Evidence That Psychotic Symptoms Are Prevalent in Disorders of Anxiety and Depression, Impacting on Illness Onset, Risk, and Severity--Implications for Diagnosis and Ultra-High Risk Research
Year: 2012
Type: article
Study design: Observational Study
Abstract: BACKGROUND: It is commonly assumed that there are clear lines of demarcation between anxiety and depressive disorders on the one hand and psychosis on the other. Recent evidence, however, suggests that this principle may be in need of updating. METHODS: Depressive and/or anxiety disorders, with no previous history of psychotic disorder, were examined for the presence of psychotic symptoms in a representative community sample of adolescents and young adults (Early Developmental Stages of Psychopathology study; n = 3021). Associations and consequences of psychotic symptomatology in the course of these disorders were examined in terms of demographic distribution, illness severity, onset of service use, and risk factors. RESULTS: Around 27% of those with disorders of anxiety and depression displayed one or more psychotic symptoms, vs 14% in those without these disorders (OR 2.23, 95% CI 1.89-2.66, P < .001). Presence as compared with nonpresence of psychotic symptomatology was associated with younger age (P < .0001), male sex (P < .0058), and poorer illness course (P < .0002). In addition, there was greater persistence of schizotypal (P < .0001) and negative symptoms (P < .0170), more observable illness behavior (P < .0001), greater likelihood of service use (P < .0069), as well as more evidence of familial liability for mental illness (P < .0100), exposure to trauma (P < .0150), recent and more distant life events (P < .0006-.0244), cannabis use (P < .0009), and any drug use (P < .0008). CONCLUSION: Copresence of psychotic symptomatology in disorders of anxiety and depression is common and a functionally and etiologically highly relevant feature, reinforcing the view that psychopathology is represented by a network or overlapping and reciprocally impacting dimensional liabilities.
Source: Schizophrenia Bulletin
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G1370885227, G171475315, G3200310752, G4229056580, Verbundprojekt: Suchtforschungsverbund Bayern ASAT: Patienten- und störungsbezogene Zuordnungsmodelle bei Substanzkonsum, Teilvorhaben 1: Epidemiologisch basierte Bedarfsmodelle, Teilvorhaben 4: Raucherentwöhnung in der allgemeinärztlichen Versorgung - Teilvorhaben: Verbundkoordination, Vulnerabilitäts- und Protektionsfaktoren bei Frühstadien von Substanzmissbrauch und -Abhängigkeit - eine Verlaufsstudie, European Network of National Schizophrenia Networks Studying Gene-Environment Interactions, Verbundprojekt: Suchtforschungsverbund Bayern/Dresden - ASAT: Teilvorhaben F1, F3, F8, Koordination und C3-Professur
OpenAlex ID: W1516107665