Vulnerability to psychosis in patients attending primary and psychiatric care. Results of the RADEP study

Abstract

We studied occurrence of psychotic symptoms and their associations with occurrence of depressive and manic symptoms; 563 patients attending primary care (PrC) and 163 patients attending psychiatric outpatient care (PsC) completed a questionnaire including lists of psychotic, manic and depressive symptoms, and patients with depressive symptoms were interviewed using the same questionnaire 6 months after baseline examination. Of PrC patients, 8.5% and of PsC patients, 36.2% reported at least seven lifetime psychotic symptoms. During the 6-month follow-up, the corresponding figures were 0.22% for PrC and 2.84% for PsC patients. Among PrC patients, men, young, never-married, students and unemployed reported more psychotic symptoms than others. In multivariate analyses, occurrence of psychotic symptoms was associated with young age, never being married, poor functioning and former psychiatric treatment, as well as with occurrence of manic and depressive symptoms. Psychotic symptoms are rather prevalent in primary care and very common in psychiatric care. In primary care, vulnerability to psychosis is associated with the patient's background more strongly than in psychiatric care. Concurrent occurrence of psychotic symptoms with manic and depressive symptoms is common.