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Clinical Psychology and Special Education
2026. Vol. 15, no. 1, 95–112
doi:10.17759/cpse.2026150107
ISSN: 2304-0394 (online)

Psychopathological and pathopsychological features of depressed patients at high risk of psychosis

 
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Abstract

Context and relevance. In recent years, the concept of a high risk of psychosis has received considerable attention, with emphasis on early identification and intervention strategies to slow disease progression, delay the onset of symptoms or ameliorate the course of schizophrenia. High impulsivity, a well-documented characteristic of patients with schizophrenia, is also observed in individuals at high risk for psychosis and may contribute to negative long-term outcomes. Despite its clinical importance, however, impulsivity remains understudied in this population. Objective. To assess impulsivity in patients with affective disorders, both with and without high risk of developing psychosis, and to examine the relationship between impulsivity, negative symptoms and cognitive functioning in each group. Hypothesis. People at ultra-high risk for developing psychosis have higher levels of impulsivity than those with non-psychotic depression. They also have more pronounced negative symptoms and severe cognitive impairment, which are associated with increased impulsivity. Methods and materials. The study included 53 female patients, comprising 26 patients diagnosed with depression without high-risk symptoms of psychosis and 27 patients with depression who met the criteria for high risk of psychosis (UHR group). The study groups were matched for gender, age and marital status. The following assessment tools were used: Barratt Impulsiveness Scale (BIS-11), Scale for the Assessment of Negative Symptoms (SANS), Brief Assessment of Cognition in Schizophrenia (BACS), WAIS-IV subtests: “Picture Completion” and “Similarities”. Results. In the non-psychotic depression group, almost all indicators of the SANS scale were significantly associated with three impulsivity factors and the total BIS-11 score. Conversely, in the UHR group, impulsivity correlated mainly with the Attention subscale of the SANS. Notably, the total Barratt score in the UHR group met the threshold for impulse control disorder (above 75 points), whereas the SANS score reflected substantial impairment. Patients in the UHR group scored significantly higher on both scales than those with non-psychotic depression. Although no significant differences were found between the groups in terms of BACS scores or WAIS-IV subtest performance, a greater number of significant correlations were found between impulsivity and cognitive functioning parameters in the UHR group. Conclusions. Patients at high risk for psychosis showed more pronounced negative symptoms, cognitive deficits and significantly higher levels of impulsivity than people with affective disorders without psychotic features. Cognitive impairment in this group was strongly related to impulsivity, whereas negative symptoms, with the exception of attentional deficits, showed minimal association with impulsivity. These findings suggest that impulsivity and negative symptoms may be distinct but co-occurring phenomena in this population, each contributing to broader psychopathological changes.

General Information

Keywords: impulsivity, negative symptoms, cognitive impairments, depression, schizophrenia, clinical high risk for psychosis, ultra-high risk for psychosis

Journal rubric: Empirical Research

Article type: scientific article

DOI: https://doi.org/10.17759/cpse.2026150107

Received 25.03.2025

Revised 06.03.2026

Accepted

Published

For citation: Shulgina, D.I., Kafarov, E.R., Shishkovskaia, T.I., Rupchev, G.E., Oleychik, M.I., Enikolopov, S.N. (2026). Psychopathological and pathopsychological features of depressed patients at high risk of psychosis. Clinical Psychology and Special Education, 15(1), 95–112. (In Russ.). https://doi.org/10.17759/cpse.2026150107

© Shulgina D.I., Kafarov E.R., Shishkovskaia T.I., Rupchev G.E., Oleychik M.I., Enikolopov S.N., 2026

License: CC BY-NC 4.0

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Information About the Authors

Daria I. Shulgina, Postgraduate Student, Chair of Neuro- and Pathopsychology, Department of Psychology, Lomonosov Moscow State University (MSU), Junior Researcher, Department of Monitoring and Program Regulation of Public Mental Health, Scientific Center for Mental Health, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0009-4412-6063, e-mail: dshshulgina@gmail.com

Eugene R. Kafarov, Junior Researcher, Department for the Study of Borderline Mental Pathology and Psychosomatic Disorders, Mental Health Research Centre, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0003-0346-8787, e-mail: kafarov.e@yandex.ru

Tatiana I. Shishkovskaia, Junior Research Fellow, Center for Language and Brain, HSE University, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0002-9154-4104, e-mail: tszyszkowska@gmail.com

Georgiy E. Rupchev, Candidate of Science (Psychology), research fellow of the Laboratory of psychopharmacology, Mental Health Research Center, Senior Research Fellow, Chair of Neuroand Pathopsychology, Department of Psychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0003-1948-6090, e-mail: rupchevgeorg@mail.ru

Mikhail I. Oleychik, Junior Researcher, Department of Medical Psychology, Mental Health Research Center, Postgraduate student, Department of Neuro- and Pathopsychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0006-4102-5978, e-mail: mr.oleychik@mail.ru

Sergey N. Enikolopov, Candidate of Science (Psychology), Docent, Head of Department of Clinical Psychology, Mental Health Research Center, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0003-0615-6703, e-mail: enikolopov@mail.ru

Contribution of the authors

Shulgina D.I. — annotation, writing and formatting of the manuscript; collection and analysis of literature; conducting the experiment; collection, statistical processing and analysis of data.

Kafarov E.R. — conducting the experiment; collection and analysis of data; analysis of results; editing.

Shishkovskaya T.I. — clinical and psychopathological assessment of patients, analysis of results; editing.

Rupchev G.E. — development of study design and supervision; analysis and interpretation of results; editing.

Oleychik M.I. — interpretation of results; editing.

Enikolopov S.N. — study supervision; scientific editing.

All authors participated in the discussion of the results and approved the final text of the manuscript.

Conflict of interest

The authors declare no conflict of interest.

Ethics statement

The study was reviewed and approved by the Local Ethics Committee of Mental Health Research Center (report no. 746, 2021/03/18).

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