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Mood instability and psychosis : analyses of British national survey data
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Marwaha, Steven, Broome, Matthew R., Bebbington, Paul, Kuipers, Liz and Freeman, Daniel (2014) Mood instability and psychosis : analyses of British national survey data. Schizophrenia Bulletin, Volume 40 (Number 2). pp. 269-277. doi:10.1093/schbul/sbt149
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Official URL: http://dx.doi.org/10.1093/schbul/sbt149
Abstract
Background: We used British national survey data to test specific hypotheses that mood instability (1) is associated with psychosis and individual psychotic phenomena, (2) predicts the later emergence of auditory hallucinations and paranoid ideation, and (3) mediates the link between child sexual abuse and psychosis. Methods: We analyzed data from the 2000 and 2007 UK national surveys of psychiatric morbidity (N = 8580 and 7403, respectively). The 2000 survey included an 18-month follow-up of a subsample (N = 2406). Mood instability was assessed from the Structured Clinical Interview for DSM-IV Axis II (SCID-II) questionnaire. Our dependent variables comprised auditory hallucinations, paranoid ideation, the presence of psychosis overall, and a 15-item paranoia scale. Results: Mood instability was strongly associated in cross-sectional analyses with psychosis (2000: OR: 7.5; 95% CI: I 4.1–13.8; 2007: OR: 21.4; CI: 9.7–41.2), paranoid ideation (2000: OR: 4.7; CI: 4.1–5.4; 2007: OR: 5.7; CI: 4.9–6.7), auditory hallucinations (2000: OR: 3.4; CI: 2.6–4.4; 2007: OR 3.5; CI: 2.7–4.7), and paranoia total score (2000: Coefficient: 3.6; CI: 3.3–3.9), remaining so after adjustment for current mood state. Baseline mood instability significantly predicted 18-month inceptions of paranoid ideation (OR: 2.3; CI: 1.6–3.3) and of auditory hallucinations (OR: 2.6; CI: 1.5–4.4). Finally, it mediated a third of the total association of child sexual abuse with psychosis and persecutory ideation and a quarter of that with auditory hallucinations. Conclusions: Mood instability is a prominent feature of psychotic experience and may have a role in its genesis. Targeting mood instability could lead to innovative treatments for psychosis.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Affective disorders -- Great Britain -- Surveys, Psychoses, Psychology, Pathological, Auditory hallucinations -- Great Britain -- Surveys, Child sexual abuse -- Psychological aspects, Mental health surveys -- Great Britain | ||||
| Journal or Publication Title: | Schizophrenia Bulletin | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 0586-7614 | ||||
| Official Date: | 25 October 2014 | ||||
| Dates: |
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| Volume: | Volume 40 | ||||
| Number: | Number 2 | ||||
| Page Range: | pp. 269-277 | ||||
| DOI: | 10.1093/schbul/sbt149 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Funder: | Great Britain. Department of Health (DoH), Scotland. Scottish Executive, Wales. National Assembly, Great Britain. National Health Service. Information Centre for Health and Social Care, South London and Maudsley NHS Trust |
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