SynthesisEarly intervention in psychiatry2025
The Role of Emotion in Psychosis Onset and Symptom Persistence: A Systematic Review.
Synthesis in Early intervention in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Role of Emotion in Psychosis Onset and Symptom Persistence: A Systematic Review.Early intervention in psychiatry · 2025Pooled it
- Clinical Correlates of Compliance, Appeasement and Resistance in Command Hallucinations: A Systematic Review.Clinical psychology & psychotherapyPooled it
- Coping Style as a Predictor of Relapse and Functioning in First Episode Psychosis.Schizophrenia bulletin · 2026Article
- Paranoid Ideation in Gay Men: The Roles of Psychological Emptiness, Identity Loss, Loneliness, and Identity Resilience.Healthcare (Basel, Switzerland) · 2026Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimEmotions have repeatedly been implicated in the development and maintenance of psychosis. However, there is no universally acknowledged theory to account for how emotions influence psychosis. This review, therefore, aims to explore how emotions and emotional coping strategies contribute to the onset and persistence of psychosis symptoms.
methodA systematic review was conducted to summarise the existing evidence base regarding the role of emotions and emotional coping strategies across the psychosis continuum, including individuals at Clinical High Risk (CHR), those experiencing a First Episode of Psychosis (FEP), and those with a diagnosis of Schizophrenia (SZ).
resultsSeventy-eight studies were eligible for inclusion. Compared to Healthy Controls (HCs), SZ and CHR individuals demonstrated significant impairments in emotional awareness, emotional understanding of self and others, and emotional regulation, along with heightened emotional reactivity. In SZ, lower emotional awareness, negative emotional reactivity, and emotional dysregulation were significantly associated with increased positive symptoms. Individuals with SZ reported high levels of Negative Affect (NA) and low levels of Positive Affect (PA), with NA being a strong predictor of paranoia and rumination strengthening the affective pathway to paranoia. In terms of coping, CHR and SZ demonstrated significantly greater use of Maladaptive Coping Strategies (MCS) than Adaptive Coping Strategies (ACS) compared to HCs. MCS such as suppression were significantly associated with increased positive and negative symptoms, social withdrawal, and depression severity in SZ, while ACS such as cognitive reappraisal significantly decreased negative symptoms, depression, and social withdrawal and improved social functioning. Individuals with SZ predominantly employed Emotion-Focused Coping (EFC) rather than Problem-Focused Coping (PFC), which were associated with negative and positive outcomes, respectively.
conclusionThese findings highlight the important role of emotion in psychosis onset and symptom persistence. Given the prominence of emotions in the manifestation and maintenance of psychosis, the development of emotion-focused interventions for psychosis is necessary to not only prevent transition and relapse but also to maintain recovery. To support clinical application, this review also provides Socratic questions and recommends practical therapeutic tools to assist clinicians in the assessment, formulation, and intervention of emotional dysregulation in psychosis.
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