Depression and clinical high-risk states: Baseline presentation of depressed vs. non-depressed participants in the NAPLS-2 cohort

• Type of Material: Article
• Authors: Emily R. Kline, Harvard Medical School; Larry J. Seidman, Harvard Medical School; Barbara A. Cornblatt, Zucker Hillside Hospital; Kristen A. Woodberry, Harvard Medical School; Caitlin Bryant, Harvard Medical School; Carrie E. Bearden, University of California Los Angeles; Kristin S. Cadenhead, University of California San Diego; Tyrone D. Cannon, Yale University; Daniel H. Mathalon, San Francisco Veterans Affairs Medical Center; Thomas H. McGlashan, Yale University; Diana O. Perkins, University of North Carolina; Ming T. Tsuang, University of California San Diego; Elaine Walker, Emory University; Scott W. Woods, Yale University; Jean Addington, University of Calgary
• Language: English
• Date: 2018-02-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.schres.2017.05.032
• Title of Journal or Parent Work: Schizophrenia Research
• ISSN: 0920-9964
• Volume: 192
• Start Page: 357
• End Page: 363
• Grant/Funding Information: This study was supported by the National Institute of Mental Health (NIMH) grants U01 MH081928, and the Commonwealth of Massachusetts SCDMH82101008006 to Dr. Seidman; grant U01 MH081984 to Dr. Addington; grants R01 MH60720, U01 MH082022 and K24 MH76191 to Dr. Cadenhead; grant U01 MH081902 to Dr. Cannon; P50 MH066286 (Prodromal Core) to Dr. Bearden; U01 MH081857 grant to Dr. Cornblatt; grant U01 MH082004 to Dr. Perkins; grant U01 MH081988 to Dr. Walker; grant U01 MH082022 to Dr. Woods; Clinical Translational Science Award (UL1RR025758) and General Clinical Research Center Grant (M01RR01032) from the National Center for Research Resources to Harvard University and Beth Israel Deaconess Medical Center, the National Center for Research Resources (P41RR14075), and Shared Instrumentation Grants (1S10RR023401, 1S10RR019307, 1S10RR023043).
• Keywords: Prodromal Symptoms; Psychiatric Status Rating Scales; Cohort Studies; Schizophrenia; Adult; Social Adjustment; North America; Female; Depression; Schizophrenic Psychology; Adolescent; Mood; Prodrome; Male; Statistics, Nonparametric; Young Adult; Remission; Humans; Child; Psychosis
• Research Categories: Psychology, Clinical

Abstract

Depressed mood appears to be highly prevalent in clinical high risk (CHR) samples. However, many prior CHR studies utilize modest size samples and do not report on the specific impact of depression on CHR symptoms. The aim of the current paper is to investigate the prevalence of depressive disorders and the impact of lifetime depression on baseline clinical presentation and longitudinal outcomes in a large cohort of individuals meeting CHR criteria in the second phase of the North American Prodrome Longitudinal Study (NAPLS-2). Depression was assessed both categorically (via DSM-IV-TR diagnoses) and symptomatically (using a clinician-rated scale of depressive symptoms) within a sample of 764 individuals at CHR and 279 controls. Current and lifetime depressive disorders were highly prevalent (60%) in this sample. Depression diagnoses were associated with more pronounced negative and general symptoms; individuals with remitted depression had significantly less severe negative, disorganized, and general symptoms and better social and role functioning relative to those with current depression. Current mood disturbance, as measured by scores on a clinician-rated symptom scale, contributed beyond the impact of positive and negative symptoms to impairments in social functioning. Both symptomatic and diagnostic baseline depression was significantly associated with decreased likelihood of remission from CHR status; however depression did not differentially distinguish persistent CHR status from transition to psychosis at follow-up. These findings suggest that depressed mood may function as a marker of poor prognosis in CHR, yet effective treatment of depression within this population can yield improvements in symptoms and functioning.