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The Cavan-Monaghan First Episode Psychosis Study (CAMFEPS): arbitrary diagnostic boundaries across the gene–environment interface and within evolving models of care

Published online by Cambridge University Press:  12 April 2019

John L. Waddington Open the ORCID record for John L. Waddington [Opens in a new window]  and
Vincent Russell Open the ORCID record for Vincent Russell [Opens in a new window]
John L. Waddington*
Affiliation:
Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland Cavan-Monaghan Mental Health Service, St. Davnet’s Hospital, Monaghan, Ireland Jiangsu Key Laboratory of Translational Research & Therapy for Neuropsychiatric Disorders and Department of Pharmacology, College of Pharmaceutical Sciences, Soochow University, Suzhou, China
Vincent Russell
Affiliation:
Cavan-Monaghan Mental Health Service, Cavan General Hospital, Cavan, Ireland Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont, Dublin, Ireland
*
*Address for correspondence: John L. Waddington, Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland. (Email: jwadding@rcsi.ie)
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Abstract

As research into psychotic illness evolves along established lines, insights are emerging that deviate from those lines and challenge more fundamentally our understanding. On the background of a new generation of studies on first-episode psychosis, investigations across the gene–environment interface and the intersection with ‘normal’ human mentation heighten these concerns. Using findings from the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS) as an exemplar, we here review the complexity of these challenges from the perspective of this real-world setting. They range from trans-diagnostic epidemiology and clinical characterisation, through molecular genetics, social milieu, developmental pathobiology and functional outcome across arbitrary diagnostic boundaries, to the evidence base for early intervention and more radical conceptualisations and structures for provision of mental health care.

Keywords

At-risk mental stateclinical high riskdiagnostic boundariesearly interventionepidemiologyfirst-episode studiesfunctional outcomemolecular geneticspsychotic illnesssocial milieu
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 36 , Issue 4: Psychosis: from early intervention to treatment resistance , December 2019 , pp. 293 - 303
Copyright
© College of Psychiatrists of Ireland 2019 

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