Predicting serious mental illness in youth

Serious mental illnesses (SMIs) such as recurrent unipolar depression, psychotic or bipolar disorder have multi-factorial causes, resulting from interactions among biological, clinical and psychosocial factors, including, but not limited to, stress, early trauma, and the use of psychoactive drugs.
Currently, if a young adult experiences mild behavioural disturbances, there is no way to determine if they will go on to develop an illness, what that illness will be, and what can be done to change its course and prevent its worsening to an SMI. Understanding the interplay of risk factors that determine the onset of SMI therefore relies on learning about the effects that key risk factors exert on the neurobiology of the developing brain.

For this project, Jean Addington and her team of researchers at the University of Calgary and the University of Toronto are aiming to identify youth at risk before they develop a SMI so that intervention can begin as soon as possible. At the same time, they are trying to understand the triggers of SMI. To do this work, they have brought together researchers who study psychotic and mood disorders, along with imaging specialists and basic scientists.

Their project involves following a large group of youth in both Calgary and Toronto, aged 14-25, who are at different stages of risk for developing SMI. They assess a wide range of clinical and psychosocial factors in order to determine the ones that can be used to predict key outcomes. Risk factors being looked at include increasing disability, secondary substance misuse, not participating in education or employment, new selfharm and worsening physical health, as well as SMI development.

They perform brain scans of each study participant to investigate whether neuroimaging can distinguish youth who will develop SMI from those who will not. They also collect and analyze blood in order to cast light on the biological factors that may contribute to SMI development in youth.

At the end of the project they will have a comprehensive database of demographic, clinical, imaging, genetic and biochemical data that will be combined to create prediction models that categorize youth across a range of risk severity for developing SMI. This information will eventually feed into national and provincial programs to optimize prevention and early intervention services.

Having just finished the second year of the grant, the team has recruited over 80% of participants at the Calgary site and just over 50% at the Toronto site. They expect to have full recruitment by the end of the summer of 2017.

“ This project will generate fundamental knowledge about the impact of key risk factors, such as stress and substance use, on the developing adolescent brain. ”

— Jean Addington, Ph.D. University of Calgary