Comorbidity rates of depression and anxiety in first episode psychosis: A systematic review and meta-analysis

Anxiety and depression symptoms are frequently experienced by individuals with psychosis, although prevalence rates have not been reviewed in first-episode psychosis (FEP). The aim of this systematic review was to focus on the prevalence rates for both anxiety and depression, comparing the rates within the same study population. A systematic review and meta-analysis was completed for all studies measuring both anxiety and depression in FEP at baseline. The search identified 6040 citations, of which n = 10 met inclusion criteria. These reported 1265 patients (age 28.3 +/- 9.1, females: 39.9%) with diagnosed FEP. Studies which used diagnosis to define comorbidity count were included in separate meta-analyses for anxiety and depression, although the heterogeneity was high limiting interpretation of separate prevalence rates. A random-effects meta-analysis also compared the mean difference between anxiety and depression within the same studies. We show that anxiety and depression co-occur at a similar rate within FEP, although the exact rates are not reliable due to the heterogeneity between the small number of studies. Future research in FEP should consider routinely measuring anxiety and depression using continuous self-report measures of symptoms. Clinically we recommend that both anxiety and depression are equally targeted during psychological intervention in FEP, together with the psychotic symptoms. (C) 2019 Elsevier B.V. All rights reserved.