The effects of recent stressful life events on outcomes in individuals at clinical high risk for psychosis: results from the longitudinal EU-GEI high-risk study

Cheryl See, Shuqing Si, Emily Hedges, Stefania Tognin, Gemma Modinos, Mark van der Gaag, Lieuwe de Haan, Eva Velthorst, Patrick D. McGorry, Barnaby Nelson, Anita Riecher-Roessler, Rodrigo A. Bressan, Neus Barrantes-Vidal, Marie-Odile Krebs, Merete Nordentoft, Stephan Ruhrmann, Gabriele Sachs, Bart P. F. Rutten, Jim van Os, EU-GEI High Risk Study GroupPhilip McGuire, Lucia Valmaggia, Matthew Kempton

Research output: Contribution to journalArticlepeer-review

Abstract

Background Recent stressful life events (SLE) are a risk factor for psychosis, but limited research has explored how SLEs affect individuals at clinical high risk (CHR) for psychosis. The current study investigated the longitudinal effects of SLEs on functioning and symptom severity in CHR individuals, where we hypothesized CHR would report more SLEs than healthy controls (HC), and SLEs would be associated with poorer outcomes. Methods The study used longitudinal data from the EU-GEI High Risk study. Data from 331 CHR participants were analyzed to examine the effects of SLEs on changes in functioning, positive and negative symptoms over a 2-year follow-up. We compared the prevalence of SLEs between CHR and HCs, and between CHR who did (CHR-T) and did not (CHR-NT) transition to psychosis. Results CHR reported 1.44 more SLEs than HC (p < 0.001), but there was no difference in SLEs between CHR-T and CHR-NT at baseline. Recent SLEs were associated with poorer functioning and more severe positive and negative symptoms in CHR individuals (all p < 0.01) but did not reveal a significant interaction with time. Conclusions CHR individuals who had experienced recent SLEs exhibited poorer functioning and more severe symptoms. However, as the interaction between SLEs and time was not significant, this suggests SLEs did not contribute to a worsening of symptoms and functioning over the study period. SLEs could be a key risk factor to becoming CHR for psychosis, however further work is required to inform when early intervention strategies mitigating against the effects of stress are most effective.

Original languageEnglish
Pages (from-to)4768-4778
Number of pages11
JournalPsychological Medicine
Volume54
Issue number16
DOIs
Publication statusPublished - 8 Jan 2025

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