title: 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.
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Electronic address: jmadding@ucalgary.ca.
authors.forename: Jean
authors.initials: J
authors.lastname: Addington
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Danijela
authors.initials: D
authors.lastname: Piskulic
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Lu
authors.initials: L
authors.lastname: Liu
authors.affiliation: Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lockwood
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Cadenhead
authors.affiliation: Department of Psychology, Yale University, New Haven, CT, United States.
authors.forename: Tyrone D
authors.initials: TD
authors.lastname: Cannon
authors.affiliation: Department of Psychiatry, Zucker Hillside Hospital, Queens, NY, United States.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cornblatt
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
authors.affiliation: Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States.
authors.forename: Diana O
authors.initials: DO
authors.lastname: Perkins
authors.affiliation: Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, United States.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Seidman
authors.affiliation: Department of Psychiatry, University of California San Diego, La Jolla, CA, United States; Institute of Genomic Medicine, University of California, La Jolla, CA, United States.
authors.forename: Ming T
authors.initials: MT
authors.lastname: Tsuang
authors.affiliation: Department of Psychology, Emory University, Atlanta, GA, United States.
authors.forename: Elaine F
authors.initials: EF
authors.lastname: Walker
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, United States; Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Bearden
authors.affiliation: Department of Psychiatry, University of California, San Francisco, San Francisco, United States; Psychiatry Service, San Francisco, CA, United States.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mathalon
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT, United States.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Woods
mesh_terms: D000293:Adolescent; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D012306:Risk; D054063:Superior Sagittal Sinus; D055815:Young Adult
keywords: Anxiety; Clinical high risk; Comorbidity; DSM-IV diagnoses; Depression