likely to affect people at different stages of life. In this first article, early life is discussed. It covers elements that contribute in the prenatal and early childhood period and includes genetic, nutritional and infective risk factors.LEARNING OBJECTIVESAfter reading this article you will be able to: •give an up-to-date overview of psychosis risk factors that can affect early life•describe some important genetic risk factors•understand more about the role of environmental factors such as nutrition and infection.DECLARATION OF INTERESTNone.

scholarly journals Pandemic and student mental health: A cross-sectional and longitudinal analysis of mental health symptoms amongst university students and young adults after the first cycle of lockdown in the UK

2021 ◽  
Author(s):  
Nicole Tang ◽  
Katharine McEnery ◽  
Laura Chandler ◽  
Carla Toro ◽  
Lukasz Walasek ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young People ◽  
University Students ◽  
Substance Misuse ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
The Uk ◽  
Anxiety Depression ◽  
The Impact

BackgroundEarly COVID-19 research suggests a detrimental impact of the initial lockdown on youngpeople’s mental health, but it is unclear whether the impact would persist.AimsWe investigated mental health symptoms amongst university students after the firstlockdown in the UK and changes in symptoms over 6 months. We examined risk factors forthese symptoms and whether they were shared by young people not in higher education.Method895 university students and 547 young people not in higher education completed an onlinesurvey at T1 (July-September 2020). A subset of 203 university students also completeda 6-month follow-up survey at T2 (January-March 2021). Mental health symptomsmeasured were anxiety, depression, insomnia, substance misuse, and suicide risk.ResultsAt T1, nearly 40% of the participants reported moderate to severe symptoms of anxiety anddepression and risk of substance misuse; a quarter reported insomnia and clinicallysignificant suicidal risk. A reduction in anxiety, depression and insomnia was observed inparticipants reassessed at T2, but not in substance misuse and suicidality.Cross-sectionally, greater symptoms across measures were consistently associated withgender (female or other), sleep irregularity, and a worse-off financial status. Longitudinally,the most consistent risk factors for T2 symptoms were having previously diagnosed mentalhealth problems and having difficulty sleeping since the first lockdown.ConclusionsMental health symptoms were prevalent in a large proportion of young people after the firstlockdown. Risk factors identified may help characterise high-risk groups for enhancedsupport and inform interventions in both university and non-university settings.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

scholarly journals Sleep disordered breathing at the extremes of age: the elderly

Breathe ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 50-60 ◽  
Author(s):  
Alison McMillan ◽  
Mary J. Morrell
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Sleep Disordered Breathing ◽  
Treatment Options ◽  
Current Evidence ◽  
List Type ◽  
Pressure Therapy ◽  
Age Related ◽  
The Impact ◽  
Disordered Breathing

Key pointsSleep disordered breathing (SDB) is common and its prevalence increases with age. Despite this high prevalence, SDB is frequently unrecognised and undiagnosed in older people.There is accumulating evidence that SDB in older people is associated with worsening cardio- cerebrovascular, cognitive and functional outcomes.There is now good evidence to support the use of continuous positive airway pressure therapy in older patients with symptomatic SDB.Educational aimsTo highlight the prevalence and presentation of sleep disordered breathing (SDB) in older people.To inform readers about the risk factors for SDB in older people.To explore the impact of SDB in older people.To introduce current evidence based treatment options for SDB in older people.Sleep disordered breathing (SBD) increases in prevalence as we age, most likely due to physiological and physical changes that occur with ageing. Additionally, SDB is associated with comorbidity and its subsequent polypharmacy, which may increase with increasing age. Finally, the increased prevalence of SDB is intrinsically linked to the obesity epidemic. SDB is associated with serious outcomes in younger people and, likewise, older people. Thus, identification, diagnosis and treatment of SDB is important irrelevant of age. This article reviews the age-related changes contributing to SDB, the epidemiology and the risk factors for SDB in older people, the association of SDB with adverse outcomes, and diagnostic and treatment options for this population.

scholarly journals Sleep disorders in psychiatry

2018 ◽  
Vol 24 (4) ◽  
pp. 273-283 ◽  
Author(s):  
Hugh Selsick ◽  
David O'Regan
Keyword(s):  
Mental Health ◽  
Sleep Disorders ◽  
Sleep Medicine ◽  
Sleep Apnoea ◽  
Learning Objectives ◽  
List Type ◽  
Obstructive Sleep ◽  
Psychiatric Conditions ◽  
Respiratory Conditions ◽  
Broad Understanding

SUMMARYSleep medicine is a truly multidisciplinary field that covers psychiatric, neurological and respiratory conditions. As the field has developed it has become increasingly clear that there is a great deal of overlap between sleep and psychiatric disorders and it is therefore essential for psychiatrists to have some knowledge of sleep medicine. Even those disorders, such as obstructive sleep apnoea, that may seem to be outside the remit of psychiatry can have complex and important interactions with psychiatric conditions. In this article we give a brief overview of the range of sleep disorders a psychiatrist might encounter, how they are recognised, investigated and treated, and how they relate to psychiatric conditions.LEARNING OBJECTIVES•Be aware of the range of sleep disorders that might be encountered in psychiatric practice•Understand how these sleep disorders affect mental health•Have a broad understanding of how these disorders are investigated and treatedDECLARATION OF INTERESTH.S. has accepted speaker fees from Janssen Pharmaceuticals.

Validation of the Massachusetts Youth Screening Instrument with a looked after population

2018 ◽  
Vol 24 (3) ◽  
pp. 593-607
Author(s):  
Claire Reilly ◽  
Dan R Johnson ◽  
Kirstin Ferguson
Keyword(s):  
Mental Health ◽  
Young People ◽  
Substance Misuse ◽  
Factor Model ◽  
Screening Instrument ◽  
Mental Health Needs ◽  
Education And Care ◽  
Good Internal Consistency ◽  
Health Need ◽  
Massachusetts Youth Screening Instrument

The Massachusetts Youth Screening Instrument–version 2 (MAYSI-2) was developed to help identify mental health needs of young people admitted to youth detention centres. Only one study has applied the tool to a UK population and none have looked at young people who live in residential and secure care in Scotland. This study aimed to assess the validity of the MAYSI-2 in Scotland with a looked after and accommodated population. Boys and girls in a large education and care centre were asked to complete the MAYSI-2 within 72 hours of being accommodated. A total of 168 males and 69 females with a mean age of 15 completed the tool. Substantial levels of mental health need were identified. Girls appeared to have higher needs on all areas, bar alcohol and substance misuse. The MAYSI-2 had good internal consistency and exploratory factor analysis showed good overlap with the tool’s original factor model. As a result, there can be more confidence in the validity and consistency of the tool with this population. This is also further evidence of the high need of this population, particularly girls.

Punch injury self-harm in young people

2016 ◽  
Vol 22 (2) ◽  
pp. 318-325
Author(s):  
Cristal Oxley ◽  
Jane E Roberts ◽  
Sebastian Kraemer ◽  
Giles Armstrong
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
High Risk ◽  
Young People ◽  
Medical Records ◽  
Substance Misuse ◽  
Total Group ◽  
Effective Interventions ◽  
Male Preponderance ◽  
Self Harm

Punch injuries are a form of self-harm characterised by the intentional act of striking an object with a closed fist. We aimed to describe the characteristics and trends in young people presenting with injuries sustained via the punch mechanism. A comprehensive retrospective review of medical records was completed of all young people aged 10–18 years presenting to our Central London Emergency Department over a 12-month period. A subset of the total group was identified as the punch injury subgroup. A total of 78 punch injury presentations were identified. In this subgroup, the male:female ratio is 4.57:1; 37.18% of presentations were associated with a fracture ( n = 29) and 35.90% ( n = 28) of patients re-presented following another punch injury, as a victim of violence, or by other psychiatric presentation. In conclusion, a male preponderance was observed, with frequent re-presentations, often in high-risk circumstances. An opportunity for screening, including mental health, social and substance misuse, was identified. Further research is needed to enable targeted effective interventions in this group.

scholarly journals Seeking sanctuary: rethinking asylum and mental health

2020 ◽  
Vol 29 ◽  
Author(s):  
Sohail Jannesari ◽  
Stephani Hatch ◽  
Siân Oram
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mental Disorder ◽  
Forced Migration ◽  
List Type ◽  
Policy Responses ◽  
Legal Term ◽  
Core Set ◽  
Increased Risk ◽  
Potential Risk Factors

Abstract Forced migrants are at an increased risk of mental disorder compared to host country populations. To effectively address this, programmatic and policy responses need to be underpinned by rigorous evidence. Drawing on our experience conducting a systematic review of post-migration risk factors for mental disorder among asylum seekers and our appraisal of related systematic reviews, this paper discusses four challenges facing the field: (1) The reliance on Western conceptions of mental health. (2) The investigation, to date, of a relatively narrow range of potential risk factors. (3) The lack of consistency in the measurement and reporting of risk factor variables. (4) The use of the legal term ‘asylum seeker’ to define study populations. We suggest potential ways forward, including using mental health measures developed in collaboration with communities affected by forced migration, the examination of key risk factors around homelessness and workers' rights, the development of a core set of risk factors to be investigated in each study, and defining study populations using the conceptual category of ‘sanctuary seekers’ – people who have fled their country and are asking another country for safety and residence.

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