Psychotic Disorders: Why Are Young People Being Diagnosed at an Increasingly Early Age?

A striking finding based on 12 million records

Do you feel like there’s more and more talk about mental health among young people? It’s not just a feeling. A massive study has just put precise numbers behind that perception. Imagine this: researchers analyzed the records of 12.2 million people born in Ontario between 1960 and 2009. That’s a massive sample.

Published Monday in the Canadian Medical Association Journal, the results are unequivocal. Among this massive dataset, 152,587 people were diagnosed with a psychotic disorder, such as schizophrenia. But what’s most surprising is how the numbers have changed over time. Dr. Daniel Myran, who holds the Gordon F. Cheesbrough Research Chair at North York General Hospital, is unequivocal: since the 1980s, each new generation appears to have more cases of psychosis than the previous one.

Generally, in Canada, there is a consensus that the incidence of these disorders is stable, affecting about 1 to 2% of the population. So why the alarm today? Because the average masks enormous disparities based on age.

Young People More Affected, Seniors Spared

This is where the numbers become staggering. Between 1997 and 2023, among adolescents and young adults aged 14 to 20, incidence rates jumped by 60%. Specifically, the rate rose from 62.5 cases to 99.7 cases per 100,000 people. The average age at diagnosis has also dropped: it fell from 25.4 years to 23.2 years in the most recent cohorts.

But then, if rates are rising among young people, why is the overall situation said to be stable? That’s the paradox. Among adults, the numbers are plummeting. Take a look: rates have fallen by 32.6% among 21- to 30-year-olds, by 62.0% among 31- to 40-year-olds, and by 33.6% among 41- to 50-year-olds.

Dr. Myran explains that the older cohorts are actually masking the increase among younger people. This view is shared by Dr. Luigi De Benedictis, a psychiatrist and researcher at the University of Montreal, who did not participate in the study. In his view, the aging population prevents us from seeing this rise in prevalence with the naked eye. Yet the evidence is clear: for those born between 1990 and 1994, the number of diagnoses by age 30 has risen by 37.5% compared to those born between 1975 and 1979.

Cannabis and Diagnosis: What Has Changed?

How can such a shift be explained? Dr. Luigi De Benedictis cautiously summarizes the situation: these figures aren’t necessarily cause for concern, but they aren’t reassuring either. We need to understand.

First, medicine has changed. Over the past 20 to 25 years, we’ve been able to detect conditions better and earlier. Early intervention programs are more accessible, and diagnostic criteria have been broadened. This “skews the results a bit,” the psychiatrist admits. But for Dr. Myran, that isn’t enough to explain everything.

We also need to look at our lifestyles. The use of psychoactive substances—cannabis, stimulants, hallucinogens, synthetic drugs—is being singled out. But here’s an important caveat: cannabis doesn’t necessarily “create” psychosis out of thin air, but it can cause it to appear earlier, explains Dr. De Benedictis. Especially since these products have become much more potent. Dr. Myran emphasizes: this phenomenon did not begin with the 2018 legalization; it was already present long before that. He regrets that while there is a lot of talk about overdoses, there isn’t enough discussion of these psychiatric consequences.

The City and Parents’ Age as Factors

There is no single explanation, warns Dr. Myran. It’s a combination of social and environmental factors. For example, did you know that the parents’ age plays a role? Canadians are having children later in life, yet studies show that children born to older parents are at higher risk of developing schizophrenia or psychosis.

Immigration is another factor mentioned by Dr. De Benedictis, as children of immigrants often have a higher prevalence of the condition. Finally, there’s where we live. Rapid urbanization is not insignificant. We’ve known since the 1960s that living in the city is associated with higher rates of psychosis. For a long time, it was believed that this was a statistical bias—because there are more doctors in cities. Not true, the two experts counter.

Studies have shown that urban life is, in and of itself, a predisposing factor. With more and more Canadians crowding into cities and suburbs, this is a factor that can no longer be ignored.

Source: ici.radio-canada.ca

Created by humans, assisted by AI.

Psychotic Disorders: Why Are Young People Being Diagnosed at an Increasingly Early Age?