1. Impact of Comorbid Affective Disorders on Longitudinal Clinical Outcomes in Individuals at Ultra-high Risk for Psychosis
- Author
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Nadine C van der Burg, Philip McGuire, Birte Glenthøj, Stephan Ruhrmann, Jim van Os, Bart P. F. Rutten, Neus Barrantes-Vidal, Patrick D. McGorry, Frederike Schirmbeck, Gabriele Sachs, Rodrigo A. Bressan, Barnaby Nelson, Marie-Odile Krebs, Jentien M Vermeulen, Anita Riecher-Rössler, G. Paul Amminger, Matthijs Blankers, Lucia Valmaggia, Mark van der Gaag, Christos Pantelis, Paolo Fusar-Poli, Merete Nordentoft, Lieuwe de Haan, Matthew J. Kempton, Adult Psychiatry, Amsterdam Neuroscience - Mood, Anxiety, Psychosis, Stress & Sleep, APH - Mental Health, Amsterdam Neuroscience - Complex Trait Genetics, Amsterdam Neuroscience - Compulsivity, Impulsivity & Attention, VU University Medical Center [Amsterdam], Arkin Institute for Mental Health [Amsterdam, The Netherlands] (AIMH), GGZ Centraal [Amersfoort, The Netherlands], Trimbos Institute, Netherlands Institute of Mental Health and Addiction, King‘s College London, Vrije universiteit = Free university of Amsterdam [Amsterdam] (VU), Psychosis Research Institute [The Hague, Netherlands], University of Basel (Unibas), Universidade Federal de São Paulo, Universitat Autònoma de Barcelona (UAB), Spanish Mental Health Research Network (CIBERSAM), Orygen [Parkville, Victoria], University of Melbourne, Melbourne Health [Carlton South, Victoria], Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Groupement de recherche en Psychiatrie (GDR Psychiatrie (3557)), Centre National de la Recherche Scientifique (CNRS), University of Cologne, Medizinische Universität Wien = Medical University of Vienna, Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], University Medical Center [Utrecht], IT University of Copenhagen, South London and Maudsley NHS Foundation Trust, University of Pavia, EU-GEI High Risk Study Group Authors: Maria Calem, Stefania Tognin, Gemma Modinos, Sara Pisani, Emily Hedges, Eva Velthorst, Tamar C Kraan, Daniella S van Dam, Nadine Burger, Athena Politis, Joanne Goodall, Stefan Borgwardt, Erich Studerus, Ary Gadelha, Elisa Brietzke, Graccielle Asevedo, Elson Asevedo, Andre Zugman, Tecelli Domínguez-Martínez, Manel Monsonet, Lidia Hinojosa, Anna Racioppi, Thomas R Kwapil, Mathilde Kazes, Claire Daban, Julie Bourgin, Olivier Gay, Célia Mam-Lam-Fook, Dorte Nordholm, Lasse Randers, Kristine Krakauer, Louise Birkedal Glenthøj, Dominika Gebhard, Julia Arnhold, Joachim Klosterkötter, Iris Lasser, Bernadette Winklbaur, Philippe A Delespaul, VU University Amsterdam, Martinez Rico, Clara, Vrije Universiteit Amsterdam [Amsterdam] (VU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), IT University of Copenhagen (ITU), Università degli Studi di Pavia = University of Pavia (UNIPV), RS: MHeNs - R3 - Neuroscience, Psychiatrie & Neuropsychologie, MUMC+: MA Psychiatrie (3), RS: MHeNs - R2 - Mental Health, and MUMC+: Hersen en Zenuw Centrum (3)
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Male ,Ultra-high risk ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Comorbid ,Comorbidity ,Anxiety ,Logistic regression ,0302 clinical medicine ,Longitudinal Studies ,psychosis ,Depression (differential diagnoses) ,Depression ,anxiety ,DEPRESSION ,Anxiety Disorders ,STATE ,EXPERIENCES ,CHILDHOOD TRAUMA ,Europe ,Psychiatry and Mental health ,YOUTH ,Schizophrenia ,Female ,medicine.symptom ,Anxiety disorder ,Adult ,Risk ,medicine.medical_specialty ,Psychosis ,Adolescent ,AcademicSubjects/MED00810 ,Prodromal Symptoms ,comorbid ,Lower risk ,ultra-high risk ,Young Adult ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Risk factor ,METAANALYSIS ,Depressive Disorder ,Mood Disorders ,business.industry ,PERSISTENCE ,prediction ,medicine.disease ,030227 psychiatry ,schizophrenia ,Psychotic Disorders ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,ONSET ,Gene-Environment Interaction ,business ,Prediction ,030217 neurology & neurosurgery ,AT-RISK ,Regular Articles ,Follow-Up Studies - Abstract
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.
- Published
- 2022
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