Depressive symptoms during first episode psychosis and functional outcome: a systematic review and meta-analysis

Jessica McGinty, Rachel Upthegrove

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
11 Downloads (Pure)


Objectives: First episode psychosis (FEP) is associated with functional decline. Existing evidence was synthesised to explore the influence of depressive symptoms during FEP on future social, occupational and global functioning.

Methods: Medline, Embase, PsychINFO, Cochrane Library, Open Grey, NICE Evidence and Web of Science were searched from inception to May 2018. Longitudinal studies of FEP patients were included. Study quality was assessed using the Downs and Black instrument. Two meta-analyses were performed using random effect models. The first meta-analysis correlates depressive symptoms during FEP with follow-up Global Assessment of Functioning (GAF) scores. The second meta-analysis shows the odds of long-term functional remission if depressive symptoms are present during FEP.

Results: 4751 unique abstracts were found. 36 articles were included. The first meta-analysis included 7 studies (932 participants) and showed depressive symptoms during FEP were negatively correlated with follow-up GAF scores (r = −0.16, 95% CI: −0.24 to −0.09, p < 0.001). The second meta-analysis of 9 studies (2265 participants) showed weak evidence of an association between the presence of depressive symptoms in FEP and reduction in functional remission (OR = 0.87, 95% CI: 0.68 to 1.13, p = 0.294).

Conclusion: Depressive symptoms during FEP are associated with poorer long-term global functioning and may be associated with a reduced chance of achieving functional remission. Clinical trials are needed to identify efficacious management of depressive symptoms in early psychosis.

Original languageEnglish
Pages (from-to)14-27
Number of pages14
JournalSchizophrenia Research
Early online date20 Jan 2020
Publication statusPublished - Apr 2020


  • Depression
  • First episode
  • Functioning
  • Meta-analysis
  • Psychoses

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


Dive into the research topics of 'Depressive symptoms during first episode psychosis and functional outcome: a systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this