Prevalence of psychiatric comorbidity and its associations with clinical, cognitive and functional variables in individuals with at-risk mental state for psychosis in Hong Kong

Abstract

Literature has indicated high rates of psychiatric comorbidities in individuals presenting with at-risk mental state (ARMS) for psychosis. Most data, however, were derived from research conducted in western populations. This study aimed to examine prevalence and correlates of ARMS with psychiatric comorbidity in Chinese people in Hong Kong. One hundred four individuals aged 15–40 years who fulfilled ARMS criteria by Comprehensive Assessment of At Risk Mental State (CAARMS) were recruited from a pilot ARMS screening program. Assessments on DSM-IV diagnoses, clinical profiles, cognition, functioning and quality of life were conducted. Our results showed that 42.3% of the cohort had comorbid psychiatric diagnosis including depressive disorder (26.9%), adjustment disorder (8.7%), obsessivecompulsive disorder (5.8%), anxiety disorders (2.9%) and somatoform disorder (1%). ARMS subjects with psychiatric comorbidity had lower cognitive composite score (t=3.4, p=0.001), more severe negative symptoms (BNSS amotivation: t=2.6, p=0.01; BNSS expressivity: t=2.1, p=0.04), lower SF36 mental health component score (t=3.2, p=0.002) and were more likely to have suicidal ideation (χ2=9.6, p=0.002) than those without psychiatric comorbidity. No significant between-group difference in functioning was observed. Multiple binary logistic regression analysis revealed that cognitive composite score and presence of suicidal ideation were independently associated with ARMS with psychiatric comorbidity (R2=0.28, p<0.001). In line with the literature, our results showed that psychiatric comorbidities are prevalent in Chinese ARMS population and they are associated with poorer clinical and cognitive outcomes, and worse psychological well-being.