Relations of Self-Esteem with Paranoia in Healthy Controls, Individuals at Ultra-High Risk for Psychosis and with Recent Onset Schizophrenia

Hui-Woo Yoon; Yun Young Song; Jee In Kang; Suk Kyoon An

doi:10.16946/kjsr.2013.16.2.86

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Yoon, Song, Kang, and An: Relations of Self-Esteem with Paranoia in Healthy Controls, Individuals at Ultra-High Risk for Psychosis and with Recent Onset Schizophrenia

Original Article

Korean J Schizophr Res 2013;16(2):86-92.

Published online: 17 January 2013

DOI: https://doi.org/10.16946/kjsr.2013.16.2.86

Relations of Self-Esteem with Paranoia in Healthy Controls, Individuals at Ultra-High Risk for Psychosis and with Recent Onset Schizophrenia

Hui-Woo Yoon, MD¹, Yun Young Song, MD^1,², Jee In Kang, MD, PhD^1,², Suk Kyoon An, MD, PhD^1,^2,

¹Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea

²Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea

Address for correspondence: Suk Kyoon An, Department of Psychiatry, Yonsei University College of Medicine, 119 Gyeongchung-daero 1926beon-gil, Gwangju 464-110, Korea Tel: 031-760-9404, Fax: 031-761-7582 E-mail: ansk@yuhs.ac

이 논문은 2010년도 정부(미래창조과학부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(No.2010-0024264).

Revised 17 July 201311 September 2013 Accepted 13 September 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Some emotional components, such as self-esteem, depression and anxiety, have been reported to be associated with paranoia in non-clinical population and schizophrenia patients. The aim of this study was to investigate the correlation between self-esteem and paranoia in healthy controls, in ultra-high risk for psychosis and schizophrenia patients.

Methods

34 subjects with recent onset schizophrenia, 36 subjects with ultra-high risk for psychosis, and 44 healthy volunteers participated in this study. A detailed assessment was made of the paranoia, self-esteem, depression, and anxiety.

Results

In all three groups, there were a negative correlation between paranoia and self-esteem, and positive correlations between paranoia and depression and anxiety. In healthy control, lower self-esteem showed a trend to predict higher paranoia, and in ultra-high risk for psychosis, this trend tern on statistically significant level, and in recent onset schizophrenia group, this correlation was disappeared.

Conclusion

The individual who have lower self-esteem showed higher paranoia tendency under delusional level, but after formation of persecutory delusion, the tendency was disappeared. This result supports the hypothesis that persecutory delusions are a defense against negative affective process.

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Keywords: Paranoia, Self-esteem, Depression, Anxiety

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Table 1.

Demographic and clinical profiles of normal control, UHR for psychosis, and early schizophrenia patients

	Normal control (n=44)	UHR for psychosis (n=36)	Early schizophrenia (n=34)
Age (years)	20.7 (1.5)	20.4 (1.4)	20.6 (1.9)
Education (years)	13.8 (1.1)	13.3 (1.4)	13.2 (1.5)
Sex (F/M)	19/25	(12/24)	15/19
Rosenberg's self-esteem scale^abc	31.5 (4.6)	21.5 (5.9)	26.4 (5.6)
Beck depression inventory^abc	05.2 (4.8)	24.0 (12.5)	15.5 (13.2)
Paranoia scale^abc	18.7 (8.4)	39 (18.1)	29.4 (16.9)
Suspiciousness/persecution item of PANSS^ac	01.1 (0.26)	02.9 (1.0)	03.4 (1.3)
Positive symptoms (PANSS)^abc	07.2 (0.7)	13.9 (3.6)	16.1 (5.2)
Negative symptoms (PANSS)^ac	07.2 (0.6)	17.6 (5.6)	19.0 (7.3)
General psychopathology (PANSS)^ac	16.4 (0.8)	33.1 (7.6)	32.2 (8.3)
Antipsychotic medications (naïve/medicated)		26/10	1/33
Chlorpromazine equivalent dose (mg/d)^b		48.3 (86.8)	459 (327.4)
State Anxiety Inventory^abc	36.7 (8.6)	59.1 (15.1)	52.0 (14.6)

Chlorpromazine equivalent dose was derived from Kroken et al. ²⁵⁾

^a : significant difference between normal controls and UHR for psychosis (p＜0.05)

^b : significant difference between UHR for psychosis and early schizophrenia patients (p＜0.05)

^c : significant difference between normal controls and early schizophrenia patients (p＜0.05)

Table 2.

Intercorrelation between paranoia scale and other variables

Normal controls	1	2	3	4	5	6
1. Paranoia scale	1
2. SE	-0.415∗∗	-1
3. BDI	-0.418∗∗	-0.601∗∗	1
4. SAI	-0.22	-0.633∗∗	0.566∗∗	1
5. PANSS P6	-0.096	-0.09	0.121	0.198	1
6. PANSS positive	-0.124	-0.001	0.135	0.093	0.811∗∗	1
UHR for psychosis	-1	-2	3	4	5	6
1. Paranoia scale	-1
2. SE	-0.696∗∗	-1
3. BDI	-0.617∗∗	-0.506∗∗	1
4. SAI	-0.656∗∗	-0.528∗∗	0.751∗∗	1
5. PANSS P6	-0.312	-0.242	0.248	0.348∗	1
6. PANSS positive	-0.322	-0.266	0.177	0.201	0.722∗∗	1
Early schizophrenia	-1	-2	3	4	5	6
1. Paranoia scale	-1
2. SE	-0.468∗∗	-1
3. BDI	-0.607∗∗	-0.523∗∗	1
4. SAI	-0.669∗∗	-0.501∗∗	0.802∗∗	1
5. PANSS P6	-0.357∗	-0.311	0.182	0.21	1
6. PANSS positive	-0.361∗2	-0.251	0.186	0.211	0.867∗∗	1

^∗ : correlation is significant at the 0.05 level,

^∗∗ : correlation is significant at the 0.01 level. SE : Rosenberg's self-esteem scale, BDI : beck depression inventory, SAI : State-Trait Anxiety Inventory, PANSS P6 : suspiciousness/persecution item of PANSS, PANSS positive : positive scale of PANSS

Table 3.

Multiple linear regression analysis of paranoia scale score with other variables

Normal control
	β	t-value	p-value	Partial correlation		VIF
Age	-0.004	-0.026	＜0.98	-0.004		1.08
Sex	-0.133	-0.950	＜0.348	-0.152		1.00
SE	-0.334	-1.699	＜0.097	-0.266		1.95
BDI	-0.309	-1.679	＜0.101	-0.263		1.72
SAI	-0.171	-0.877	＜0.386	-0.141		1.93
R	-R²	-dR²	＜F change	df1	df2	Sig. F change
0.5	-0.25	-0.250	＜2.535	.85	38	0.045
UHR for psychosis
	β	t-value	p-value	Partial correlation		VIF
Age	-0.163	-1.545	＜0.133	-0.272		1.04
Sex	-0.236	-2.044	＜0.050	-0.350		1.25
SE	-0.578	-4.209	＜0.001	-0.436		1.76
BDI	-0.119	-0.736	＜0.468	-0.076		2.43
SAI	-0.267	-1.637	＜0.112	-0.170		2.47
R	-R²	-dR²	＜F change	df1	df2	Sig. F change
0.824	-0.678	-0.678	012.653	-5	30	0.00
Recent onset schizophrenia
	β	t-value	p-value	Partial correlation		VIF
Age	-0.037	-0.269	＜0.79	-0.051		1.16
Sex	-0.242	-1.790	＜0.084	-0.32		1.11
SE	-0.159	-1.027	＜0.313	-0.19		1.47
BDI	-0.173	-0.761	＜0.453	-0.142		3.17
SAI	-0.469	-2.145	＜0.041	-0.376		2.92
R	-R²	-dR²	＜F change	df1	df2	Sig. F change
0.736	-0.542	-0.542	＜6.617	-5	28	0.00

SE : Rosenberg's self-esteem scale, BDI : beck depression inventory, SAI : state anxiety inventory

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