Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis

Abstract

Objective: Recent studies suggest that psychotic-like experiences may also act as markers for non-psychotic psychiatric disorders, which may indicate that the focus of research in individuals at high risk (HR) for psychosis needs updating. In this study we thoroughly examined the clinical and functional characteristics of a consecutive cohort of young people at HR for psychosis and compared them to a matched sample of healthy volunteers.

Method: Between February 2010 and September 2012 60 help-seeking HR individuals, aged 16-35, were recruited from CAMEO Early Intervention in Psychosis Service, Cambridgeshire, UK. Forty-five age- and gender-matched healthy volunteers were randomly recruited from the same geographical area. Sociodemographic, psychiatric morbidity, functioning and quality of life measures were compared between both groups.

Results: HR individuals suffered a wide range of DSM-IV psychiatric disorders, mainly within the affective and anxiety diagnostic spectra. In comparison to healthy volunteers, young people at HR reported more suicidal ideation/intention, depressive and anxiety symptoms and presented with remarkably poor functioning and quality of life.

Conclusion: The presence of co-morbid moderate or severe depressive and anxiety symptoms was common in our sample of young people at enhanced risk for psychosis. A HR mental state may be associated not only with an increased risk for psychosis, but also other psychiatric disorders. Our findings may have implications for the future implementation of therapeutic interventions that this population could benefit from.

Keywords: At-risk-mental-state; BAI; BDI-II; BLIPS; Beck Anxiety Inventory; Beck Depression Inventory, Version II; Brief Limited Intermittent Psychotic Symptoms; CAARMS; Comprehensive Assessment of At-Risk-Mental-States; Early intervention; FEP; First-Episode Psychosis; GAF; Global Assessment of Functioning; HR; High Risk; High-risk; MANSA; MINI; Manchester Short Assessment of Quality of Life; Mini International Neuropsychiatric Interview; PAF; PANSS; Positive and Negative Syndrome Scale; Postcode Address File; Psychosis; Psychotic-like; Schizophrenia; YBOCS; YMRS; Yale-Brown Obsessive Compulsive Symptoms Scale; Young Mania Rating Scale.