DETECT, Early Intervention in Psychosis Service, Co. Dublin, Ireland.
School of Medicine, University College Dublin, Dublin 4, Ireland.
Child Adolesc Ment Health. 2024 Sep;29(3):316-318. doi: 10.1111/camh.12713. Epub 2024 Apr 11.
The detection of psychosis and its prodrome have unique considerations in a child and adolescent population. Young people attending CAMHS are already a high-risk group, which confers significant limitations in applying the current clinical high-risk (CHR) model. This has catalysed calls for a transdiagnostic approach to psychosis risk prediction, but without a clear pathway forward. We contribute to the debate opened by Salazar de Pablo and Arango (2023, Child and Adolescent Mental Health) on the role of CAMHS in this initiative. CAMHS have a key role in developing comprehensive longitudinal datasets to inform risk models. Closer integration with early intervention in psychosis (EIP) services will be needed to realise this potential. This integration is also required to reliably detect prodromes and emerging psychosis in young people. Where there is robust evidence to support prevention initiatives, we should proceed with their implementation, even in the absence of enhanced risk models.
在儿童和青少年人群中,精神病的检测及其前驱期具有独特的考虑因素。已经在儿童和青少年心理健康服务机构(CAMHS)就诊的年轻人属于高风险群体,这对应用当前的临床高危(CHR)模型造成了重大限制。这促使人们呼吁采用一种针对精神病风险预测的跨诊断方法,但目前还没有明确的前进道路。我们为 Salazar de Pablo 和 Arango(2023,儿童和青少年心理健康)在 CAMHS 在这一倡议中的作用方面展开的辩论做出了贡献。CAMHS 在开发全面的纵向数据集以告知风险模型方面发挥着关键作用。需要与精神病早期干预(EIP)服务更紧密地结合,才能实现这一潜力。这种整合也是可靠地检测年轻人前驱期和早期精神病所必需的。在有强有力的证据支持预防举措的情况下,即使没有增强的风险模型,我们也应该着手实施这些举措。