Self-reported experiences as predictors for onset of psychotropic medication. A prospective study of healthy draftees

Abstract

Background: Psychosis and other psychiatric disorders are often preceded by prodromal symptoms. There are few community-based studies on symptom predictors of severe mental problems in healthy people. Aims: We aimed to study how a new self-reported screen for prodromal symptoms (PROD) predicts onset of all psychotropic and antipsychotic medication in healthy draftees. Methods: In a prospective follow-up study, 2330 18-year-old Finnish draftees who at call-up in 1999 completed the PROD comprising 21 symptom items divided into positive, negative and general symptom categories were prospectively followed for 6 years. First purchases of any psychotropic and antipsychotic drugs separately between 2000 and 2005 were used as an indicator of the onset of psychiatric disorder and predicted by PROD symptoms in Cox regression analysis. Results: A majority of the PROD items significantly predicted the first purchases of any psychotropic and of antipsychotic drugs, separately. Positive, negative and general symptoms predicted purchases of any psychotropic medication, while negative and general symptoms predicted purchases of antipsychotic drugs. General symptoms, in particular anxiety, had a strong independent association with onset of psychotropic medication. Conclusions: In young healthy men, self-reported sub-clinical psychic symptoms predict onset of psychiatric disorders requiring psychotropic, including antipsychotic, medication.