Factors impacting intent to seek treatment within youth at clinical high risk for psychosis

Abstract

Existing work indicates that there is unmet need for care in those at clinical high risk (CHR) for psychosis. However, research on the factors that drive treatment seeking behaviors in this population is limited. Further, it is unknown how help-seeking behavior in CHR individuals compares to those seen in mood disorders, who have a higher rate of treatment seeking behavior. Participants (n = 559) completed an assessment of their intent to seek mental health treatment, attenuated psychosis-risk symptoms, and psychiatric symptoms and diagnoses. Participants were divided into CHR (n = 91), Mood Disorders (MD) (n = 72), or Community Controls (CC) groups (n = 396), whose intent to seek treatment was compared. Associations between intent to seek treatment with past treatment, depression, anxiety, positive and negative symptoms, distress from symptoms, intelligence quotient (IQ) estimates, and insight were assessed in CHR individuals. Further, it was assessed how this differs for the MD group. The MD group reported higher intent to seek treatment than CHR individuals, which reported higher intent to seek treatment than the CC group. In those at CHR, previous treatment, greater depression and anxiety severity, and higher distress all independently predicted higher intent to seek treatment. Depression predicted intent to seek treatment in both MD and CHR individuals. Previous treatment predicted intent to seek treatment in those at CHR. Our findings suggest that depression and past treatment utilization are critical factors in increasing intent to seek treatment in those at CHR, potentially serving as important targets for engaging this population in treatment.

Keywords: Clinical high risk for psychosis; Intent to seek treatment; Mood disorders; Psychosis-risk; Service utilization.

Fig 1.

Participants included in the final analytic sample and reasons for exclusion.

Fig 2.

Distribution of intent to seek treatment across groups. An ANOVA revealed that those with MD had significantly higher intent to seek treatment than those at CHR and those at CHR had significantly higher intent to seek treatment than CC. *p<0.05, **p<0.01, ***p<0.001.

Fig 3.

(A) Relation between past psychiatric treatment utilization and current intent to seek treatment. (B) Higher depression scores predicted greater intent to seek treatment. (C) Higher anxiety scores predicted greater intent to seek treatment. (D) Higher distress ratings predict greater intent to seek treatment.

Fig 4.

Interaction between group and past treatment. A multiple regression revealed a significant interaction between group and past treatment such that those in the CHR group who previously engaged in treatment reported higher intent to seek treatment than those who did not.