Raimo K R Salokangas1, Frauke Schultze-Lutter2, Jarmo Hietala3,4,5, Markus Heinimaa3, Tiina From3, Tuula Ilonen3, Eliisa Löyttyniemi6, Heinrich Graf von Reventlow7, Georg Juckel8, Don Linszen9,10, Peter Dingemans9,11, Max Birchwood12, Paul Patterson13, Joachim Klosterkötter14, Stephan Ruhrmann14. 1. Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland. raimo.k.r.salokangas@utu.fi. 2. University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland. 3. Department of Psychiatry, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland. 4. Psychiatric Clinic, Turku University Central Hospital, Turku, Finland. 5. Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland. 6. Department of Biostatistics, University of Turku, Turku, Finland. 7. Ev. Zentrum für Beratung und Therapie am Weißen Stein, Evangelischer Regionalverband Frankfurt am Main, Frankfurt Am Main, Germany. 8. Department of Psychiatry, LWL University Hospital, Ruhr-University Bochum, Bochum, Germany. 9. Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. 10. Department of Psychiatry and Psychology, University of Maastricht, Maastricht, The Netherlands. 11. Mediant, Enschede, The Netherlands. 12. School of Psychology, University of Birmingham, Birmingham, UK. 13. Youthspace, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK. 14. Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
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.
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.
Entities:
Keywords:
Anxiety; Clinical high risk; Depression; Paranoia; Persistence
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