Comorbid diagnoses for youth at clinical high risk of psychosis

• Type of Material: Article
• Authors: Jean Addington, University of Calgary; Danijela Piskulic, University of Calgary; Lu Liu, University of Calgary; Jonathan Lockwood, University of Calgary; Kristin S. Cadenhead, University of California San Diego; Tyrone D. Cannon, Yale University; Barbara A. Cornblatt, Zucker Hillside Hospital; Thomas H. McGlashan, Yale University; Diana O. Perkins, University of North Carolina; Larry J. Seidman, Harvard Medical School; Ming T. Tsuang, University of California; Elaine Walker, Emory University; Carrie E. Bearden, University of California Los Angeles; Daniel H. Mathalon, University of California San Francisco; Scott W. Woods, Yale University
• Language: English
• Date: 2017-12
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier B.V. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.schres.2017.03.043
• Title of Journal or Parent Work: Schizophrenia Research
• ISSN: 0920-9964
• Volume: 190
• Start Page: 90
• End Page: 95
• Grant/Funding Information: This study was supported by the National Institute of Mental Health (grant U01MH081984 to Dr. Addington; grants U01 MH081928; P50 MH080272; Commonwealth of Massachusetts SCDMH82101008006 to Dr. Seidman; grants R01 MH60720, U01 MH082022 and K24 MH76191 to Dr. Cadenhead; grant U01MH081902 to Dr. Cannon; P50 MH066286 (Prodromal Core) to Dr. Bearden; grant U01MH082004 to Dr. Perkins; grant U01MH081988 to Dr. Walker; grant U01MH082022 to Dr. Woods; and UO1 MH081857-05 grant to Dr. Cornblatt.
• Keywords: depression; DSM-IV diagnoses; anxiety; clinical high risk; comorbidity
• Research Categories: Psychology, Behavioral

Abstract

Several studies have demonstrated that youth at clinical high risk (CHR) of developing psychosis have a high prevalence of comorbid psychiatric disorders. Less is known about the impact of comorbid diagnoses on later conversion to psychosis and the change over time. The aim of this study was to determine the frequency and distribution of psychiatric diagnoses at baseline and over time in the North American Prodrome Longitudinal Study (NAPLS 2) and the role of comorbid diagnoses in conversion to psychosis. The NAPLS 2 sample consisted of 744 CHR youth and 276 healthy controls. Only 21% of the CHR group did not have a comorbid diagnosis with many have 2–3 DSM-IV comorbid diagnoses. The most common diagnoses were anxiety and depressive disorders, which did improve over time. The only diagnosis at baseline that differentiated the converters from the non-converters was cannabis misuse. Comorbidity, except for cannabis use, was essentially independent of clinical outcome. It is possible that those with comorbid diagnoses are preferentially the help-seeking individuals that present for help in our clinics and research projects and that those who at risk but do not have a comorbid diagnosis may not be seeking help in the prodromal phase.