Persistence or recurrence of non-psychotic comorbid mental disorders associated with 6-year poor functional outcomes in patients at ultra high risk for psychosis
Open accessAbstract
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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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”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [229]
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]”
From Prevention and early intervention in youth mental health: is it time for a multidisciplinary and trans-diagnostic model for care? (2020) · cites this paper as [26]
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Self-citation
- 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)
- ORCID
- 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
- green
- kclpure.kcl.ac.uk
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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