Skip to Main content Skip to Navigation
Journal articles

Impact of Comorbid Affective Disorders on Longitudinal Clinical Outcomes in Individuals at Ultra-high Risk for Psychosis

Frederike Schirmbeck 1, 2 Nadine C van Der Burg 1, 3 Matthijs Blankers 1, 2, 4 Jentien M Vermeulen 1 Philip Mcguire 5 Lucia R Valmaggia 5 Matthew J Kempton 5 Mark van Der Gaag 6, 7 Anita Riecher-Rössler 8 Rodrigo A Bressan 9 Neus Barrantes-Vidal 10, 11 Barnaby Nelson 12, 13 G Paul Amminger 12 Patrick Mcgorry 12, 13 Christos Pantelis 13, 14 Marie-Odile Krebs 15, 16 Stephan Ruhrmann 17 Gabriele Sachs 18 Bart P F Rutten 19 Jim van Os 5, 19, 20 Merete Nordentoft 21 Birte Glenthøj 21 Paolo Fusar-Poli 22, 23, 5 Lieuwe de Haan 1, 2 
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.
Complete list of metadata
Contributor : Clara Martinez Rico Connect in order to contact the contributor
Submitted on : Tuesday, August 24, 2021 - 9:42:39 AM
Last modification on : Thursday, April 7, 2022 - 1:58:20 PM
Long-term archiving on: : Friday, November 26, 2021 - 9:21:20 AM


Schirmbeck et al. Schizophr Bu...
Publication funded by an institution




Frederike Schirmbeck, Nadine C van Der Burg, Matthijs Blankers, Jentien M Vermeulen, Philip Mcguire, et al.. Impact of Comorbid Affective Disorders on Longitudinal Clinical Outcomes in Individuals at Ultra-high Risk for Psychosis. Schizophrenia Bulletin, Oxford University Press (OUP), 2021, pp.sbab088. ⟨10.1093/schbul/sbab088⟩. ⟨inserm-03324843⟩



Record views


Files downloads