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The co-occurrence of manic and depressive dimensions in early psychosis: a latent transition analysis

Published online by Cambridge University Press:  19 May 2023

Julie Ramain Open the ORCID record for Julie Ramain [Opens in a new window] ,
Lilith Abrahamyan Empson ,
Luis Alameda ,
Alessandra Solida ,
Julien Elowe ,
Nadir Mebdouhi ,
Philippe Conus  and
Philippe Golay
Julie Ramain*
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland Training and Research Institute in Mental Health (IFRSM), Neuchâtel Centre of Psychiatry, Neuchâtel, Switzerland
Lilith Abrahamyan Empson
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
Luis Alameda
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK Departamento de Psiquiatria, Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Universidad de Sevilla, Sevilla, Spain
Alessandra Solida
Affiliation:
Department II of Adult Psychiatry, Neuchâtel Center of Psychiatry, Neuchâtel, Switzerland
Julien Elowe
Affiliation:
Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prangins, Switzerland
Nadir Mebdouhi
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
Philippe Conus
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
Philippe Golay
Affiliation:
Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland Faculty of Social and Political Sciences, Institute of Psychology, University of Lausanne, Lausanne, Switzerland
*
Corresponding author: Julie Ramain; Email: julie.ramain@cnp.ch
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Abstract

Background

Frequently associated with early psychosis, depressive and manic dimensions may play an important role in its course and outcome. While manic and depressive symptoms can alternate and co-occur, most of the studies in early intervention investigated these symptoms independently. The aim of this study was therefore to explore the co-occurrence of manic and depressive dimensions, their evolution and impact on outcomes.

Methods

We prospectively studied first-episode psychosis patients (N = 313) within an early intervention program over 3 years. Based on latent transition analysis, we identified sub-groups of patients with different mood profiles considering both manic and depressive dimensions, and studied their outcomes.

Results

Our results revealed six different mood profiles at program entry and after 1.5 years follow-up (absence of mood disturbance, co-occurrence, mild depressive, severe depressive, manic and hypomanic), and four after 3 years (absence of mood disturbance, co-occurrence, mild depressive and hypomanic). Patients with absence of mood disturbance at discharge had better outcomes. All patients with co-occurring symptoms at program entry remained symptomatic at discharge. Patients with mild depressive symptoms were less likely to return to premorbid functional level at discharge than the other subgroups. Patients displaying a depressive component had poorer quality of physical and psychological health at discharge.

Conclusions

Our results confirm the major role played by mood dimensions in early psychosis, and show that profiles with co-occurring manic and depressive dimensions are at risk of poorer outcome. An accurate assessment and treatment of these dimensions in people with early psychosis is crucial.

Keywords

Depressionearly interventionfirst-episode psychosismaniamood
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 16 , December 2023 , pp. 7601 - 7608
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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