Depression Predicts Global Functional Outcomes in Individuals at Clinical High Risk for Psychosis

Wisteria, Deng, Yale University; Jean, Addington, Hotchkiss Brain Institute; Carrie E, Bearden, University of California, Los Angeles; Kristin S, Cadenhead, University of California, San Diego; Barbara A, Cornblatt, Zucker Hillside Hospital; Daniel H, Mathalon, UCSF, SFVA Medical Center; Thomas H, McGlashan, Yale University; Diana O, Perkins, University of North Carolina; Larry J, Seidman, Harvard Medical School; Ming T, Tsuang, University of California, San Diego; Scott W, Woods, Yale University; Elaine, Walker, Emory University; Jutta, Joormann, Yale University; Tyrone, Cannon, Yale University

Persistent URL

https://open.library.emory.edu/purl/337vmcvfpn-emory

Last modified

07/08/2025

Type of Material

Article

Authors

Wisteria Deng, Yale University

Jean Addington, Hotchkiss Brain Institute

Carrie E Bearden, University of California, Los Angeles

Kristin S Cadenhead, University of California, San Diego

Barbara A Cornblatt, Zucker Hillside Hospital

Daniel H Mathalon, UCSF, SFVA Medical CenterThomas H McGlashan, Yale UniversityDiana O Perkins, University of North CarolinaLarry J Seidman, Harvard Medical SchoolMing T Tsuang, University of California, San DiegoScott W Woods, Yale UniversityElaine Walker, Emory UniversityJutta Joormann, Yale UniversityTyrone Cannon, Yale University

Language

English

Date

2021-11-17

Publisher

Wiley Periodicals LLC

Publication Version

Final Published Version

Copyright Statement

© 2021 The Authors. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC on behalf of American Psychiatric Association

License

Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International

Final Published Version (URL)

http://dx.doi.org/10.1176/appi.prcp.20210023

Title of Journal or Parent Work

Psychiatric Research and Clinical Practice

Volume

3

Issue

4

Start Page

163

End Page

171

Supplemental Material (URL)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9175802/bin/RCP2-3-163-s001.docx

Abstract

Objectives While co‐morbid depression is associated with poor functional outcome among patients with schizophrenia, whether depression similarly predicts poorer outcomes in individuals at clinical high‐risk for psychosis (CHR‐P) is not clear. The present study aimed to examine depressive symptoms in relation to long‐term global functional outcomes in the North American Prodrome Longitudinal Study cohort (NAPLS2). Methods CHR individuals were evaluated clinically at baseline and at 12‐ and 24‐month follow‐ups for depressive and prodromal symptom severity as well as general functioning. Regression models were built to investigate whether baseline positive and depressive symptom scores predicted longitudinal improvement in global functioning. Results A total of 406 CHR individuals completed the 12‐month follow‐up assessment and 259 CHR individuals completed the 24‐month assessment. Baseline depressive symptoms in the CHR‐P population were found to predict better global functional outcomes at 2 years. Furthermore, the degree of recovery of depressive symptoms in the first year following baseline completely mediated the association between depressive symptoms at baseline and functional improvement at 2 years. Conclusions Presence of affective symptoms within the CHR‐P population has different implications for prognosis compared with patients with schizophrenia. The present findings support the view that among those at risk for psychosis, depressive symptoms at baseline predict a more favorable course of functional recovery, and highlight the potential importance of treating co‐occurring depressive symptoms at an early stage of psychosis risk.

Author Notes