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

Research output: Contribution to journalArticle



Objectives: First episode psychosis (FEP) is associated with functional decline. Existing evidence was synthesisedto explore the inVuence 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 weresearched from inception to May 2018. Longitudinal studies of FEP patients were included. Study quality was assessedusing the Downs and Black instrument. Two meta-analyses were performed using random effect models.The Urst 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 depressivesymptoms are present during FEP.

Results: 4751 unique abstracts were found. 36 articles were included. The Urst meta-analysis included 7 studies(932 participants) and showed depressive symptoms during FEP were negatively correlated with follow-up GAFscores (r = Ч0.16, 95% CI: Ч0.24 to Ч0.09, 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 reductionin 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 beassociated with a reduced chance of achieving functional remission. Clinical trials are needed to identify efUcaciousmanagement of depressive symptoms in early psychosis.


Original languageEnglish
JournalSchizophrenia Research
Early online date20 Jan 2020
Publication statusE-pub ahead of print - 20 Jan 2020