Cited by 138Schizophrenia research and treatmentBipolar Disorder and TreatmentPsychopathy, Forensic Psychiatry, Sexual Offending

Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis

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Rutigliano, Grazia, Valmaggia, Lucia, Landi, Paola, Frascarelli, Marianna, Cappucciati, Marco, Sear, Victoria, Rocchetti, Matteo, De Micheli, Andrea +4 more·2016·Journal of Affective Disorders

Abstract

Background Patients at ultra-high risk for psychosis (UHR) are a highly heterogeneous group in terms of clinical and functional outcomes. Several non-psychotic mental disorders co-occur together with the UHR state. Little is known about the impact of non-psychotic comorbid mental disorders on clinical and functional outcomes of UHR patients.Methods The sample included 154 UHR help-seeking patients (identified with the CAARMS, comprehensive assessment of the at-risk mental state), evaluated at baseline on the Ham-D, Ham-A (Hamilton depression/anxiety rating scale), and PANSS (positive and negative syndrome scale). 74 patients completed the 6-year follow-up assessment (mean=6.19, SD=1.87). Comorbid disorders at follow-up were assessed with the SCID I and II. Global functioning was rated on the global assessment of functioning (GAF) scale.Results In the present sample, 6-year risk of psychosis transition was 28.4%. Among non-transitioned UHR patients, 28.3% reported attenuated psychotic symptoms (APS) and 45.3% remained functionally impaired at follow-up (GAF<60). 56.8% patients were affected by at least one comorbid disorder at follow-up. Among UHR patients who presented with some comorbid disorder at baseline, 61.5% had persistent or recurrent course. Incident comorbid disorders emerged in 45.4% of baseline UHR patients. The persistence or recurrence of non-psychotic comorbid mental disorders was associated with poorer global functional outcomes at follow-up.Limitations A substantial proportion of the initial sample was not available for follow-up interviews and some groups in the analyses had small sample size. Predictors of longitudinal outcomes were not explored.Conclusions Among UHR patients, persistence or recurrence of non-psychotic comorbid mental disorders, mostly affective disorders, is associated with 6-year poor functional outcomes.

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Crossref · 10.1016/j.jad.2016.05.053

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  • The majority of CHR-P individuals have comorbid non-psychotic mental disorders (which do not increase the risk for psychosis but tend to persist over time), mostly common mental disorders: 41% depressive disorders and 15% anxiety disorders.

    “The majority of CHR-P individuals have comorbid non-psychotic mental disorders (which do not increase the risk for psychosis but tend to persist over time 229 ), mostly common mental disorders: 41% depressive disorders and 15% anxiety disorders 72,230”
  • In addition to transition to psychosis, longer-term psychotic disorder, or persistent sub-threshold psychotic symptoms, progression to persistent mood, anxiety, personality and/or substance use disorders is also a very common outcome.

    “in addition to transition to psychosis, longer-term psychotic disorder, or persistent sub-threshold psychotic symptoms, progression to persistent mood, anxiety, personality and/or substance use disorders is also a very common outcome [25, 26]”

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Authors
Rutigliano, G., Valmaggia, L., Landi, P., Frascarelli, M., Cappucciati, M., Sear, V., Rocchetti, M., De Micheli, A., Jones, C., Palombini, E., McGuire, P., & Fusar-Poli, P.
Affiliations
  • University of Pisa (IT)
  • King's College London (GB)
  • South London and Maudsley NHS Foundation Trust (GB)
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2016-10
Volume
203
Pages
101-110
ISSN
0165-0327 (ISSN-L)
OpenAlex
W2417001166
Cited by
138
References
69
Citations by year
2026: 6 · 2025: 6 · 2024: 14 · 2023: 10 · 2022: 13 · 2021: 20 · 2020: 21 · 2019: 21 · 2018: 12 · 2017: 12 · 2016: 3
FWCI
14.24
Type
journal article
Language
en
Open access
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
Keywords
clinical high risk for psychosis, mood disorders, functional outcome, attenuated psychotic symptoms, global functioning, longitudinal follow-up
MeSH terms
Mental Disorders, Female, Humans, London, Male, Prognosis, Psychiatric Status Rating Scales, Psychotic Disorders, Recurrence, Risk Factors, Comorbidity, Young Adult, Prodromal Symptoms

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