Probing the roots of psychotic symptoms A significant proportion of young people experience psychotic symptoms in childhood, which leaves them at higher risk of developing mental ill-health later in life. The iHEAR project brings together researchers in several disciplines to probe deeper into the roots of psychotic experiences in childhood and the longer term outcomes, as Professor Mary Cannon explains. A number of
different symptoms are associated with psychotic disorders, including hearing voices and delusional beliefs. These types of experiences are more common than might be expected, with emerging evidence that a significant proportion of young people have experienced them at some point in their lives. “In my study I distributed questionnaires to 11-13 year old children in schools. Around 20 percent of students ticked a box saying that they had experienced one of a list of seven symptoms associated with psychotic disorders. When we interviewed them we found that they were indeed suffering these symptoms,” says Mary Cannon, Professor of Psychiatric Epidemiology and Youth Mental Health at the Royal College of Surgeons in Ireland (RCSI). As the Principal Investigator of the iHEAR project, Professor Cannon aims to help build a fuller understanding of the young people who experience these symptoms. “We are trying to increase our knowledge about the young people who describe these symptoms, why they experience these symptoms and their outcomes,” she outlines.
iHEAR project This work is multi-disciplinary in scope, bringing together researchers in epidemiology, social science and neuroscience to develop a broad perspective on psychotic symptoms in young people. Researchers have data on a large cohort of young people, from which Professor Cannon hopes to gain some deeper insights. “We have information on whether these children have experienced these symptoms by the age of 13. That will allow us to look at risk factors in a large population,” she explains. Another strand of her research involves brain imaging and detailed psychological testing. A further strand involves conducting in-depth interviews with a smaller group of young people who experienced psychotic symptoms at an earlier point in their lives. “We want to find out what’s been going on in their lives. What may have triggered these symptoms? What stresses were they undergoing?” says Professor Cannon. “I’m interested in whether an accumulation of trauma or adversity in childhood could lead to an increased risk of psychotic symptoms.”
26
Above: The iHEAR team: from left to right – Helen Coughlan, Colm Healy, Prof Mary Cannon, Dr Aisling O’Neill, Eleanor Carey. Right: iHEAR team members Colm Healy and Aisling O’Neill at the College of Psychiatrists of Ireland Spring Meeting, March 2019.
individuals may be pre-disposed to developing a disorder, in others it may be that a particular risk factor led to them developing a condition when they wouldn’t have otherwise. “One thing I’m very interested in is cannabis use. Can that trigger a psychotic disorder later in life in a young person who may not otherwise have
the ones we don’t have to worry about?” she asks. “That’s very important for designing an intervention, as you don’t want to be subjecting a child to treatment when they don’t need it.” Results emerging already from Professor Cannon’s team suggest that self-esteem is very important in modifying the risk of
Around 20 percent of 11 to 13 year olds ticked a box saying that they had experienced one of a list of seven symptoms associated with psychotic disorders. When we interviewed them we found that they were
iHEAR Investigating the meanings and mechanisms of psychotic experiences in young people: a novel, mixed-methods approach Project Objectives
The objectives of the iHEAR project are to investigate the meanings and mechanisms of psychotic experiences in young people and to advance understanding of why some young people who report psychotic symptoms are at greater risk of poorer outcomes later in life.
Project Funding
The project is funded by European Research Council. Funding amount: €1.78 million.
indeed experiencing these symptoms.
Project Partners
developed it?” says Professor Cannon. “This is something that we will be able to explore in greater depth as the cohort grows older.” A firmer evidence base in this area could lead to the development of interventions designed to prevent mental illness in at-risk groups. Quite a number of adverse outcomes are associated with psychotic symptoms in young people, with evidence suggesting that they are more likely to experience anxiety and depression. “This doesn’t mean that all young people who experience psychotic symptoms will go on to develop mental illness, but some of them may be affected,” continues Professor Cannon. Some young people report these symptoms in early adolescence but then don’t report them again, another area of interest to Professor Cannon. “Is there any way we can predict which young people will go on experiencing these symptoms, and which are
Contact Details
developing a mental illness. Young people with high self-esteem seem to be better equipped to overcome adversities in life, which could represent a potential avenue for intervention,Professor Cannon says there are also other possibilities. “The issue of parentchild attachment is an area where it could be possible to intervene and help reduce the risk of experiencing these symptoms,” she outlines. The wider aim with this research is to help identify those young people who may be at risk of developing serious mental health difficulties later in life, and potentially develop effective interventions. “We could perhaps develop interventions tailored to individual needs, or maybe groups of young people within the population who report these symptoms and experiences,” says Professor Cannon. “We may be able to identify sub-groups who would benefit from specific types of treatments.”
• Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland Project Coordinator, Professor Mary Cannon MB BCh BAO, FRCPsych, MSc, PhD RCSI Psychiatry Royal College of Surgeons in Ireland RCSI Education & Research Centre, Beaumont Hospital, Beaumont Dublin 9 Ireland T: +35 3 1-809 3855 E: marycannon@rcsi.com W: www.rcsi.com
Transforming Healthcare Education, Research and Service: RCSI Strategic Plan 2018-2022 Professor Mary Cannon
Below: iHEAR team member Eleanor Carey presenting her work at the RCSI Research Day 2019.
Adversity in this context does not necessarily mean serious cases of abuse and neglect, but rather relatively common experiences that can nevertheless leave a significant mark on young people. Childhood adversities could involve going through parental conflict, bullying, or the loss of a grandparent for example. “These things all cause difficulties for young children,” stresses Professor Cannon. Some children may be able to overcome these difficulties, while others struggle. “Bullying can be incredibly painful for some young people for example, while others are very resilient. We’ve seen some young people who’ve come through horrendous bullying and done very well,” says Professor Cannon. “They’ve been able to overcome difficulties by volunteering for instance, or helping other people – that seems to be very important.”
Mary Cannon is Professor of Psychiatric Epidemiology and Youth Mental Health in the Department of Psychiatry, Royal College of Surgeons in Ireland. She also works as a consultant psychiatrist in Beaumont Hospital Dublin. Her longstanding research interest is in the area of childhood and adolescent risk and protective factors for adult mental.
There are others who are less resilient however, and their experiences during their youth may leave them at higher risk of developing a disorder later in life. While some
EU Research
www.euresearcher.com
27