The impact of affective and negative symptoms on the development of psychosis in a six-year follow-up of a community-based population

Ceylan Ergul*, Tolga Binbay, Umut Kirli, Hayriye Elbi, Koksal Alptekin, Jim van Os, Marjan Drukker

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PurposeThe Clinical High Risk (CHR) concept has a limited transition risk to psychotic disorders (PD). This study investigates the association between affective and negative symptoms, currently not included in the CHR concept, and the risk of transition to PD in a community-based population of 2185 participants in Turkey.MethodsParticipants were assessed twice over six years using a multistage sampling technique. Two separate linear regression analyses were conducted on data from both assessments, investigating the relationship between affective and negative symptoms, subclinical and clinical psychotic experiences (PE) and progression to PD.ResultsThe overall transition rate to PD was 1.3%. The analysis showed no increased risk of developing PD for the 'subclinical PE only' group at follow-up, compared to the 'no PE' group. However, being classified as having 'clinical PE only' (OR: 6.23; p = 0.010) and 'clinical PE + affective/negative symptoms' (OR: 8.48; p = 0.001) at baseline was associated with an increased risk of developing PD at follow-up. The presence of 'affective/negative symptoms' at baseline was associated with an increased risk of incident subclinical PE (RR: 1.98; p = 0.001), incident clinical PE (RR: 3.14; p = 0.001), and incident PD (RR: 4.21; p = 0.030) at follow-up.ConclusionThe results confirm the significance of the baseline severity of positive symptoms in predicting the transition to PD and suggest that both positive and affective/negative symptoms impact the transition risk to PD and incident psychotic symptoms. This highlights the potential utility of defining CHR groups based on a combination of positive, affective, and negative symptoms.
Original languageEnglish
Number of pages10
JournalSocial Psychiatry and Psychiatric Epidemiology
DOIs
Publication statusE-pub ahead of print - 1 Nov 2024

Keywords

  • Psychotic experiences
  • Psychotic disorders
  • Clinical high risk
  • Transition
  • INTERNATIONAL DIAGNOSTIC INTERVIEW
  • CLINICAL HIGH-RISK
  • METAANALYSIS
  • ONSET
  • PSYCHOPATHOLOGY
  • RELIABILITY
  • EXPERIENCES
  • DEPRESSION
  • DISORDERS
  • STATE

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