Journal article
Depression predicts persistence of paranoia in clinical high-risk patients to psychosis: results of the EPOS project.
- Salokangas RK Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland. raimo.k.r.salokangas@utu.fi.
- Schultze-Lutter F University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
- Hietala J Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.
- Heinimaa M Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.
- From T Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.
- Ilonen T Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland.
- Löyttyniemi E Department of Biostatistics, University of Turku, Turku, Finland.
- von Reventlow HG Ev. Zentrum für Beratung und Therapie am Weißen Stein, Evangelischer Regionalverband Frankfurt am Main, Frankfurt Am Main, Germany.
- Juckel G Department of Psychiatry, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany.
- Linszen D Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Dingemans P Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Birchwood M School of Psychology, University of Birmingham, Birmingham, UK.
- Patterson P Youthspace, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.
- Klosterkötter J Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
- Ruhrmann S Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
- 2015-12-09
Published in:
- Social psychiatry and psychiatric epidemiology. - 2016
Anxiety
Clinical high risk
Depression
Paranoia
Persistence
Adolescent
Adult
Depressive Disorder
Female
Follow-Up Studies
Humans
Interview, Psychological
Male
Paranoid Disorders
Personality Inventory
Psychiatric Status Rating Scales
Psychotic Disorders
Risk Assessment
Risk Factors
Young Adult
English
BACKGROUND
The link between depression and paranoia has long been discussed in psychiatric literature. Because the causality of this association is difficult to study in patients with full-blown psychosis, we aimed to investigate how clinical depression relates to the presence and occurrence of paranoid symptoms in clinical high-risk (CHR) patients.
METHODS
In all, 245 young help-seeking CHR patients were assessed for suspiciousness and paranoid symptoms with the structured interview for prodromal syndromes at baseline, 9- and 18-month follow-up. At baseline, clinical diagnoses were assessed by the Structured Clinical Interview for DSM-IV, childhood adversities by the Trauma and Distress Scale, trait-like suspiciousness by the Schizotypal Personality Questionnaire, and anxiety and depressiveness by the Positive and Negative Syndrome Scale.
RESULTS
At baseline, 54.3% of CHR patients reported at least moderate paranoid symptoms. At 9- and 18-month follow-ups, the corresponding figures were 28.3 and 24.4%. Depressive, obsessive-compulsive and somatoform disorders, emotional and sexual abuse, and anxiety and suspiciousness associated with paranoid symptoms. In multivariate modelling, depressive and obsessive-compulsive disorders, sexual abuse, and anxiety predicted persistence of paranoid symptoms.
CONCLUSION
Depressive disorder was one of the major clinical factors predicting persistence of paranoid symptoms in CHR patients. In addition, obsessive-compulsive disorder, childhood sexual abuse, and anxiety associated with paranoia. Effective pharmacological and psychotherapeutic treatment of these disorders and anxiety may reduce paranoid symptoms in CHR patients.
The link between depression and paranoia has long been discussed in psychiatric literature. Because the causality of this association is difficult to study in patients with full-blown psychosis, we aimed to investigate how clinical depression relates to the presence and occurrence of paranoid symptoms in clinical high-risk (CHR) patients.
METHODS
In all, 245 young help-seeking CHR patients were assessed for suspiciousness and paranoid symptoms with the structured interview for prodromal syndromes at baseline, 9- and 18-month follow-up. At baseline, clinical diagnoses were assessed by the Structured Clinical Interview for DSM-IV, childhood adversities by the Trauma and Distress Scale, trait-like suspiciousness by the Schizotypal Personality Questionnaire, and anxiety and depressiveness by the Positive and Negative Syndrome Scale.
RESULTS
At baseline, 54.3% of CHR patients reported at least moderate paranoid symptoms. At 9- and 18-month follow-ups, the corresponding figures were 28.3 and 24.4%. Depressive, obsessive-compulsive and somatoform disorders, emotional and sexual abuse, and anxiety and suspiciousness associated with paranoid symptoms. In multivariate modelling, depressive and obsessive-compulsive disorders, sexual abuse, and anxiety predicted persistence of paranoid symptoms.
CONCLUSION
Depressive disorder was one of the major clinical factors predicting persistence of paranoid symptoms in CHR patients. In addition, obsessive-compulsive disorder, childhood sexual abuse, and anxiety associated with paranoia. Effective pharmacological and psychotherapeutic treatment of these disorders and anxiety may reduce paranoid symptoms in CHR patients.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00127-015-1160-9
- PMID 26643940
- Persistent URL
- https://sonar.ch/global/documents/167030
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