title: Biological and psychosocial risk factors for psychotic major depression.
abstract: OBJECTIVE
  Few studies have investigated risk factors for psychotic major depression (PMD). We aimed to investigate the biological and psychosocial risk factors associated with PMD compared with other psychotic disorders.
  
  
  METHODS
  Based on the aetiology and ethnicity in schizophrenia and other psychoses (ÆSOP) study, we used a case-control study to identify and recruit, at baseline and 10-year follow-up, all first episode cases of psychosis, presenting for the first time to specialist mental health services in defined catchment areas in the UK. Population-based controls were recruited from the same areas. Data were collected on: sociodemographics; social isolation; childhood adversity; life events; minor physical anomalies; and neurological soft signs.
  
  
  RESULTS
  Living alone (aOR = 2.26, CI = 1.21-4.23), basic level qualification (aOR = 2.89, CI = 1.08-7.74), being unemployed (aOR = 2.12, CI = 1.13-3.96), having contact with friends less than monthly (aOR = 4.24, CI = 1.62-11.14), having no close confidants (aOR = 4.71, CI = 2.08-10.68), having experienced childhood adversity (aOR = 2.57, CI = 1.02-6.44), family history of mental illness (aOR = 10.68, CI = 5.06-22.52), family history of psychosis (aOR = 12.85, CI = 5.24-31.51), and having more neurological soft signs (aOR = 1.15, CI = 1.07-1.24) were all associated with a follow-up diagnosis of PMD and schizophrenia. Few variables associated with PMD were also associated with a diagnosis of bipolar disorder. Minor physical anomalies were associated with a follow-up diagnosis of schizophrenia and bipolar disorder, but not PMD.
  
  
  CONCLUSIONS
  Risk factors associated with PMD appear to overlap with those for schizophrenia, but less so for bipolar disorder. Future work on the differential aetiology of PMD, from other psychoses is needed to find the 'specifier' between PMD and other psychoses. Future research on aetiology in PMD, and perhaps other psychoses, should account for diagnostic change.
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. Margaret.Heslin@kcl.ac.uk.
authors.forename: M
authors.initials: M
authors.lastname: Heslin
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
authors.forename: R
authors.initials: R
authors.lastname: Desai
authors.affiliation: University of New South Wales, Sydney, Australia.
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authors.initials: JM
authors.lastname: Lappin
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
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authors.initials: K
authors.lastname: Donoghue
authors.affiliation: University of Nottingham, Nottingham, UK.
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authors.initials: B
authors.lastname: Lomas
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.|Maastricht University, Maastrict, The Netherlands.
authors.forename: U
authors.initials: U
authors.lastname: Reininghaus
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
authors.forename: A
authors.initials: A
authors.lastname: Onyejiaka
authors.affiliation: University of Dundee, Dundee, UK.
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authors.initials: T
authors.lastname: Croudace
authors.affiliation: University of Cambridge, Cambridge, UK.
authors.forename: P B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.|National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: Trinity College, Dublin, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Fearon
authors.affiliation: University of Nottingham, Nottingham, UK.
authors.forename: G A
authors.initials: GA
authors.lastname: Doody
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.|National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dazzan
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
authors.forename: H L
authors.initials: HL
authors.lastname: Fisher
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
authors.forename: A
authors.initials: A
authors.lastname: Demjaha
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.
authors.forename: T
authors.initials: T
authors.lastname: Craig
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK.|National Institute for Health Research (NIHR), Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: C
authors.initials: C
authors.lastname: Morgan
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; Epidemiology; Psychosis; Risk factors