Abstract
BackgroundThe first signs of serious mental illnesses (SMIs) including schizophrenia, bipolar disorder and major depression are likely to occur before the age of 25. The combination of high prevalence of severe mental health symptoms, inability to recognise mental health deterioration and increased likelihood of comorbidity in a complex transitional young group makes detecting deterioration paramount. Whilst studies have examined physical and mental health deterioration in adults, no systematic review has examined the indicators of mental and physical deterioration in young adults with SMI. The study aim is to systematically review the existing evidence from observational studies that examine the indicators of mental and physical deterioration in young adults with SMI and highlight gaps in knowledge to inform future research.MethodsSeven databases including CINHAL, MEDLINE, Embase, PsycINFO, Health Management Information Consortium, Cochrane databases and Web of Science will be searched against five main facets (age, serious mental illness, sign, deterioration and patient) and a subsequent comprehensive list of search terms. Searches will be run individually in each database to reflect each unique set of relevant subject headings and appropriate MeSH terms. Inclusion and exclusion criteria were developed and refined by the research team. Two reviewers will participate in each search stage including abstract/title and full text screening, data extraction and appraisal, to ensure reliability. A narrative synthesis of the data will also be conducted.DiscussionThis systematic review will likely make a significant contribution to the field of mental health and help inform future research pertaining to interventions that help highlight deteriorating patients. This may vary depending on the patient group, mental illness or deterioration type.Systematic review registrationPROSPERO CRD42017075755
Highlights
The first signs of serious mental illnesses (SMIs) including schizophrenia, bipolar disorder and major depression are likely to occur before the age of 25
Serious mental illness (SMI) include conditions that are usually debilitating to the brain, behaviour and day to day functioning
Whilst 5.8% of the general population has SMI at any one time, three quarters of serious mental health problems develop before the age of 25, with young adults at particular risk of
Summary
The first signs of serious mental illnesses (SMIs) including schizophrenia, bipolar disorder and major depression are likely to occur before the age of 25. The combination of high prevalence of severe mental health symptoms, inability to recognise mental health deterioration and increased likelihood of comorbidity in a complex transitional young group makes detecting deterioration paramount. Research has identified indicators of mental health deterioration or re-/hospitalisation across several SMIs including schizophrenia [6, 7], bipolar disorder [8, 9] and major depressive disorder [10]. Other health issues including pain, severe insomnia, CVD, gastrointestinal disease, respiratory disorders and substance misuse disorders are common in this patient group [14]. Despite these well-known associative factors, physical health deterioration in people with SMI is often missed. Early identification of deterioration and rapid response can significantly reduce adverse events, including, in some cases, suicide [16]
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