Evidence of mediation of severity of anxiety and depressive symptoms between abuse and positive symptoms of psychosis.


Journal

Journal of psychiatric research
ISSN: 1879-1379
Titre abrégé: J Psychiatr Res
Pays: England
ID NLM: 0376331

Informations de publication

Date de publication:
06 2022
Historique:
received: 07 08 2021
revised: 21 10 2021
accepted: 17 11 2021
pubmed: 29 11 2021
medline: 18 5 2022
entrez: 28 11 2021
Statut: ppublish

Résumé

Considerable evidence on general population suggests that an "Affective pathway to psychosis", involving depression and anxiety dimensions, mediates the abuse-psychosis association. However, this has never been tested in Early Psychosis (EP) patients. We aim at testing whether severity of depressive and anxiety mediates the abuse-positive symptoms dyad in an EP prospective sample. 330 EP subjects aged 18-35 were assessed for psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Abuse was considered as facing at least one experience of physical, sexual, or emotional abuse before age 16. Positive psychotic symptoms and anxiety were measured with the Positive and Negative Syndrome Scale and depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Mediation analyses were performed to study whether the abuse-positive symptom's link was mediated by depressive, anxiety, and a combination of anxiety/mood symptoms. Among the 330 EP patient included, 104 (31.5% of the total) were exposed to abuse. Analyses across the 36 months of follow-up showed that depression and anxiety partially mediated 26.7% of the total effect of the abuse-positive symptoms association (indirect effects (IE) = 0.392 and 0.421 respectively), while the combined anxiety/mood model mediated 28.9% (IE = 0.475). Subanalyses at two and 36 months revealed a consistent role of depression, while that of anxiety was only present at baseline. Our work confirms a mediating role of mood and anxiety in the association between abuse and positive symptoms during the first three years of treatment.

Sections du résumé

BACKGROUND
Considerable evidence on general population suggests that an "Affective pathway to psychosis", involving depression and anxiety dimensions, mediates the abuse-psychosis association. However, this has never been tested in Early Psychosis (EP) patients. We aim at testing whether severity of depressive and anxiety mediates the abuse-positive symptoms dyad in an EP prospective sample.
METHODS
330 EP subjects aged 18-35 were assessed for psychopathology after 2, 6, 12, 18, 24, 30, and 36 months of treatment. Abuse was considered as facing at least one experience of physical, sexual, or emotional abuse before age 16. Positive psychotic symptoms and anxiety were measured with the Positive and Negative Syndrome Scale and depressive symptoms with the Montgomery-Asberg Depression Rating Scale. Mediation analyses were performed to study whether the abuse-positive symptom's link was mediated by depressive, anxiety, and a combination of anxiety/mood symptoms.
RESULTS
Among the 330 EP patient included, 104 (31.5% of the total) were exposed to abuse. Analyses across the 36 months of follow-up showed that depression and anxiety partially mediated 26.7% of the total effect of the abuse-positive symptoms association (indirect effects (IE) = 0.392 and 0.421 respectively), while the combined anxiety/mood model mediated 28.9% (IE = 0.475). Subanalyses at two and 36 months revealed a consistent role of depression, while that of anxiety was only present at baseline.
CONCLUSION
Our work confirms a mediating role of mood and anxiety in the association between abuse and positive symptoms during the first three years of treatment.

Identifiants

pubmed: 34838264
pii: S0022-3956(21)00676-2
doi: 10.1016/j.jpsychires.2021.11.027
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

353-359

Informations de copyright

Copyright © 2021. Published by Elsevier Ltd.

Auteurs

Luis Alameda (L)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital CHUV, CH-1008, Lausanne, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centro Investigacion Biomedica en Red de Salud Mental CIBERSAM, Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain. Electronic address: laluisalameda@gmail.com.

Philippe Conus (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital CHUV, CH-1008, Lausanne, Switzerland.

Julie Ramain (J)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital CHUV, CH-1008, Lausanne, Switzerland.

Alessandra Solida (A)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital CHUV, CH-1008, Lausanne, Switzerland.

Philippe Golay (P)

Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital CHUV, CH-1008, Lausanne, Switzerland; Community Psychiatry Service, Department of Psychiatry, Consultations de Chauderon, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Psychology, Faculty of Social and Politic Al Science, University of Lausanne, Lausanne, Switzerland.

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