Jessica Hartmann1, Marieke Wichers2, Patrick McGorry1, Barnaby Nelson1; 1Orygen, the National Centre of Excellence in Youth Mental Health, University of Melbourne, 2Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
With more than half of mental disorders emerging by the age of 24, it is of utmost importance to be able to predict which help-seeking young people are at greatest risk of mental health deterioration. Mental health has increasingly been conceptualised as a complex system characterised by phase transitions, preceded by early warning signals. The aim of the current study is to predict ‘tipping points’ in mental health in at-risk young people by means of an early warning signal called ‘critical slowing down’. Using ecological momentary assessment in combination with actigraphy, N=10 help-seeking young people aged 12-24 are followed for four months to capture transitions to full-threshold disorder in real-time. The young people, part of a larger cohort study, are at pluripotential risk for developing full-threshold disorder (depression, psychosis, mania and borderline personality disorder) within a short (12-month) time frame. We present on this ongoing pilot study investigating critical slowing down in psychopathology (mood states and attenuated psychotic symptoms) and actigraphy preceding transitions from at-risk state (stage 1b) to full-threshold state (stage 2) or to remission (State 0). We expect to find an increase in temporal autocorrelation at-lag-1, variance and skewness in mood states and circadian activity prior to a transition. Data collection is expected to be completed by time of presentation. This new framework may represent a paradigm shift from static prediction approaches to dynamic, individualised models of psychosis prediction and may inform the development of new clinical identification tools and early and individualised interventions to prevent such transitions.
