Impact of comorbid affective disorders on longitudinal clinical outcomes in individuals at ultra-high risk for psychosis

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 m...

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Detalles Bibliográficos
Autores: Schirmbeck, Frederike|||0000-0003-1700-0958, Van der Burg, Nadine C., Blankers, Matthijs, Vermeulen, Jentien M., McGuire, Philip|||0000-0003-4381-0532, Valmaggia, Lucia|||0000-0001-6099-8464, Kempton, Matthew|||0000-0003-3541-9947, Gaag, Mark van der, 1953-|||0000-0002-3525-6415, Riecher-Rössler, Anita|||0000-0001-6361-8789, Bressan, Rodrigo Affonseca|||0000-0002-0868-4449, Barrantes Vidal, Neus|||0000-0002-8671-1238, Nelson, Barnaby|||0000-0002-6263-2332, Amminger, G. Paul|||0000-0001-8969-4595, McGorry, Patrick|||0000-0002-3789-6168, Pantelis, Christos|||0000-0002-9565-0238, Krebs, Marie Odile|||0000-0002-4715-9890, Ruhrmann, Stephan|||0000-0002-6022-2364, Sachs, Gabriele|||0000-0002-8359-9877, Rutten, Bart P. F.|||0000-0002-9834-6346, Os, Jim Van|||0000-0002-7245-1586, Nordentoft, Merete|||0000-0003-4895-7023, Glenthøj, Birte|||0000-0003-3056-7262, Fusar-Poli, Paolo|||0000-0003-3582-6788, Haan, Lieuwe de, 1960-|||0000-0002-3820-7926
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:248988
Acceso en línea:https://ddd.uab.cat/record/248988
https://dx.doi.org/urn:doi:10.1093/schbul/sbab088
Access Level:acceso abierto
Palabra clave:Ultra-high risk
Comorbid
Anxiety
Depression
Psychosis
Schizophrenia
Prediction
Descripción
Sumario: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.

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