Phenotypically Continuous With Clinical Psychosis, Discontinuous in Need for Care: Evidence for an Extended Psychosis Phenotype
Open Access
- 9 September 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in Schizophrenia Bulletin
- Vol. 38 (2), 231-238
- https://doi.org/10.1093/schbul/sbr129
Abstract
Rates of self-reported psychotic experiences (SRPEs) in general population samples are high; however the reliability against interview-based assessments and the clinical significance of false-positive (FP) ratings remain unclear. Design: The second Netherlands Mental Health Survey and Incidence Study-2, a general population study. Trained lay interviewers administered a structured interview assessing psychopathology and psychosocial characteristics in 6646 participants. Participants with at least one SRPE (N = 1084) were reassessed by clinical telephone interview. Thirty-six percent of participants with SRPEs were confirmed by clinical interview as true positive (TP). SPREs not confirmed by clinical interview (FP group) generated less help-seeking behavior and occurred less frequently compared with TP experiences (TP group). However, compared with controls without psychotic experiences, the FP group more often displayed mood disorder (relative risk [RR] 1.7, 1.4–2.2), substance use disorder (RR 2.0, 1.6–2.6), cannabis use (RR 1.5, 1.2–1.9), higher levels of neuroticism (RR 1.8, 1.5–2.2), affective dysregulation, and social dysfunction. The FP group also experienced more sexual (RR 2.0, 1.5–2.8) and psychological childhood trauma (RR 2.1, 1.7–2.6) as well as peer victimization (RR 1.5, 1.2–2.0) and recent life events (RR 2.0, 1.6–2.4) than controls without psychotic experiences. Differences between the FP group and the TP group across these domains were much smaller and less conclusive. SRPEs not confirmed by clinical interview may epresent the softest expression of an extended psychosis phenotype that is phenotypically continuous with clinical psychosis but discontinuous in need for care.Keywords
This publication has 30 references indexed in Scilit:
- The Netherlands Mental Health Survey and Incidence Study‐2 (NEMESIS‐2): design and methodsInternational Journal of Methods in Psychiatric Research, 2010
- Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year studyThe British Journal of Psychiatry, 2010
- Are Screening Instruments Valid for Psychotic-Like Experiences? A Validation Study of Screening Questions for Psychotic-Like Experiences Using In-Depth Clinical InterviewSchizophrenia Bulletin, 2009
- Evidence That Onset of Clinical Psychosis Is an Outcome of Progressively More Persistent Subclinical Psychotic Experiences: An 8-Year Cohort StudySchizophrenia Bulletin, 2009
- The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomaliesPsychological Medicine, 2008
- A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorderPsychological Medicine, 2008
- How false are “false” positive psychotic symptoms?Schizophrenia Research, 2003
- Self‐reported psychotic experiences in the general population: a valid screening tool for DSM‐III‐R psychotic disorders?Acta Psychiatrica Scandinavica, 2003
- The MOS 36-ltem Short-Form Health Survey (SF-36)Medical Care, 1992
- The MOS Short-form General Health SurveyMedical Care, 1988