Depressive symptoms and their relationship with negative and other psychotic symptoms in early onset psychosis

Eur Child Adolesc Psychiatry. 2021 Sep;30(9):1383-1390. doi: 10.1007/s00787-020-01618-0. Epub 2020 Aug 31.


The importance of depression in adult people with first-episode psychosis (FEP) has been demonstrated. However, it has hardly been studied in children and adolescents. There is a need to broaden knowledge of the relationship between psychotic symptoms and specific depression symptomatology. The aims of study were (a) to examine the frequency of presence and type of depressive symptoms in early onset FEP, and (b) to assess the relationship between depressive symptoms and psychotic symptomatology, and specifically negative symptoms. An observational cross-sectional study was performed in 62 FEP cases. Inclusion criteria were two or more psychotic symptoms, age 7-17 years old, first mental health service consultation, and fewer than 6 months from the first contact with the service. Participants were assessed with clinical and socio-demographic questionnaires: the Positive and Negative Syndrome Scale (PANSS) and the Children Depression Inventory (CDI). A Student t test was performed to compare psychotic symptoms in both groups: presence of depression and the absence of depression. A Pearson correlation was performed in order to relate subscales of the PANSS and each of the depression subscales and factors, as well the relation between negative and depressive symptoms. Our results show that a high percentage of people with an early onset of a FEP scored positively for depression. The most prevalent depressive symptoms were associated with schooling. The presence of depression was associated with negative, affective, and excited symptoms. Self-esteem, school problems, negative affect, and biological dysregulation were associated with psychotic symptoms. Finally, depressive items related to social functioning were more closely associated with negative symptoms of the PANSS. In conclusion, owing to the high incidence of depression in FEP in those suffering early onset of psychosis, there is a need for instruments to measure the depression more specifically in children and adolescent, and to uncover the clinical characteristics of depression in this population.

Keywords: CDI; Depression; Early-onset psychosis; Negative symptoms; Psychotic symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cross-Sectional Studies
  • Depression* / diagnosis
  • Depression* / epidemiology
  • Humans
  • Psychotic Disorders* / complications
  • Psychotic Disorders* / diagnosis
  • Psychotic Disorders* / epidemiology
  • Self Concept
  • Social Adjustment