A groundbreaking international study of more than 1,000 adolescents and young adults at risk for psychosis found that social and academic difficulties emerge years before clinical symptoms appear, presenting an important opportunity for early intervention.

Psychosis, a symptom of mental illness, refers to a mental state in which a person loses contact with reality and is accompanied by hallucinations, delusions, or difficulty deciphering reality.

this research One of the first papers to analyze data from Accelerating Pharmaceutical Partnerships Schizophrenia This project was the largest and most diverse international study of psychosis risk to date.

led by an assistant professor henry cowanMichigan State University researchers worked closely with an international consortium at 43 international locations and recruited participants from 13 countries. Researchers completed clinical interviews, cognitive tests, and symptom assessments.

This study found that functional decline and negative symptoms appear to develop long before psychosis risk syndromes are identified. Social and academic struggles during childhood strongly predicted later negative symptoms and cognitive impairment.

Negative symptoms, particularly lack of motivation and pleasure, have long been the most obvious marker of functional problems, even when depression and anxiety are controlled. These patterns were consistent across early and late symptom onset.

However, the researchers also found that the reduction in psychotic symptoms (low-level hallucinations and delusions that appear before the first true psychotic episode) was not related to the level of functioning before symptoms of psychosis risk appeared.

“Psychotic disorders are very disabling, and the prognosis remains poor for many people. This study shows that by the time symptoms of psychosis risk appear, many years of functional decline may already have occurred,” said Cowan, a co-author of the study and a professor at MSU. Faculty of Psychology. “Early social and academic problems are important developmental signals that emerge during critical developmental periods years before actual clinical symptoms appear.”

This study highlights the need for clinicians to recognize and address social and academic challenges during critical developmental periods.

“We hope this study will encourage clinicians and researchers to consider the risk of serious mental illness earlier and more broadly,” Cowan said. “Rather than narrowly focusing on psychotic symptoms, the findings support early intervention strategies that target developmental issues such as motivation, social engagement, and cognitive function, which may be more closely related to long-term outcomes.”