Post-psychotic depression: Paranoia and the damage done.

To mitigate the often chronic course of schizophrenia and improve functional outcome, researchers are increasingly interested in prodromal states and psychological risk factors that may predict the outbreak of psychotic symptoms, but are also amenable to change. In recent years, depressive symptoms have been proposed as precursors of psychosis and some interventional studies indicate that the amelioration of depressive symptoms and depression-related thinking styles (e.g., worrying) improves positive symptoms, thereby "killing two birds with one stone". Yet, in a prior study, we were unable to find a strong specific predictive role of depression on paranoia over three years, which may have been due to the use of a nonclinical sample with minimal/mild symptom fluctuations. To address this further, in the present study we adopted a similar methodological approach but assessed a large patient sample with a schizophrenia spectrum disorder at three assessment points; baseline (N = 250), 6 weeks later (n = 207, 82.8% retention) and 6 months after baseline (n = 185, 74% retention). Using cross-lagged modeling, we assessed paranoia with the respective items from the Positive and Negative Syndrome Scale (PANSS) and the Psychosis Rating Scales (PSYRATS) delusions subscale. Depression was measured using the Patient Health Questionnaire-9 (PHQ-9) and the Calgary Depression Scale for Schizophrenia (CDSS). We could identify a significant pathway from depression to paranoia from baseline to post (negative association) but not from post to follow-up. Paranoia significantly predicted depressive symptoms for both intervals. Our findings do not refute claims that depression may precede or even predict psychosis, but such a linkage does not seem to be ubiquitous.

[Mediators of Problematic Social Media Use in Adolescence as Possible Mechanisms of Change in Psychotherapy]. / Mediatoren der problematischen Nutzung sozialer Medien im Jugendalter als mögliche Wirkmechanismen von psychotherapeutischen Interventionen.

Mediators of Problematic Social Media Use in Adolescence as Possible Mechanisms of Change in Psychotherapy Social media are omnipresent in the lives of adolescents. Problematic use of social media has been linked to adverse mental health outcomes including depression, anxiety, suicidality, self-harm, body dissatisfaction and eating pathology. Preliminary evidence suggests that interventions aiming at reducing the amount of time spent in social media and changing dysfunctional beliefs about social media use are promising. However, the mechanisms of change of these interventions with regard to mental health remain unclear. Therefore, this review first provides an overview of the association between social media and mental health and then identifies mediators of this relationship as potential mechanisms of change of interventions targeting problematic media use in adolescents. The identified mediators encompass social comparison, decreased self-esteem, fear of missing out, sleep problems and increased rumination. Future studies should apply a longitudinal design, should investigate additional confounding variables (e. g. age, level of psychopathology) and should also focus on positive effects of social media use on mental health. Thereby, this line of research has the potential to improve our understanding how social media use exerts its effects and based thereupon to develop new or optimize current interventions on problematic social media use to improve mental health in adolescents by targeting the identified mediators.