Progression from unipolar depression to schizophrenia

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Progression from unipolar depression to schizophrenia. / Musliner, Katherine L; Munk-Olsen, Trine; Mors, Ole; Østergaard, Søren D.

In: Acta Psychiatrica Scandinavica, Vol. 135, No. 1, 01.01.2017, p. 42-50.

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@article{79ee7562282d4d7cbb504cec936a9186,
title = "Progression from unipolar depression to schizophrenia",
abstract = "OBJECTIVE: To examine progression from unipolar depression (UD) to schizophrenia and to identify groups of UD patients at elevated risk for progression.METHOD: Historical prospective cohort study using data from Danish national registers. The sample included 71 932 individuals who received a diagnosis of UD in Denmark between January 1, 1995, and May 31, 2013. Analyses were conducted using Kaplan-Meier estimates and Cox regressions.RESULTS: The 18.5-year cumulative incidence of schizophrenia was 5.5{\%} in women and 8.4{\%} in men. The strongest predictors of progression included younger age (adjusted hazard ratio (AHR) for individuals 18-24 vs. 40+ = 7.42, 95{\%} confidence interval = [6.29, 8.74]), psychotic symptoms at index UD diagnosis (AHR = 3.70 [3.18, 4.31]), previous disorder with psychotic features (AHR = 3.71 [3.31, 4.16]), and previous illicit substance use disorder (AHR = 1.66 [1.40, 1.97]). Groups of UD patients with different combinations of risk factors had elevated risk for progression, with 10-year cumulative incidences ranging from 9{\%} to 62{\%}. To conclude, at the time of UD diagnosis, the strongest risk factors for progression to schizophrenia include male sex, younger age, past/current psychotic symptoms, and illicit substance use disorders. These clinical predictors may aid in targeting monitoring for schizophrenia among patients with UD.",
keywords = "Adolescent, Adult, Aged, Denmark/epidemiology, Depressive Disorder, Major/psychology, Disease Progression, Female, Humans, Incidence, Kaplan-Meier Estimate, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Registries, Risk Factors, Schizophrenia/epidemiology, Young Adult",
author = "Musliner, {Katherine L} and Trine Munk-Olsen and Ole Mors and {\O}stergaard, {S{\o}ren D}",
note = "{\circledC} 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.",
year = "2017",
month = "1",
day = "1",
doi = "10.1111/acps.12663",
language = "English",
volume = "135",
pages = "42--50",
journal = "Acta Psychiatrica Scandinavica",
issn = "0001-690X",
publisher = "John Wiley & Sons",
number = "1",

}

RIS

TY - JOUR

T1 - Progression from unipolar depression to schizophrenia

AU - Musliner, Katherine L

AU - Munk-Olsen, Trine

AU - Mors, Ole

AU - Østergaard, Søren D

N1 - © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - OBJECTIVE: To examine progression from unipolar depression (UD) to schizophrenia and to identify groups of UD patients at elevated risk for progression.METHOD: Historical prospective cohort study using data from Danish national registers. The sample included 71 932 individuals who received a diagnosis of UD in Denmark between January 1, 1995, and May 31, 2013. Analyses were conducted using Kaplan-Meier estimates and Cox regressions.RESULTS: The 18.5-year cumulative incidence of schizophrenia was 5.5% in women and 8.4% in men. The strongest predictors of progression included younger age (adjusted hazard ratio (AHR) for individuals 18-24 vs. 40+ = 7.42, 95% confidence interval = [6.29, 8.74]), psychotic symptoms at index UD diagnosis (AHR = 3.70 [3.18, 4.31]), previous disorder with psychotic features (AHR = 3.71 [3.31, 4.16]), and previous illicit substance use disorder (AHR = 1.66 [1.40, 1.97]). Groups of UD patients with different combinations of risk factors had elevated risk for progression, with 10-year cumulative incidences ranging from 9% to 62%. To conclude, at the time of UD diagnosis, the strongest risk factors for progression to schizophrenia include male sex, younger age, past/current psychotic symptoms, and illicit substance use disorders. These clinical predictors may aid in targeting monitoring for schizophrenia among patients with UD.

AB - OBJECTIVE: To examine progression from unipolar depression (UD) to schizophrenia and to identify groups of UD patients at elevated risk for progression.METHOD: Historical prospective cohort study using data from Danish national registers. The sample included 71 932 individuals who received a diagnosis of UD in Denmark between January 1, 1995, and May 31, 2013. Analyses were conducted using Kaplan-Meier estimates and Cox regressions.RESULTS: The 18.5-year cumulative incidence of schizophrenia was 5.5% in women and 8.4% in men. The strongest predictors of progression included younger age (adjusted hazard ratio (AHR) for individuals 18-24 vs. 40+ = 7.42, 95% confidence interval = [6.29, 8.74]), psychotic symptoms at index UD diagnosis (AHR = 3.70 [3.18, 4.31]), previous disorder with psychotic features (AHR = 3.71 [3.31, 4.16]), and previous illicit substance use disorder (AHR = 1.66 [1.40, 1.97]). Groups of UD patients with different combinations of risk factors had elevated risk for progression, with 10-year cumulative incidences ranging from 9% to 62%. To conclude, at the time of UD diagnosis, the strongest risk factors for progression to schizophrenia include male sex, younger age, past/current psychotic symptoms, and illicit substance use disorders. These clinical predictors may aid in targeting monitoring for schizophrenia among patients with UD.

KW - Adolescent

KW - Adult

KW - Aged

KW - Denmark/epidemiology

KW - Depressive Disorder, Major/psychology

KW - Disease Progression

KW - Female

KW - Humans

KW - Incidence

KW - Kaplan-Meier Estimate

KW - Male

KW - Middle Aged

KW - Proportional Hazards Models

KW - Prospective Studies

KW - Registries

KW - Risk Factors

KW - Schizophrenia/epidemiology

KW - Young Adult

UR - http://www.scopus.com/inward/record.url?scp=84995906316&partnerID=8YFLogxK

U2 - 10.1111/acps.12663

DO - 10.1111/acps.12663

M3 - Journal article

VL - 135

SP - 42

EP - 50

JO - Acta Psychiatrica Scandinavica

JF - Acta Psychiatrica Scandinavica

SN - 0001-690X

IS - 1

ER -