Get access

Anxiety symptoms severity and short-term clinical outcome in first-episode psychosis

Authors

  • Tina C. Montreuil,

    1. Prevention and Early Intervention Program for Psychoses (PEPP – Montreal), Montreal, Canada
    2. Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada
    3. Department of Psychology, University of Québec in Montréal, Montreal, Canada
    Search for more papers by this author
  • Ashok K. Malla,

    1. Prevention and Early Intervention Program for Psychoses (PEPP – Montreal), Montreal, Canada
    2. Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada
    3. Department of Psychiatry, McGill University, Montreal, Canada
    Search for more papers by this author
  • Ridha Joober,

    1. Prevention and Early Intervention Program for Psychoses (PEPP – Montreal), Montreal, Canada
    2. Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada
    3. Department of Psychiatry, McGill University, Montreal, Canada
    Search for more papers by this author
  • Claude Bélanger,

    1. Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada
    2. Department of Psychology, University of Québec in Montréal, Montreal, Canada
    Search for more papers by this author
  • Martin Lepage

    Corresponding author
    1. Prevention and Early Intervention Program for Psychoses (PEPP – Montreal), Montreal, Canada
    2. Department of Psychiatry, McGill University, Montreal, Canada
    • Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada
    Search for more papers by this author

Corresponding author: Dr Martin Lepage, Douglas Mental Health University Institute, Frank B Common Pavilion, F1143, 6875 LaSalle Boulevard, Verdun, Quebec, Canada H4H 1R3. Email: martin.lepage@mcgill.ca

Abstract

Aim

In psychotic disorders, a limited number of studies have documented the presence of symptoms of anxiety, especially in first-episode psychosis (FEP). There is a growing interest in better understanding how these symptoms may affect the severity of psychotic symptoms and clinical outcome. This study examined the association between symptoms of anxiety, as measured by the Hamilton Anxiety Rating Scale (HARS) and the Positive and Negative Syndrome Scale (PANSS), and short-term clinical outcome. We first examined the potential association between anxiety symptom severity among FEP patients and remission. A secondary objective explored the relation between the PANSS single item subscale ‘anxiety’ item and the total score value of the HARS.

Method

Data were collected on 201 FEP patients divided into remitted and unremitted groups based on clinical data at 6 months. Anxiety ratings were compared between 67 remitted and 99 unremitted patients with the HARS, and for 72 remitted and 103 unremitted patients with the (G2) PANSS.

Results

A significant interaction Time × Group was observed on the HARS and on the PANSS G2 item. Looking at the two time points specifically, groups did not significantly differ at baseline on either the HARS or the PANSS. At 6 months, these two groups were significantly different on both anxiety rating scores – HARS [t(170) = 3.48, P = 0.001)] and PANSS G2 [t(173) = 2.51, P = 0.013)].

Conclusion

Anxiety severity is marked in FEP, and appears to be linked to poor short-term clinical outcome. The PANSS single item (G2) seems to represent a good indicator of anxiety as it significantly correlates with a more systematic measure of anxiety, namely the HARS score. Anxiety severity appears to vary across diagnosis type.

Ancillary