Comorbid diagnoses for youth at clinical high risk of psychosis
- PMID: 28372906
- PMCID: PMC5731830
- DOI: 10.1016/j.schres.2017.03.043
Comorbid diagnoses for youth at clinical high risk of psychosis
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 are at risk but do not have a comorbid diagnosis may not be seeking help in the prodromal phase.
Keywords: Anxiety; Clinical high risk; Comorbidity; DSM-IV diagnoses; Depression.
Copyright © 2017 Elsevier B.V. All rights reserved.
Conflict of interest statement
Dr. Cannon reports that he is a consultant to the Los Angeles County Department of Mental Health and to Boehringer Ingelheim Pharmaceuticals.
Dr. Woods reports that since 2005 he has received investigator-initiated research funding support from UCB Pharma, Glytech, Lilly, Bristol-Myers Squibb, and Pfizer. He has received sponsor-initiated research funding support from Kali-Duphar, Zeneca, Sandoz, Janssen, Auspex, and Teva and has consulted to Otsuka, Schering-Plough, Merck, Biomedisyn (unpaid), and Boehringer-Ingelheim and has received grants from NIMH, NARSAD, and the Donaghue Foundation. He has also served as an unpaid consultant to DSM-5. He has been granted US patent no. 8492418 B2 for a method of treating prodromal schizophrenia with glycine agonists, is an inventor on a patent pending for a method of predicting psychosis risk using blood biomarker analysis, and has received royalties from Oxford University Press.
All other authors report no conflicts.
References
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