Subclinical psychosis and depression: co-occurring phenomena that do not predict each other over time.

BACKGROUND: The path from subclinical psychotic experiences to clinical disorder is thought to be mediated by the persistence of subclinical psychotic experiences. One of the factors that is likely associated with this persistence is depression. Although commonly viewed as interrelated concepts, the exact relationship between subclinical psychosis and depression is not clear. METHODS: Cross-lagged path modeling was used to explore the relationship between subclinical psychosis and depression across and over time in an adolescent population seeking assistance for non-psychotic disorders (N=138), measured at four occasions over a two-year period. RESULTS: Subclinical psychosis and depression were related to each other at every cross-sectional measurement, but did not predict each other over time. Subclinical psychotic experiences and depressive symptom levels were highest at baseline, when participants presented to the clinical service for help. In addition, the relationship between them was also strongest at baseline and decreased significantly over time. CONCLUSION: The results suggest that psychosis and depression are interrelated phenomena that strongly co-occur in time, but longitudinally, one does not predict change in the other. Both psychopathological dimensions should be addressed when treatment is provided to adolescent help-seekers.

The relationship between coping and subclinical psychotic experiences in adolescents from the general population--a longitudinal study.

BACKGROUND: Subclinical psychotic experiences during adolescence may represent liability for developing psychotic disorder. Both coping style and the degree of persistence of psychotic experiences may play a role in the progression to clinical psychotic disorder, but little is known about the causal relationship between the two. METHOD: Path modelling was used to examine longitudinal relationships between subclinical positive psychotic experiences and three styles of coping (task-, emotion- and avoidance-oriented) in an adolescent general population sample (n=813) assessed three times in 3 years. Distinct developmental trajectories of psychotic experiences, identified with growth mixture modelling, were compared on the use of these coping styles. RESULTS: Over time, emotion-oriented coping in general was bi-directionally related to psychotic experiences. No meaningful results were found for task- or avoidance-oriented coping. Females reported using a wider range of coping styles than males, but the paths between coping and psychotic experiences did not differ by gender. Persistence of psychotic experiences was associated with a greater use of emotion-oriented coping, whereas a decrease in experiences over time was associated with an increased use of task-orientated coping. CONCLUSIONS: Emotion-oriented coping is the most important coping style in relation to psychotic experiences, as it may contribute to a 'vicious cycle' and is associated with persistence of experiences. In addition, more task-oriented coping may result in a decrease in psychotic experiences. Results suggest that opportunities for intervention may already be present at the level of subclinical psychosis.