Brian O'Donoghue1, John Lyne2, Kevin Madigan3, Abbie Lane4, Niall Turner5, Eadbhard O'Callaghan6, Mary Clarke7. 1. Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia. Electronic address: briannoelodonoghue@gmail.com. 2. DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: john.paul.lyne@gmail.com. 3. Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Institute of Leadership, Royal College of Surgeons, Ireland. Electronic address: kevin.madigan@hotmail.com. 4. University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: abbielane0@gmail.com. 5. DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland. Electronic address: niall.turner@sjog.ie. 6. DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland. 7. DETECT Early Intervention for Psychosis Service, Avila House, Blackrock Business Park, Dublin 4, Ireland; University College Dublin, Belfield, Dublin 4, Ireland. Electronic address: mary.clarke@sjog.ie.
Abstract
OBJECTIVE: Factors that influence the age at onset in psychotic disorders could provide valuable insights into precipitating or causative factors of the disorder. Despite being established risk factors, it is not yet known whether migration status, place of birth, social class at birth and season of birth influence the age at onset of psychotic disorders. This study aimed to determine whether these environmental factors, in addition to cannabis abuse and obstetric complications, influence the age at onset. Additionally, we investigated whether environmental factors could have a cumulative effect on the age at onset. METHOD: Data was obtained from two first episode of psychosis (FEP) cohort studies. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses. RESULTS: The age at onset was determined for 555 individuals with a FEP and the median age at onset was 27.3years. Individuals with a history of cannabis abuse had an earlier age at onset by nearly six years. There was a trend for a history of obstetric complications to be associated with a younger age at onset by 2.7years and this was significant in the subgroup with a family history of psychosis. Social class at birth, migration status, place of birth and season of birth were not associated with the age at onset. Exposure to a higher number of environmental factors was associated with an earlier age at onset. CONCLUSIONS: Cannabis and obstetric complications are associated with an earlier age at onset and there appears to be a cumulative effect of exposure to multiple environmental factors.
OBJECTIVE: Factors that influence the age at onset in psychotic disorders could provide valuable insights into precipitating or causative factors of the disorder. Despite being established risk factors, it is not yet known whether migration status, place of birth, social class at birth and season of birth influence the age at onset of psychotic disorders. This study aimed to determine whether these environmental factors, in addition to cannabis abuse and obstetric complications, influence the age at onset. Additionally, we investigated whether environmental factors could have a cumulative effect on the age at onset. METHOD: Data was obtained from two first episode of psychosis (FEP) cohort studies. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses. RESULTS: The age at onset was determined for 555 individuals with a FEP and the median age at onset was 27.3years. Individuals with a history of cannabis abuse had an earlier age at onset by nearly six years. There was a trend for a history of obstetric complications to be associated with a younger age at onset by 2.7years and this was significant in the subgroup with a family history of psychosis. Social class at birth, migration status, place of birth and season of birth were not associated with the age at onset. Exposure to a higher number of environmental factors was associated with an earlier age at onset. CONCLUSIONS: Cannabis and obstetric complications are associated with an earlier age at onset and there appears to be a cumulative effect of exposure to multiple environmental factors.
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