Chair: Professor Belinda Lennox
Abstract: Depression and anxiety are extremely common in early phases of psychosis, related to illness onset, relapse and poor functional outcomes. Antidepressant medication may be effective in patients with schizophrenia and the prevention of depression after first episode psychosis is a new therapeutic goal in early intervention treatment trials. Depression in so-called ‘non-affective’ psychosis has previously been characterised as a co-morbidity, related to the psychological reaction of the experience of psychosis itself. However, it is also possible that affective dysfunction is inherent to psychotic disorders, reflecting common biological mechanisms, such as activation of innate inflammatory pathways that are active in the early stages of illness. Early phases of psychosis, when affective symptoms are pervasive, may present the best stage of illness and best opportunity to identify the effect of immune focused novel treatments. This presentation will outline longitudinal studies of first episode psychosis, population cohorts charting immune dysfunction in early psychosis and depression, together with data driven modelling of affective and psychotic immune relevant phenotypes. The focus will also include translational and early stage experimental medicine studies beginning to address opportunities raised when the Kraepelinian Dichotomy is challenged.