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Digital archive of theses discussed at the University of Pisa

 

Thesis etd-06192014-092820


Thesis type
Tesi di specializzazione (5 anni)
Author
LANDI, PAOLA
URN
etd-06192014-092820
Thesis title
COMORBID ANXIETY AND DEPRESSION ASSOCIATED WITH POOR FUNCTIONAL OUTCOME IN SUBJECTS AT HIGH CLINICAL RISK FOR PSYCHOSIS
Department
MEDICINA CLINICA E SPERIMENTALE
Course of study
PSICHIATRIA
Supervisors
relatore Prof. Dell'Osso, Liliana
Keywords
  • comorbidity
  • hish risk
  • outcome
  • psychosis
Graduation session start date
22/07/2014
Availability
Full
Summary
Background: Comorbid anxiety and depression have been shown to impact on the clinical presentation and distress of individuals at high risk for psychosis (HR). We investigated the impact of anxiety and depressive comorbidity on baseline and longitudinal HR characteristics.
Methods: The sample included 154 referrals to the OASIS clinic with an At Risk Mental State for psychosis. Baseline assessment data was collected using the CAARMS (Comprehensive Assessment of the At Risk. Mental State), PANSS (Positive and Negative Syndrome Scale), HAM-D and HAM-A (Hamilton Depression/Anxiety Rating Scale), SCID I and II as well as GAF (Global Assessment of Functioning). Follow-up data were available for 74 individuals.
Results: There were baseline differences in employment status across comorbidity groups (χ213.835; p=.008). The mean total scores of CAARMS, HAM-A, HAM-D and PANSS were also significantly different in the three comorbidity groups, with highest scores in the anxiety and/or depression comorbidity group (CAARMS F=3.572 p=.027; HAM-A F=10.231 p=.000; HAM-D F=8.374 p=.001; PANSS F=7.467 p=.001). We detected 22 cases of incident depression and/or anxiety disorders, 9 remissions and 17 recurrent/continuous cases (χ2=9.480; p=.047). Baseline anxiety and depressive comorbidity did not predict global functioning at follow-up (p=.657). Conversely, there was a significant association between presence of comorbid anxiety or depressive disorders at follow-up and functional status (p=.008).
Conclusions: Anxiety and depressive comorbidities are associated with poorer functional outcomes in HR individuals.
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