| Resum: |
Diagnoses of anxiety and/or depression are common in subjects at Ultra-High Risk for Psychosis (UHR) and associated with extensive functional impairment. Less is known about the impact of affective comorbidities on the prospective course of attenuated psychotic symptoms (APS). Method: Latent class mixed modelling identified APS trajectories in 331 UHR subjects assessed at baseline, 6, 12, and 24 months follow-up. The prognostic value of past, baseline, and one-year DSM-IV depressive or anxiety disorders on trajectories was investigated using logistic regression, controlling for confounders. Cox proportional hazard analyses investigated associations with transition risk. Results: 46. 8% of participants fulfilled the criteria for a past depressive disorder, 33. 2% at baseline, and 15. 1% at one-year follow-up. Any past, baseline, or one-year anxiety disorder was diagnosed in 42. 9%, 37. 2%, and 27. 0%, respectively. Participants were classified into one of three latent APS trajectory groups: (1) persistently low, (2) increasing, and (3) decreasing. Past depression was associated with a higher risk of belonging to the increasing trajectory group, compared to the persistently low (OR = 3. 149, [95%CI: 1. 298-7. 642]) or decreasing group (OR = 3. 137, [1. 165-8. 450]). In contrast, past (OR = . 443, [. 179-1. 094]) or current (OR = . 414, [. 156-1. 094]) anxiety disorders showed a trend-level association with a lower risk of belonging to the increasing group compared to the persistently low group. Past depression was significantly associated with a higher risk of transitioning to psychosis (HR = 2. 123, [1. 178-3. 828]). Conclusion: A past depressive episode might be a particularly relevant risk factor for an unfavorable course of APS in UHR individuals. Early affective disturbances may be used to advance detection, prognostic, and clinical strategies. |
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