TY - JOUR
T1 - Impact of Comorbid Affective Disorders on Longitudinal Clinical Outcomes in Individuals at Ultra-high Risk for Psychosis
AU - Schirmbeck, Frederike
AU - Van Der Burg, Nadine C.
AU - Blankers, Matthijs
AU - Vermeulen, Jentien M.
AU - McGuire, Philip
AU - Valmaggia, Lucia R.
AU - Kempton, Matthew J.
AU - Van Der Gaag, Mark
AU - Riecher-Rossler, Anita
AU - Bressan, Rodrigo A.
AU - Barrantes-Vidal, Neus
AU - Nelson, Barnaby
AU - Amminger, G. Paul
AU - McGorry, Patrick
AU - Pantelis, Christos
AU - Krebs, Marie Odile
AU - Ruhrmann, Stephan
AU - Sachs, Gabriele
AU - Rutten, Bart P.F.
AU - Van Os, Jim
AU - Nordentoft, Merete
AU - Glenthoj, Birte
AU - Calem, Maria
AU - Tognin, Stefania
AU - Modinos, Gemma
AU - Pisani, Sara
AU - Hedges, Emily
AU - Velthorst, Eva
AU - Kraan, Tamar C.
AU - Van Dam, Daniella S.
AU - Burger, Nadine
AU - Politis, Athena
AU - Goodall, Joanne
AU - Borgwardt, Stefan
AU - Studerus, Erich
AU - Gadelha, Ary
AU - Brietzke, Elisa
AU - Asevedo, Graccielle
AU - Asevedo, Elson
AU - Zugman, Andre
AU - Domínguez-Martínez, Tecelli
AU - Monsonet, Manel
AU - Hinojosa, Lidia
AU - Racioppi, Anna
AU - Kwapil, Thomas R.
AU - Kazes, Mathilde
AU - Daban, Claire
AU - Bourgin, Julie
AU - Gay, Olivier
AU - Mam-Lam-Fook, Ccrossed D.Sign©lia
AU - Nordholm, Dorte
AU - Randers, Lasse
AU - Krakauer, Kristine
AU - Birkedal Glenthoj, Louise
AU - Gebhard, Dominika
AU - Arnhold, Julia
AU - Klosterkotter, Joachim
AU - Lasser, Iris
AU - Winklbaur, Bernadette
AU - Delespaul, Philippe A.
AU - Fusar-Poli, Paolo
AU - De Haan, Lieuwe
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Introduction: Diagnoses of anxiety and/or depression are common in subjects at Ultra-High Risk for Psychosis (UHR) and associated with extensive functional impairment. Less is known about the impact of affective comorbidities on the prospective course of attenuated psychotic symptoms (APS). Method: Latent class mixed modelling identified APS trajectories in 331 UHR subjects assessed at baseline, 6, 12, and 24 months follow-up. The prognostic value of past, baseline, and one-year DSM-IV depressive or anxiety disorders on trajectories was investigated using logistic regression, controlling for confounders. Cox proportional hazard analyses investigated associations with transition risk. Results: 46.8% of participants fulfilled the criteria for a past depressive disorder, 33.2% at baseline, and 15.1% at one-year follow-up. Any past, baseline, or one-year anxiety disorder was diagnosed in 42.9%, 37.2%, and 27.0%, respectively. Participants were classified into one of three latent APS trajectory groups: (1) persistently low, (2) increasing, and (3) decreasing. Past depression was associated with a higher risk of belonging to the increasing trajectory group, compared to the persistently low (OR = 3.149, [95%CI: 1.298-7.642]) or decreasing group (OR = 3.137, [1.165-8.450]). In contrast, past (OR =. 443, [.179-1.094]) or current (OR =. 414, [.156-1.094]) anxiety disorders showed a trend-level association with a lower risk of belonging to the increasing group compared to the persistently low group. Past depression was significantly associated with a higher risk of transitioning to psychosis (HR = 2.123, [1.178-3.828]). Conclusion: A past depressive episode might be a particularly relevant risk factor for an unfavorable course of APS in UHR individuals. Early affective disturbances may be used to advance detection, prognostic, and clinical strategies.
AB - Introduction: Diagnoses of anxiety and/or depression are common in subjects at Ultra-High Risk for Psychosis (UHR) and associated with extensive functional impairment. Less is known about the impact of affective comorbidities on the prospective course of attenuated psychotic symptoms (APS). Method: Latent class mixed modelling identified APS trajectories in 331 UHR subjects assessed at baseline, 6, 12, and 24 months follow-up. The prognostic value of past, baseline, and one-year DSM-IV depressive or anxiety disorders on trajectories was investigated using logistic regression, controlling for confounders. Cox proportional hazard analyses investigated associations with transition risk. Results: 46.8% of participants fulfilled the criteria for a past depressive disorder, 33.2% at baseline, and 15.1% at one-year follow-up. Any past, baseline, or one-year anxiety disorder was diagnosed in 42.9%, 37.2%, and 27.0%, respectively. Participants were classified into one of three latent APS trajectory groups: (1) persistently low, (2) increasing, and (3) decreasing. Past depression was associated with a higher risk of belonging to the increasing trajectory group, compared to the persistently low (OR = 3.149, [95%CI: 1.298-7.642]) or decreasing group (OR = 3.137, [1.165-8.450]). In contrast, past (OR =. 443, [.179-1.094]) or current (OR =. 414, [.156-1.094]) anxiety disorders showed a trend-level association with a lower risk of belonging to the increasing group compared to the persistently low group. Past depression was significantly associated with a higher risk of transitioning to psychosis (HR = 2.123, [1.178-3.828]). Conclusion: A past depressive episode might be a particularly relevant risk factor for an unfavorable course of APS in UHR individuals. Early affective disturbances may be used to advance detection, prognostic, and clinical strategies.
KW - anxiety
KW - comorbid
KW - depression
KW - prediction
KW - psychosis
KW - schizophrenia
KW - ultra-high risk
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U2 - 10.1093/schbul/sbab088
DO - 10.1093/schbul/sbab088
M3 - Article
C2 - 34417795
AN - SCOPUS:85122129868
SN - 0586-7614
VL - 48
SP - 100
EP - 110
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 1
ER -