Axis-I disorders and vulnerability to psychosis.
BACKGROUND
The psychopathology that manifests during the prodromal phase of first-episode psychosis is varied. Little is known about the clinical diagnoses of subjects with so-called prodromal or psychotic-like symptoms.


METHODS
Samples of psychotic patients, first-degree relatives (FDRs) of psychotic, or severely ill patients, treatment-seeking patients, and a random community sample (in all 157 subjects) were assessed by the Structured Interview for Prodromal Symptoms (SIPS) and the SCID-I. Vulnerability to psychosis (VTP) was defined by severity of positive symptoms reported in the SIPS interview and associated with lifetime SCID-I diagnoses.


RESULTS
The number of lifetime diagnoses received increased linearly as the SIPS symptoms approached more psychotic-like phenomena. All VTP subjects received on average 2.5, and currently prodromal subjects 2.9 lifetime SCID-I diagnoses, while the corresponding figure for non-VTP subjects was 0.7 (p<0.0001). Mood disorders and comorbid anxiety disorders were particularly common.


CONCLUSIONS
Vulnerability to psychosis seems to be associated with a high number of lifetime Axis-I diagnoses. Occurrence of anxiety disorders is remarkable, and most VTP subjects can be diagnosed with a lifetime mood disorder. VTP subjects require careful assessment of mood and anxiety symptoms and adequate treatment for their multiple disorders.
Svirskis
Tanja
T
University of Turku, Department of Psychiatry, Kunnallissairaalantie 20 rak., 9 20700 Turku, Finland. tapasu@utu.fi
Korkeila
Jyrki
J
Heinimaa
Markus
M
Huttunen
Jukka
J
Ilonen
Tuula
T
Ristkari
Terja
T
McGlashan
Thomas
T
Salokangas
Raimo K R
RK
D000328:Adult; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011618:Psychotic Disorders / Q000523:psychology