Biological and psychosocial risk factors for psychotic major depression

M. Heslin (Lead / Corresponding author), R. Desai, J. M. Lappin, K. Donoghue, B. Lomas, U. Reininghaus, A. Onyejiaka, T. Croudace, P. B. Jones, R. M. Murray, P. Fearon, G. A. Doody, P. Dazzan, H. L. Fisher, A. Demjaha, T. Craig, C. Morgan

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    Aims: Few studies have investigated risk factors for psychotic major depression (PMD). We aimed to investigate the biological and psychosocial risk factors associated with PMD compared with other psychotic disorders. Methods: Based on the aetiology and ethnicity in schizophrenia and other psychoses (ÆSOP) study, we used a case–control study to identify and recruit, at baseline and 10-year follow-up, all first episode cases of psychosis, presenting for the first time to specialist mental health services in defined catchment areas in the UK. Population-based controls were recruited from the same areas. Data were collected on: sociodemographics; social isolation; childhood adversity; life events; minor physical anomalies; and neurological soft signs. Results: Living alone (aOR = 2.26, CI = 1.21–4.23), basic level qualification (aOR = 2.89, CI = 1.08–7.74), being unemployed (aOR = 2.12, CI = 1.13–3.96), having contact with friends less than monthly (aOR = 4.24, CI = 1.62–11.14), having no close confidants (aOR = 4.71, CI = 2.08–10.68), having experienced childhood adversity (aOR = 2.57, CI = 1.02–6.44), family history of mental illness (aOR = 10.68, CI = 5.06–22.52), family history of psychosis (aOR = 12.85, CI = 5.24–31.51), and having more neurological soft signs (aOR = 1.15, CI = 1.07–1.24) were all associated with a follow-up diagnosis of PMD and schizophrenia. Few variables associated with PMD were also associated with a diagnosis of bipolar disorder. Minor physical anomalies were associated with a follow-up diagnosis of schizophrenia and bipolar disorder, but not PMD. Conclusions: Risk factors associated with PMD appear to overlap with those for schizophrenia, but less so for bipolar disorder. Future work on the differential aetiology of PMD, from other psychoses is needed to find the ‘specifier’ between PMD and other psychoses. Future research on aetiology in PMD, and perhaps other psychoses, should account for diagnostic change.

    Original languageEnglish
    Pages (from-to)233-245
    Number of pages13
    JournalSocial Psychiatry and Psychiatric Epidemiology
    Issue number2
    Early online date31 Oct 2015
    Publication statusPublished - Feb 2016


    • Depression
    • Epidemiology
    • Psychosis
    • Risk factors

    ASJC Scopus subject areas

    • Psychiatry and Mental health
    • Epidemiology
    • Health(social science)
    • Social Psychology


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