Staging's determinants in early intervention youth: a retrospective study

Mirvat Hamdan; Laurent Lecardeur; Marine Habert; Mireille Okassa; Aurélie Lacroix; Benjamin Calvet

doi:10.1016/j.encep.2023.08.015

Staging's determinants in early intervention youth: a retrospective study

Encephale. 2023 Nov 18:S0013-7006(23)00179-3. doi: 10.1016/j.encep.2023.08.015. Online ahead of print.

Authors

Mirvat Hamdan¹, Laurent Lecardeur², Marine Habert³, Mireille Okassa⁴, Aurélie Lacroix⁵, Benjamin Calvet⁵

Affiliations

¹ Department of Adult Psychiatry, Early Intervention Unit, Centre Hospitalier Esquirol, 87000 Limoges, France; Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France; Inserm UMR1094, IRD U270, University Limoges, CHU de Limoges, EpiMaCT- Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France. Electronic address: mirvat.h@gmail.com.
² 08, quai des Docks, 06300 Nice, France.
³ Department of Adult Psychiatry, Early Intervention Unit, Centre Hospitalier Esquirol, 87000 Limoges, France.
⁴ Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France.
⁵ Unité de Recherche et d'Innovation, Centre Hospitalier Esquirol, Limoges, France; Inserm UMR1094, IRD U270, University Limoges, CHU de Limoges, EpiMaCT- Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.

PMID: 37985255
DOI: 10.1016/j.encep.2023.08.015

Abstract

Objectives: Since 2019 our early intervention unit has assessed help-seekers, mainly referred by psychiatric departments, and we have conducted a descriptive retrospective study. Our objective was to identify clinical determinants associated to staging at assessment for our three groups: "no psychosis", "ultra-high risk" and "first episode psychosis".

Methods: One hundred and thirteen participants (mean age 20.05±3.28) were enrolled, mainly referred by adult psychiatry (81.4%). We tested the association of each group with the following determinants: age, gender, family history of psychosis, referral (adolescent or adult psychiatry), cognitive, depressive complaint, cannabis active consumption, and current activity (scholar or employment).

Results: Multivariate analyses showed significant association with depressive symptoms (P=0.019) but an absence of family history of psychosis (P=0.002) or current activity (P=0.09) for "no psychosis" group. "Ultra-high risk" was significantly correlated with a family history of psychosis (P=0.001) and adolescent psychiatry referral (P=0.044) but an absence of depressive complaint (P=0.04). As for "first episode psychosis", we found significant cognitive complaint (P=0.026), family history (P=0.024) and current activity (0.026).

Conclusions: As all our participants were seen in tertiary care, adolescent psychiatrists were more efficient in detecting a high-risk state. "No psychosis" help-seekers presented in fact mood issues, which have been confused with attenuated psychotic symptoms by their addressers, who have probably been misled by their absence of activity integration. High-risk and characterized psychotic episodes were logically correlated with family history. Surprisingly, "first episode psychosis" youth were currently integrated in scholarly or professional life despite an active cognitive complaint. Robust studies, especially prospective cohorts, are needed to test these associations.

Keywords: Activité maintenue; Adressage; Early intervention; First episode psychosis; Intervention précoce; Maintained activity; Premier épisode psychotique; Referral; Ultra-high risk; État mental à risque.