Comorbid Mood and Anxiety Disorder Diagnoses in Patients With First‐Episode Psychosis: Comparison Between Research and Clinical Diagnoses

BACKGROUND: Clinically significant depression and anxiety disorders are common in different phases of first-episode psychosis (FEP). These comorbidities can be undervalued in clinical practice. We studied how often comorbid depression and anxiety disorders are diagnosed using the SCID-I interview in FEP patients and explored the corresponding clinical diagnoses for the same sample. METHOD: As a part of the Turku Early Psychosis Study (TEPS), we screened 3772 consecutive admissions during 5 years to the clinical psychiatric services of Turku Psychiatry. The final FEP sample in this study consisted of 94 patients with nonaffective (n = 67) and affective (n = 27) psychoses. Research diagnoses (SCID-I) were compared with clinical diagnoses (ICD-10) obtained from patient records 1 year from admission. RESULTS: SCID-I indicated that 42% (n = 28) and 9% (n = 6) of nonaffective FEP patients fulfilled the diagnostic criteria for lifetime (LT) and current (C) major depression. Depression diagnosis (F32 or F33) was recorded in only half of these cases in clinical practice during the 1-year follow-up. The SCID-I also indicated that 45% (n = 42) and 48% (n = 45) of the whole FEP sample had LT and C anxiety disorders according to the SCID-I. An anxiety disorder diagnosis (F40-48) was recorded for only 40% of the patients with SCID-based LT or C anxiety disorder in clinical practice during the 1-year follow-up period. CONCLUSION: Comorbid depression and anxiety disorders are common in FEP patients but are often not clinically diagnosed. A systematic diagnostic procedure in clinical practice will characterise the full syndromic nature of FEP for personalised treatment strategy.