Adolescents exhibiting symptoms of mental disorders should be asked about hallucinations
Visual distortions and hallucinations related to an elevated risk of psychosis are linked to self-destructive thought processes among adolescents with psychological symptoms, according to a recent Finnish study. Early indications of the risk of psychosis can usually be detected long before the onset of a full-blown disorder.
Patients with schizophrenia are known to generally show a higher risk of suicide. Previous research on adolescents with psychological symptoms has also shown that self-destructive thought patterns are more common among those who show a higher risk of psychosis than those who do not show such a risk.
The risk of psychosis is evaluated on the basis of whether the patient has experienced psychosis-like episodes, which are milder and occur less frequently than fully developed psychosis.
A research group led by Docent Niklas Granö, PhD (Psychology), found self-destructive thought processes in one-third of the on average 15-year-old adolescents who were referred to the Early Psychosis Recognition and Intervention group at the HUCH Department of Psychiatry due to incipient mental disorders. The study indicated that all the risk symptoms of psychosis were more common in these adolescents than in those with psychological symptoms but no self-destructive thoughts. Depressive symptoms was also diagnosed more commonly in adolescents with risk symptoms of psychosis.
Visual distortions and hallucinations were symptoms particularly strongly linked to self-destructive behaviour.
"Our study shows that self-destructive thoughts emerge simultaneously with the risk symptoms of psychosis, that is, long before psychosis is manifest," Granö explains. "School health care, for example, should pay early attention to potential self-destructive thoughts and risk symptoms of psychosis in adolescents with mental issues."
"Since visual distortions or hallucinations are most clearly linked to self-destructive thoughts, adolescents should be asked directly whether they have ever suffered from them," Granö adds.
The cross-sectional study conducted at the Helsinki University Central Hospital studied 309 adolescents who were participating in the Jorvi Early Psychosis Recognition and Intervention (JERI) research project of the HUCH Department of Psychiatry from 2009 to 2013. At the beginning of their treatment contact, the participants completed surveys measuring symptoms of depression, psychosis risk symptoms and self-destructive thought processes. They were also interviewed for risk symptoms of psychosis.