The Toronto Adolescent and Youth Cohort Study: Study Design and Early Data Related to Psychosis Spectrum Symptoms, Functioning, and Suicidality
Kristin Cleverley, George Foussias, Stephanie H. Ameis, Darren Courtney, Benjamin I. Goldstein, Lisa D. Hawke, Nicole Kozloff, Lena C. Quilty, Martin Rotenberg, Anne L. Wheeler, Brendan F. Andrade, Madison Aitken, Don Mahleka, Melanie Jani, Margot Frayne, Jimmy K Y Wong, Rachel Kelly, Erin W. Dickie, Daniel Felsky, John D. Haltigan, Meng‐Chuan Lai, Yuliya S. Nikolova, Wanda Tempelaar, Wei Wang, Marco Battaglia, Muhammad Omair Husain, Sean A. Kidd, Paul Kurdyak, Robert D. Levitan, Stephen P. Lewis, Alexia Polillo, Péter Szatmári, Anna I. R. van der Miesen, Masoud Ahmadzad-Asl, Aristotle N. Voineskos, Madison Aitken, Stephanie H. Ameis, Brendan F. Andrade, Marco Battaglia, Isabelle Boileau, Kristin Cleverley, Darren B. Courtney, Andreea O. Diaconescu, Erin W. Dickie, Daniel Felsky, George Foussias, Benjamin I. Goldstein, Vanessa Gonçalves, John D. Griffiths, John D. Haltigan, Hayley Hamilton, Lisa D. Hawke, Sean Hill, Muhammad Omair Husain, Melanie Jani, Sean A. Kidd, Nicole Kozloff, Paul Kurdyak, Meng-Chuan Lai, Stephen P. Lewis, Robert D. Levitan, Hsiang-Yuan Lin, Yona Lunsky, Akshay Mohan, Yuliya S. Nikolova, Sam Osman, Shannon Pascoe, Alexia Polillo, Connie Putterman, Martin Rotenberg, Dafna Sara Rubin-Kahana, Lena C. Quilty, Harijah Sivakumar, Peter Szatmari, Wanda Tempelaar, Neil Vasdev, Wei Wang, Anne L. Wheeler, Anna I.R. van der Miesen, Erica L. Vieira, Aristotle N. Voineskos
Abstract
BACKGROUND: Psychosis spectrum symptoms (PSSs) occur in a sizable percentage of youth and are associated with poorer cognitive performance, poorer functioning, and suicidality (i.e., suicidal thoughts and behaviors). PSSs may occur more frequently in youths already experiencing another mental illness, but the antecedents are not well known. The Toronto Adolescent and Youth (TAY) Cohort Study aims to characterize developmental trajectories in youths with mental illness and understand associations with PSSs, functioning, and suicidality. METHODS: The TAY Cohort Study is a longitudinal cohort study that aims to assess 1500 youths (age 11-24 years) presenting to tertiary care. In this article, we describe the extensive diagnostic and clinical characterization of psychopathology, substance use, functioning, suicidality, and health service utilization in these youths, with follow-up every 6 months over 5 years, including early baseline data. RESULTS: A total of 417 participants were enrolled between May 4, 2021, and February 2, 2023. Participants met diagnostic criteria for an average of 3.5 psychiatric diagnoses, most frequently anxiety and depressive disorders. Forty-nine percent of participants met a pre-established threshold for PSSs and exhibited higher rates of functional impairment, internalizing and externalizing symptoms, and suicidality than participants without PSSs. CONCLUSIONS: Initial findings from the TAY Cohort Study demonstrate the feasibility of extensive clinical phenotyping in youths who are seeking help for mental health problems. PSS prevalence is much higher than in community-based studies. Our early data support the critical need to better understand longitudinal trajectories of clinical youth cohorts in relation to psychosis risk, functioning, and suicidality.