A New Era for Psychotic Illness

Clinical Research Profile: Dr. Jean Addington

For psychotic illnesses such as schizophrenia, early detection is a key to effective treatment. At CAMH, identifying and treating early signs of psychosis is the focus of the PRIME (Prevention through Risk Identification, Management and Education) Clinic.

As a clinician-scientist and Director of the PRIME Clinic, Dr. Jean Addington’s research focuses on identifying people at risk for developing a psychotic illness and improving prediction of psychosis. She takes a psychosocial approach to developing interventions designed to help prevent or delay the onset of a psychotic illness.

Using newly established criteria, Dr. Addington is able to identify the 25 to 35 per cent of young people at risk for psychosis who are the most likely to actually develop a psychotic illness. These are people who already experience early warning signs such as social withdrawal, trouble thinking clearly, or confusion about what is real or imaginary. By focusing efforts on these high-risk individuals, “we have an opportunity to identify and treat young people in the very early stages of illness,” says Dr. Addington. “This means we may be able to help stop the illness from developing. At the very least, we can give them better tools to manage their illness, should it develop.”

Young people who come to the PRIME Clinic have been unable to find help elsewhere, and need support. They receive extensive assessment and treatment through the clinic’s research studies. These two studies are PREDICT and ADAPT.

PREDICT is a monitoring study that aims to improve the ability to identify people at risk of developing a psychotic illness. Most at-risk individuals who develop a psychotic illness will do so within the first year of showing symptoms. The PREDICT study, a National Institute of Mental Health–funded collaboration with colleagues at Yale University and the University of South Carolina, aims to develop a better model of prediction and to determine if there are variables that will help researchers better understand who might go on to develop a psychotic illness.

The ADAPT study, funded by the Ontario Mental Health Foundation, compares two psychological treatments for people at risk of developing a psychotic illness. The goal is to see if psychological intervention can reduce early symptoms and prevent or delay the onset of a psychotic illness.

Dr. Addington’s research at PRIME is the beginning of a new era for psychotic illness. By demonstrating that there is a whole spectrum of psychotic illness, her work is helping the world see schizophrenia not just as a severe and chronic mental illness. “If we can show that meaningful recovery and even illness prevention are possible, it will be a major step in reducing stigma,” says Dr. Addington.

Her important work is also a stepping-stone for further investigation. Identifying at-risk individuals requires a tremendous amount of effort. By identifying a sample of people who are at the very early stages of psychosis, Dr. Addington is opening the door for further research in areas such as genetics.

A New Era for Psychotic Illness

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