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Title: An epidemiological investigation into the onset, course and outcome of psychotic major depression and schizoaffective disorder, depressed type
Author: Heslin, Margaret
ISNI:       0000 0004 5357 4972
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2014
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There is very little research on the psychosocial risk factors associated with psychotic major depression (PMD) and schizoaffective disorder, depressed type (SAD). Although there is much more research on the course and outcomes of these disorders, the studies have significant methodological limitations. Therefore, this thesis aimed to investigate the following while improving on the limitations of previous research: 1) the risk factors associated with PMD and SAD with a focus on psychosocial risk factors; and 2) the long-term course of illness and outcomes in cases with PMD and SAD. A case control study of incident psychosis cases was used to examine psychosocial risk factors in PMD and SAD cases compared with schizophrenia and bipolar disorder cases. A cohort study following up all cases identified in the case control study was conducted to investigate course of illness and outcomes. Findings on the risk factors suggest that less psychosocial risk factors are involved in the aetiology of PMD and SAD compared with schizophrenia and bipolar disorder. Exploratory analyses of life events indicate that humiliation life events could be an important factor in the development of PMD and requires further research. Findings on outcomes suggest that PMD cases are more likely to self-harm and attempt suicide but are less likely to use inpatient services and have a lower proportion of compulsory admissions. These findings have important clinical implications. Findings on risk factors and outcomes in SAD cases are similar but a lack of power due to low numbers limits the interpretation of the findings. Important differences in both the risk factors and outcomes analyses were identified when based on the baseline and lifetime diagnoses. This highlights the importance of accounting for diagnostic change when examining these diagnostic groups.
Supervisor: Morgan, Craig; Jamieson-Craig, Thomas Kern Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available