Katherine L Musliner1,2, Trine Munk-Olsen1,2,3, Ole Mors2,4, Søren D Østergaard2,4. 1. National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark. 2. The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark. 3. CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark. 4. Psychosis Research Unit, Department of Clinical Medicine, Aarhus University Hospital, Risskov, Denmark.
Abstract
OBJECTIVE: To examine progression from unipolar depression (UD) to schizophrenia and to identify groups of UD patients at elevated risk for progression. METHOD: Historical prospective cohort study using data from Danish national registers. The sample included 71 932 individuals who received a diagnosis of UD in Denmark between January 1, 1995, and May 31, 2013. Analyses were conducted using Kaplan-Meier estimates and Cox regressions. RESULTS: The 18.5-year cumulative incidence of schizophrenia was 5.5% in women and 8.4% in men. The strongest predictors of progression included younger age (adjusted hazard ratio (AHR) for individuals 18-24 vs. 40+ = 7.42, 95% confidence interval = [6.29, 8.74]), psychotic symptoms at index UD diagnosis (AHR = 3.70 [3.18, 4.31]), previous disorder with psychotic features (AHR = 3.71 [3.31, 4.16]), and previous illicit substance use disorder (AHR = 1.66 [1.40, 1.97]). Groups of UD patients with different combinations of risk factors had elevated risk for progression, with 10-year cumulative incidences ranging from 9% to 62%. To conclude, at the time of UD diagnosis, the strongest risk factors for progression to schizophrenia include male sex, younger age, past/current psychotic symptoms, and illicit substance use disorders. These clinical predictors may aid in targeting monitoring for schizophrenia among patients with UD.
OBJECTIVE: To examine progression from unipolar depression (UD) to schizophrenia and to identify groups of UD patients at elevated risk for progression. METHOD: Historical prospective cohort study using data from Danish national registers. The sample included 71 932 individuals who received a diagnosis of UD in Denmark between January 1, 1995, and May 31, 2013. Analyses were conducted using Kaplan-Meier estimates and Cox regressions. RESULTS: The 18.5-year cumulative incidence of schizophrenia was 5.5% in women and 8.4% in men. The strongest predictors of progression included younger age (adjusted hazard ratio (AHR) for individuals 18-24 vs. 40+ = 7.42, 95% confidence interval = [6.29, 8.74]), psychotic symptoms at index UD diagnosis (AHR = 3.70 [3.18, 4.31]), previous disorder with psychotic features (AHR = 3.71 [3.31, 4.16]), and previous illicit substance use disorder (AHR = 1.66 [1.40, 1.97]). Groups of UD patients with different combinations of risk factors had elevated risk for progression, with 10-year cumulative incidences ranging from 9% to 62%. To conclude, at the time of UD diagnosis, the strongest risk factors for progression to schizophrenia include male sex, younger age, past/current psychotic symptoms, and illicit substance use disorders. These clinical predictors may aid in targeting monitoring for schizophrenia among patients with UD.
Authors: Katherine L Musliner; Preben B Mortensen; John J McGrath; Nis P Suppli; David M Hougaard; Jonas Bybjerg-Grauholm; Marie Bækvad-Hansen; Ole Andreassen; Carsten B Pedersen; Marianne G Pedersen; Ole Mors; Merete Nordentoft; Anders D Børglum; Thomas Werge; Esben Agerbo Journal: JAMA Psychiatry Date: 2019-05-01 Impact factor: 21.596
Authors: Shile Qi; Gunter Schumann; Juan Bustillo; Jessica A Turner; Rongtao Jiang; Dongmei Zhi; Zening Fu; Andrew R Mayer; Victor M Vergara; Rogers F Silva; Armin Iraji; Jiayu Chen; Eswar Damaraju; Xiaohong Ma; Xiao Yang; Michael Stevens; Daniel H Mathalon; Judith M Ford; James Voyvodic; Bryon A Mueller; Aysenil Belger; Steven G Potkin; Adrian Preda; Chuanjun Zhuo; Yong Xu; Congying Chu; Tobias Banaschewski; Gareth J Barker; Arun L W Bokde; Erin Burke Quinlan; Sylvane Desrivières; Herta Flor; Antoine Grigis; Hugh Garavan; Penny Gowland; Andreas Heinz; Jean-Luc Martinot; Marie-Laure Paillère Martinot; Eric Artiges; Frauke Nees; Dimitri Papadopoulos Orfanos; Tomáš Paus; Luise Poustka; Sarah Hohmann; Juliane H Fröhner; Michael N Smolka; Henrik Walter; Robert Whelan; Vince D Calhoun; Jing Sui Journal: Biol Psychiatry Date: 2021-01-30 Impact factor: 12.810