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Early Detection of Severe Mental Illness to Improve Treatment Interventions

As with other forms of chronic disease, the early detection of severe mental illness (SMI) maybe beneficial to the advancement of preventive intervention measures and to the comprehension of mechanisms that lead to psychosis. Given that about half of Americans will meet the criteria for a DSM-IV disorder at some point in their lifetime, early detection and intervention of psychotic disorders is particularly relevant.[1]

SMI has traditionally been diagnosed through the analysis of behavioral symptoms, however these symptoms are thought to be late manifestations in a longer process of psychosis conversion. Many studies are now focusing on the relevance of the prodromal phase of SMI, the period of degeneration prior to the full onset of psychotic symptoms.[2]

Initiated in 2003, the NIMH-funded North American Prodrome Longitudinal Study (NAPLS) has evaluated clinical and psychosocial data among patients who were identified for a prodromal risk syndrome in an effort to predict SMI in its early stages. Participants of the study were identified as prodromal based on criteria that included the onset or worsening of psychotic symptoms, family history of psychosis, and recent deterioration in functioning.[3] In a follow-up period of 2.5 years, 40% of study participants who were identified as prodromal later converted to psychosis.[4]

A number of studies have investigated the use of biological screening markers as early diagnosis measures the use of neuroimaging and neurocognitive testing in schizophrenia patients.  In one study, neurocognition-based classifiers showed some predictive power in determining later psychosis.[5] In another, the use of functional magnetic resonance imaging during eye tracking tasks among children revealed amplified blood flow in the hippocampus, a physiological dysfunction that is correlated with eventual diagnosis of schizophrenia.[6]

Although progress has been made in the early detection of SMI, challenges still remain in ascertaining prodromal markers for behaviorally defined disorders. Many potential screening factors have been postulated, but further analysis is necessary to determine which markers are truly correlated to later conversion of psychosis. Looking forward, early detection measures directed toward youth will be essential to the success of preventive interventions among SMI patients.[7]

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Who We Are

People With Disabilities Foundation is an operating 501(c)(3) nonprofit organization based in San Francisco, California, which focuses on the rights of the mentally and developmentally disabled.

Services

Advocacy: PWDF advocates for Social Security claimant's disability benefits in eight Bay Area counties. We also provide services in disability rights, on issues regarding returning to work, and in ADA consultations, including areas of employment, health care, and education, among others. There is representation before all levels of federal court and Administrative Law Judges. No one is declined due to their inability to pay, and we offer a sliding scale for attorney's fees.

Education/Public Awareness: To help eliminate the stigma against people with mental disabilities in society, PWDF's educational program organizes workshops and public seminars, provides guest speakers with backgrounds in mental health, and produces educational materials such as videos.

Continuing Education Provider: State Bar of California MCLE, California Board of Behavioral Sciences Continuing Education, and Commission of Rehabilitation Counselor Certification.