In Step 2, genetic and environmental risk factors were incorporated to examine the degree to which symptoms associated with polygenic risk scores for depression and schizophrenia, lifetime exposure to trauma and area-level factors (including deprivation, air pollution and greenspace). In Step 1, a network model identified bridge nodes between lifetime symptoms of depression and psychosis and functional impairment. This study included data from European ancestry participants in UK Biobank, a large population-based sample (N = 77,650). The present study aimed to advance understanding of this comorbidity via a network approach, by (1) identifying bridge nodes that connect clusters of lifetime depression and psychosis symptoms and (2) evaluating the influence of polygenic and environmental risk factors in these symptoms. P1_ = Delusions P2 = Conceptual Organization P3 = Hallucinatory Behaviour P4 = Excitement P5 = Grandiosity P6 = Suspiciousness/Persecution P7 = Hostility N1 = Blunted Affect N2 = Emotional Withdrawal N3 = Poor Rapport N4 = Passive/Apathetic Social Withdrawal N5 = Difficulty in Abstract Thinking N6 = Lack of Spontaneity and Flow of Conversation N7 = Stereotyped Thinking C1 = Depression C2 = Hopelessness C3 = Self Depreciation C4 = Guilt Ideas of Reference C5 = Pathological Guilt C6 = Morning Depression C7 = Early Awakening C8 = Suicide C9 = Observed Depression.ĭepression and psychosis are often comorbid they also have overlapping genetic and environmental risk factors, including trauma and area-level exposures. Blue edges represent positive associations and red edges represent negative associations denser lines represent stronger connections. Edge weights (lines) represent the strength of association between symptoms. Blue nodes represent 7 negative symptoms from the PANSS scale, and green nodes represent items from the PANSS positive scale.
Orange nodes represent depressive items from the Calgary Depression Scale for Schizophrenia (CDSS). Nodes (circles) represent individual symptoms. A network structure for baseline is depicted in 1(a), and 1(b) for the 12 month network.