Depression in First Episode Psychosis: the Role of Subordination and Shame

Upthegrove, R.; Ross, K.; Brunett, K.; McCollum, R. and Jones, Lisa (2014) Depression in First Episode Psychosis: the Role of Subordination and Shame.

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Official URL: 10.1016/j.psychres.2014.03.023


Depression in early psychosis is linked to poor outcome, relapse and risk of suicide, yet remains poorly understood. This article aims to examine the development of depression in acute and post psychotic phases of first episode psychosis (FEP), and its relationship to persecutors, voices, insight, and recovery. Data were gathered on 92 patients with acute FEP on depression course, severity and experience of positive symptoms, insight and appraisals of illness using validated semi-structured interviews and questionnaires. Measures were repeated at 12 months. Malevolent voices, use of safety behaviours and subordination to persecutors were associated with depression and suicidal behaviour in acute FEP. Loss, Shame, low level continuing positive symptoms and longer duration of untreated psychosis were associated with post psychotic depression. Negative appraisals remained stable despite recovery in other symptom domains. Thus, depression and risk in early psychosis may be propagated by the personal significance and content of positive symptoms experienced. When in recovery, low level symptoms, longer period of illness and negative appraisals are significant factors.

Item Type: Article
Keywords: BF Psychology, RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Members: University of Worcester
Depositing User: ULCC Admin
Date Deposited: 08 Nov 2016 13:15
Last Modified: 08 Nov 2016 13:15

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