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Temporal association of stress sensitivity and symptoms in individuals at clinical high risk for psychosis

Published online by Cambridge University Press:  01 June 2012

J. E. DeVylder ,
S. Ben-David ,
S. A. Schobel ,
D. Kimhy ,
D. Malaspina  and
C. M. Corcoran
J. E. DeVylder
Affiliation:
Columbia University School of Social Work, New York, NY, USA
S. Ben-David
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
S. A. Schobel
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
D. Kimhy
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
D. Malaspina
Affiliation:
Department of Psychiatry, New York University, New York, NY, USA
C. M. Corcoran*
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
*
*Address for correspondence: C. M. Corcoran, M.D., New York State Psychiatric Institute at Columbia University, Unit 55, 1051 Riverside Drive, New York, NY 10032, USA. (Email: cc788@columbia.edu)
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Abstract

Background

Increased sensitivity and exposure to stress are associated with psychotic symptoms in schizophrenia and its risk states, but little is known about the co-evolution of stress sensitivity and exposure with positive and other symptoms in a clinical high-risk (CHR) cohort.

Method

A combined cross-sectional and longitudinal design was used to examine the associations over time of stress sensitivity and exposure (i.e. life events) with ‘prodromal’ symptoms in a cohort of 65 CHR patients assessed quarterly for up to 4 years, and at baseline in 24 healthy controls similar in age and gender.

Results

Impaired stress tolerance was greater in patients, in whom it was associated over time with positive and negative symptoms, in addition to depression, anxiety and poor function. By contrast, life events were comparable in patients and controls, and bore no association with symptoms. In this treated cohort, there was a trajectory of improvement in stress tolerance, symptoms and function over time.

Conclusions

Impaired stress tolerance was associated with a wide range of ‘prodromal’ symptoms, consistent with it being a core feature of the psychosis risk state. Self-reported life events were not relevant as a correlate of clinical status. As in other treated CHR cohorts, most patients improved over time across symptom domains.

Keywords

Hassleshigh risklife eventsprodromalschizophreniastress
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 2 , February 2013 , pp. 259 - 268
Copyright
Copyright © Cambridge University Press 2012

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