Depression predicts persistence of paranoia in clinical high-risk patients to psychosis: results of the EPOS project.

Abstract:

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.

authors

Salokangas RK,Schultze-Lutter F,Hietala J,Heinimaa M,From T,Ilonen T,Löyttyniemi E,von Reventlow HG,Juckel G,Linszen D,Dingemans P,Birchwood M,Patterson P,Klosterkötter J,Ruhrmann S,EPOS Group.

doi

10.1007/s00127-015-1160-9

subject

Has Abstract

pub_date

2016-02-01 00:00:00

pages

247-57

issue

2

eissn

0933-7954

issn

1433-9285

pii

10.1007/s00127-015-1160-9

journal_volume

51

pub_type

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