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Evaluating differential developmental trajectories to adolescent-onset mood and psychotic disorders

Lookup NU author(s): Emeritus Professor Jan Scott



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: It is an open question as to whether differential developmental trajectories, potentially representing underlying pathophysiological processes, can form the basis of a more useful typology in young persons who present for mental health care.Methods: A cohort of 605 young people was recruited from youth mental health services that target the early phases of anxiety, mood or psychotic disorders. Participants were assigned to one of three clinical sub-types (anxious-depression; mania-fatigue; developmental-psychotic) according to putative developmental trajectories.Results: The distribution of subtypes was: 51% anxiety-depression, 25% mania-fatigue and 24% developmental-psychotic, with key differences in demographic, clinical, family history and neuropsychological characteristics. When analyses were limited to 286 cases with 'attenuated' or sub-threshold syndromes, the pattern of differences was similar. Multinomial logistic regression demonstrated that compared to the developmental-psychotic subtype, both the mania-fatigue and anxiety-depression subtypes were younger and more depressed at presentation, but less functionally impaired. Other discriminating variables between the developmental-psychotic and mania-fatigue sub-types were that the latter were significantly more likely to have a family history of bipolar disorder but have less likelihood of impaired verbal learning; whilst the anxious-depression group were more anxious, more likely to have a family history of depression, and had a higher premorbid IQ level.Conclusions: This cross-sectional evaluation provides preliminary support for differing developmental trajectories in young persons presenting for mental health care. Prospective follow-up is needed to examine the predictive validity of this approach and its relationships to underlying pathophysiological mechanisms.

Publication metadata

Author(s): Hickie IB, Hermens DF, Naismith SL, Guastella AJ, Glozier N, Scott J, Scott EM

Publication type: Article

Publication status: Published

Journal: BMC Psychiatry

Year: 2013

Volume: 13

Online publication date: 12/11/2013

Acceptance date: 04/11/2013

Date deposited: 09/12/2015

ISSN (electronic): 1471-244X

Publisher: BioMed Central Ltd


DOI: 10.1186/1471-244X-13-303

PubMed id: 24215120


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Funder referenceFunder name
PB-PG-0609-16166NHS RfPb
NSW Health, Mental Health and Drug Alcohol Office
University of Sydney
464914National Health & Medical Research Council (NHMRC) Australia Fellowship
264611Centres of Clinical Research Excellence
402864NHMRC Clinical Research Fellowship