Emory University in Atlanta is playing a key role in the largest, most comprehensive study ever funded by the National Institute of Mental Health (NIMH) of adolescents and young adults at risk for developing a psychotic disorder.
The five-year, $25-million study joins the resources of Emory and seven other major research universities, with the goal of identifying more precise predictors for psychosis, and a better understanding of the neural mechanisms involved.
"This is a critical, watershed study," said Elaine Walker, Samuel Candler Dobbs Professor of Psychology and Neuroscience at Emory. "To date, no one has systematically studied brain development, patterns of electrical brain activity and changes in gene expression in youth at risk for psychosis."
Schizophrenia, the most extreme psychosis, affects about 1 percent of the population and can have devastating consequences. Most people diagnosed with schizophrenia are unable to hold a job or live independently for most of their lives. They often suffer from homelessness, major depression and anxiety disorders.
"Because schizophrenia is severely debilitating, usually chronic and very costly, preventing its onset has become a major area of emphasis of the NIMH," said Walker, who has studied the origins and precursors of psychosis for 30 years.
Early Diagnosis Critical for Teens
The typical onset of schizophrenia and other psychotic disorders is about 21 years of age, with warning signs beginning, on average, around age 17. Studies have shown that about 30 to 40 percent of prodromal teenagers – those showing warning signs – will develop schizophrenia or another psychotic disorder. About 25 percent of the prodromal teens continue to experience mild symptoms without getting worse, while the remaining 35 percent get better as they enter adulthood.
"We are hoping to get to the point where we can identify people who will cross the threshold into psychosis with 85 to 95 percent accuracy, instead of 30 to 40 percent," Walker said. "Evidence has been accumulating that, not only are there brain abnormalities in people with psychotic disorders, the brain abnormalities get worse the longer the patient goes untreated."
While anti-psychotic drugs can be effective, they also have serious side effects, so physicians are hesitant to recommend them until someone enters the clinical stages of psychosis.