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Exploring Group Differences in Attenuated Symptoms and Functioning Between Clinical High Risk Individuals With and Without Posttraumatic Stress Disorder
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  • Danielle Pham,
  • Leda Kennedy,
  • Jean Addington,
  • Carrie Bearden,
  • Tyrone Cannon,
  • Barbara Cornblatt,
  • Matcheri Keshavan,
  • Daniel Mathalon,
  • Diana Perkins,
  • William Stone,
  • Elaine Walker,
  • Scott Woods,
  • Kristin Cadenhead
Danielle Pham
University of California San Diego Division of Infectious Diseases & Global Public Health
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Leda Kennedy
University of California San Diego Department of Psychiatry
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Jean Addington
University of Calgary Hotchkiss Brain Institute
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Carrie Bearden
University of California Los Angeles Department of Psychiatry and Biobehavioral Sciences
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Tyrone Cannon
Yale University Department of Psychology
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Barbara Cornblatt
Zucker Hillside Hospital
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Matcheri Keshavan
Beth Israel Deaconess Medical Center Department of Psychiatry
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Daniel Mathalon
University of California San Francisco Medical Center at Parnassus
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Diana Perkins
The University of North Carolina at Chapel Hill Department of Psychiatry
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William Stone
Beth Israel Deaconess Medical Center Department of Psychiatry
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Elaine Walker
Emory University Department of Psychology
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Scott Woods
Yale University Department of Psychiatry
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Kristin Cadenhead
University of California San Diego Department of Psychiatry

Corresponding Author:[email protected]

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Abstract

Background: Posttraumatic stress disorder (PTSD) is a common comorbid diagnosis in psychotic disorders. However, little is known about the effect of comorbid PTSD in youth at clinical high risk (CHR) for psychosis. Purpose: The purpose of this study was to investigate group differences in symptom severity, risk for psychotic conversion, and functioning among youth at CHR for psychosis with and without PTSD. Methods: This longitudinal study utilized data from N = 693 individuals who met criteria for CHR as part of the North American Prodrome Longitudinal Study 3 (NAPLS-3). Individuals who met criteria for PTSD were compared to those who did not meet criteria for PTSD on demographic, symptom and functional variables. Results: Individuals diagnosed with PTSD (N=54) reported more severe overall positive symptoms (p<0.001), negative symptoms (p<0.01), and general symptoms (p<0.001) compared to those without the diagnosis (N=639). These symptom differences were primarily accounted for by more grandiose (p<0.01) and perceptual symptoms (p<0.04), decreased experience of emotions (p<0.01) and occupational functioning (p<0.03), sleep disturbance (p<0.01), dysphoric mood (p<0.002) and impaired tolerance to stress (p<0.001) in those with PTSD. A diagnosis of PTSD was not associated with a greater rate of psychotic conversion or greater functional deficits. Conclusions: Our findings suggest that a diagnosis of PTSD is associated with more severe overlapping symptoms in individuals meeting the criteria for CHR but not psychotic conversion. Our findings underscore the importance of recognizing and treating comorbid psychiatric conditions including PTSD in CHR populations as a means of reducing symptoms and improving outcome.
11 Aug 2024Submitted to Early Intervention in Psychiatry
15 Aug 2024Submission Checks Completed
15 Aug 2024Assigned to Editor
15 Aug 2024Review(s) Completed, Editorial Evaluation Pending
25 Aug 2024Reviewer(s) Assigned