Citation

Raballo A, Schultze-Lutter F, Armando M. Front. Psychiatry 2021; 12: e812229.

Copyright

(Copyright © 2021, Frontiers Media)

DOI

10.3389/fpsyt.2021.812229

PMID

34992558

PMCID

PMC8724427

Abstract

Serious Mental Illnesses (SMI), such as depressive, bipolar, and psychotic disorders, often start in childhood and adolescence, are the leading cause of disability in young people and tend to cause life-long disability (1-4). SMI are commonly considered to originate from multiple, unfavorable and developmentally relevant gene-environment interactions; yet, the cause (or, more plausibly, the diachronic constellation of determinants and precipitating factors) of the SMI in an individual patient is usually unknown (5). Among epidemiological predictors, family disposition and early onset of mental problems are well-established predictors of SMI, in particular, when combined (6, 7). Furthermore, having a family member suffering from SMI profoundly affects family dynamics, e.g., by increasing expressed emotions, or by decreasing the patient's ability to support other family members while simultaneously increasing his or her need for their support (8, 9). On a converging line, it has been recently confirmed that, for example, preventive interventions targeting the offspring of parents with SMI have tangible prognostic impact both in terms of reduced incidence of mental illness in children and attenuation of internalizing symptoms (10, 11). However, within the framework of the early detection of psychosis, a positive family history of psychosis even in combination with a recent drop in functioning was an insufficient predictor of a conversion to first-episode psychosis by itself when compared to symptom-based risk criteria (12-14). Thus, contemporary clinical applied research on the early detection of SMI, even in its most developmentally-oriented branches, typically emphasizes an indicated approach based on subtle psychopathological antecedents (e.g., attenuated positive symptoms and basic symptoms [BS] as included in Clinical High Risk [CHR] criteria, anomalous subjective experiences, and schizotypal traits) (15) while the best strategy to incorporate evidence-based, transgenerational familial risk features still warrants more research (14, 16). Therefore, addressing the need of care and developing suitable early identification strategies for familial or genetic high-risk, and other young vulnerable groups is essential (11, 16-23).

In light of the above, this Research Topic aimed to disentangle some of the complexities in the field of children, adolescents and families with SMI, to advance knowledge on young people and families suffering from or being at risk of developing SMI and set the stage toward a comprehensive early identification of risk for SMI in children and adolescents...

Language: en

Keywords

prevention; prognosis; suicide; psychopathology; developmental; family; high risk; severe mental disorder