"I fear going crazy" ... could Cognitive Concerns be early warning signs of Psychosis? Evidence from the Anxiety Sensitivity in the first stages of Psychosis study (ASP study)

Purpose. Anxiety Sensitivity, a vulnerability and maintenance cognitive factor for several mental conditions, include Physical Concerns (the belief that palpitations lead to a cardiac arrest), Social Concerns (the belief that observable anxiety reactions will elicit social rejection), and Cognitive Concerns (cognitive difficulties could lead to mental incapacitation). Whereas Anxiety Sensitivity has been consistently studied in the development of Anxiety Disorders, poor knowledge is available on its role as possible early sign of first stages of Psychosis. The current study investigated differences on Anxiety Sensitivity factors between patients with At-Risk Mental State (ARMS), patients with a First-Episode Psychosis (FEP) and matched non-clinical controls (NCCs). Materials and methods. Thirty patients with ARMS, 30 with a FEP and 30 NCCs completed the Anxiety Sensitivity Index-3. Mean age of the total sample was 23.52 years (range= 17–32). Sixty patients were males. Between-group ANOVA with post hoc tests was conducted. Results. Patients with ARMS and those with a FEP had higher scores than NCCs on ASI-3 Cognitive Concerns scale (F2,87= 11.48, p<.001). Patients with ARMS had significantly higher scores on ASI-3 Physical Concerns scale than those with a FEP (F2,87= 5.10, p<.01) and at a trend level than NCCs. No difference was found on Social Concerns between all the groups. Conclusion. Cognitive Concerns should be considered in the treatment of ARMS and FEP. Physical Concerns could be a treatment target for ARMS. Future longitudinal studies should examine whether Cognitive Concerns predict FEP in patients with ARMS in order to develop early detection and prevention strategies.