Cited by 234Schizophrenia research and treatmentMental Health and PsychiatryBipolar Disorder and Treatment

Anxiety and depression in psychosis: a systematic review of associations with positive psychotic symptoms

Hartley, S., Barrowclough, C., Haddock, G.·2013·Acta Psychiatrica Scandinavica

Abstract

OBJECTIVE: This review explores the influence of anxiety and depression on the experience of positive psychotic symptoms, and investigates the possibility of a causal role for anxiety and depression in the emergence and persistence of psychosis. METHOD: A systematic literature search was undertaken, producing a number of papers which comment on the links between anxiety and depression, and the experience of delusions and hallucinations. In addition, evidence which could contribute to our understanding of the causal role of anxiety and depression was highlighted. RESULTS: The findings show that both anxiety and depression are associated in meaningful ways with the severity of delusions and hallucinations, the distress they elicit and their content. However, the cross-sectional nature of the majority of studies and the focus on certain symptom subtypes tempers the validity of the findings. Data from non-clinical samples, studies which track the longitudinal course of psychosis and those which examine the impact of anxiety and depression on the prognosis for people experiencing psychosis, offer some support for the possibility of an influential role for anxiety and depression. CONCLUSION: We conclude that anxiety and depression are related to psychotic symptom severity, distress and content and are also linked with sub-clinical experiences, symptom development, prognosis and relapse. These links may imply that anxiety and depression could be targets for therapeutic intervention. The article concludes with suggestions for further research, highlighting avenues which may circumvent the limitations of the body of work as it stands.

Integrity signals

Registry

Crossref · 10.1111/acps.12080

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142 of 142 references verified0 citation errors · 0 not checkable

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  • Depression and anxiety are strongly associated with positive symptoms, negative symptoms, psychotic relapses and impaired social function, and are among the best symptom predictors of quality of life outcomes in people with SSDs.

    “Depression and anxiety are strongly associated with positive symptoms,2,3,5–7,9 negative symptoms,2,8 psychotic relapses3,9 and impaired social function,3,5,9 and are among the best symptom predictors of quality of life outcomes in people with SSDs.2–9”

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Authors
Hartley, S., Barrowclough, C., & Haddock, G.
Affiliations
  • Greater Manchester Mental Health NHS Foundation Trust (GB)
  • University of Manchester (GB)
Corresponding author
Hartley, S.
Venue
Acta Psychiatrica Scandinavica
Publisher
Wiley
Published
2013-02-04
Volume
128
Issue
5
Pages
327-346
ISSN
0001-690X (ISSN-L)
OpenAlex
W2132883301
Cited by
234
References
144
Citations by year
2026: 13 · 2025: 27 · 2024: 25 · 2023: 17 · 2022: 27 · 2021: 21 · 2020: 22 · 2019: 21 · 2018: 19 · 2017: 14 · 2016: 10 · 2015: 11 · 2014: 4 · 2013: 3
FWCI
1.27
Type
journal article
Language
en
Open access
closed
Locations
  • Acta Psychiatrica Scandinavica (publishedVersion)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion)
Funders
University of Manchester
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
anxiety, depression, psychosis, positive psychotic symptoms, delusions, hallucinations, symptom severity, symptom distress, subclinical psychotic experiences, transition to psychosis, relapse, prognosis
MeSH terms
Anxiety, Delusions, Depression, Hallucinations, Humans, Psychotic Disorders, Comorbidity

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