Teen risk factors for schizophrenia identified

NEW YORK (Reuters Health) - Five key factors can help predict whether at-risk young people will go on to develop schizophrenia, researchers have found.

The findings show that it is “feasible” to identify a person’s risk of schizophrenia as accurately as gauging his or her risk of heart disease or diabetes, and raise the possibility of preventing psychotic illness, Dr. Tyrone D. Cannon of the University of California, Los Angeles and colleagues say.

The earlier schizophrenia is identified and treated, the less damaging its course, they note in the Archives of General Psychiatry. However, current methods designed to predict schizophrenia risk are imprecise, they point out.

Cannon and his team followed 291 teenagers considered to be at high risk for developing schizophrenia for two-and-a-half years to look for a more accurate predictive technique. All of the study participants had been diagnosed with prodromal syndrome for schizophrenia, meaning they had non-specific symptoms such as paranoia, disorganized communication, and unusual thoughts that could signal the onset of full-blown disease.

Thirty-five percent of the study participants developed schizophrenia during the study. Five characteristics identified at the study’s outset sharply increased the likelihood that a teen would develop the disease: a genetic risk for schizophrenia combined with recent decline in function; higher levels of unusual thought content; more suspicion/paranoia; more social impairment; and past or current substance abuse.

Among people with two or three of these characteristics, 68 percent to 80 percent developed schizophrenia during the course of the study, the researchers report.

Cannon and his colleagues caution that the people in their study were seeking treatment, so the results can’t be applied to the general population. Nevertheless, they say their findings suggest that the first two-and-a-half years after a diagnosis of prodromal syndrome offer “a critical window of opportunity” for identifying brain changes that may lead to psychosis, and for intervening to slow or even prevent the development of psychosis and disability.

In an editorial accompanying the study, Dr. Patrick D. McGorry of the University of Melbourne, Victoria, Australia and colleagues write that large clinical trials are now needed to investigate early treatment of schizophrenia. “While there are risks in the endeavor to reshape the early course of schizophrenia and related psychoses, it is now within our grasp,” they conclude.

SOURCE: Archives of General Psychiatry, January 2008.