The DOI matches its Crossref record; 15 of the 15 references it cites were found in a registry or an index.
The evolution of insight, paranoia and depression during early schizophrenia
Abstract
BACKGROUND: How insight, paranoia and depression evolve in relation to each other during and after the first episode of schizophrenia is poorly understood but of clinical importance. METHOD: Serial assessments over 18 months were made using multiple instruments in a consecutive sample of 257 patients with first episode DSM-IV non-affective psychosis. Repeated measures of paranoia, insight, depression and self-esteem were analysed using structural equation modelling, to examine the direction of relationships over time after controlling for confounds. RESULTS: Depression was predicted directly by greater insight, particularly at baseline, and by greater paranoia at every stage of follow-up. Neither relationship was mediated by self-esteem, although there was a weak association of lower self-esteem with greater depression and better insight. Paranoia was not strongly associated with insight. Duration of untreated psychosis and substance use at baseline predicted depression at 18 months. CONCLUSIONS: In first-episode psychosis, good insight predicts depression. Subsequently, paranoia is the strongest predictor. Neither effect is mediated by low self-esteem. Effective treatment of positive symptoms is important in preventing and treating low mood in early schizophrenia.
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“longer duration of untreated psychosis (Drake et al., 2003)”
From A parallel group randomised open blinded evaluation of A cceptance and Commitment Therapy for d epression a fter p sychosis: Pilot t rial outcomes (ADAPT) (2017) · cites this paper as Drake et al., 2003
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Suspicious minds: The psychology of persecutory delusions
Freeman, D. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.10.004 · Cited by 814
van der Gaag, M., Hoffman, T. O., REMIJSEN, M., Hijman, R., DEHAAN, L., VANMEIJEL, B., VANHARTEN, P., Valmaggia, L., DEHERT, M., & CUIJPERS, A. (2006) · Schizophrenia Research · doi:10.1016/j.schres.2006.03.021 · Cited by 555
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Self-citation
Metadata
- Authors
- DRAKE, R. J., PICKLES, A., BENTALL, R. P., KINDERMAN, P., HADDOCK, G., TARRIER, N., & LEWIS, S. W.
- Affiliations
- University of Manchester (GB)
- University of Liverpool (GB)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2004-01-28
- Volume
- 34
- Issue
- 2
- Pages
- 285-292
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2056061093
- Cited by
- 204
- References
- 15
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 7 · 2015: 10 · 2014: 18 · 2013: 12 · 2012: 19
- FWCI
- 8.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- schizophrenia, first-episode psychosis, insight, paranoia, depression, self-esteem, duration of untreated psychosis, substance use, depressive mood
- MeSH terms
- Adult, Awareness, Depression, Female, Humans, Male, Paranoid Disorders, Predictive Value of Tests, Surveys and Questionnaires, Schizophrenia, Self Concept, Severity of Illness Index, Comorbidity, Incidence, Diagnostic and Statistical Manual of Mental Disorders
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