Anxiety and depression in psychosis: a systematic review of associations with positive psychotic symptoms
Article first published online: 4 FEB 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Volume 128, Issue 5, pages 327–346, November 2013
How to Cite
Anxiety and depression in psychosis: a systematic review of associations with positive psychotic symptoms.
- Issue published online: 13 OCT 2013
- Article first published online: 4 FEB 2013
- Manuscript Accepted: 18 DEC 2012
- Manuscript Revised: 13 OCT 2012
- Manuscript Received: 19 JUN 2012
- Greater Manchester West Mental Health NHS Foundation Trust
This review explores the influence of anxiety and depression on the experience of positive psychotic symptoms, and investigates the possibility of a causal role for anxiety and depression in the emergence and persistence of psychosis.
A systematic literature search was undertaken, producing a number of papers which comment on the links between anxiety and depression, and the experience of delusions and hallucinations. In addition, evidence which could contribute to our understanding of the causal role of anxiety and depression was highlighted.
The findings show that both anxiety and depression are associated in meaningful ways with the severity of delusions and hallucinations, the distress they elicit and their content. However, the cross-sectional nature of the majority of studies and the focus on certain symptom subtypes tempers the validity of the findings. Data from non-clinical samples, studies which track the longitudinal course of psychosis and those which examine the impact of anxiety and depression on the prognosis for people experiencing psychosis, offer some support for the possibility of an influential role for anxiety and depression.
We conclude that anxiety and depression are related to psychotic symptom severity, distress and content and are also linked with sub-clinical experiences, symptom development, prognosis and relapse. These links may imply that anxiety and depression could be targets for therapeutic intervention. The article concludes with suggestions for further research, highlighting avenues which may circumvent the limitations of the body of work as it stands.