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

Upthegrove, R. and Ross, K. and Brunett, K. and McCollum, R. and Jones, Lisa (2014) Depression in First Episode Psychosis: the Role of Subordination and Shame. Psychiatry Research, 217 (3). pp. 177-184. ISSN Online: 0165-1781

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Abstract

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
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Uncontrolled Keywords: depression, psychosis, first episode, schizophrenia, appraisals
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: Academic Departments > Institute of Health and Society
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Depositing User: Lisa Jones
Date Deposited: 30 Oct 2015 09:18
Last Modified: 30 Oct 2015 09:18
URI: https://eprints.worc.ac.uk/id/eprint/4027

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