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Thungana Y, Zingela Z, van Wyk S, Kim HH, Ametaj A, Stevenson A, Stroud RE, Stein DJ, Gelaye B. Psychosis screening questionnaire: Exploring its factor structure among South African adults. S Afr J Psychiatr 2023; 29:2051. [PMID: 38059200 PMCID: PMC10696556 DOI: 10.4102/sajpsychiatry.v29i0.2051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023] Open
Abstract
Background Early detection of psychosis improves treatment outcomes, but there is limited research evaluating the validity of psychosis screening instruments, particularly in low-resourced countries. Aim This study aims to assess the construct validity and psychometric properties of the psychosis screening questionnaire (PSQ) in South Africa. Setting This study was conducted at several health centres in the Western and Eastern Cape provinces in South Africa. Methods The sample consisted of 2591 South African adults participating as controls in a multi-country case-control study of psychiatric genetics. Using confirmatory factor analysis and item response theory, we evaluated the psychometric properties of the PSQ. Results Approximately 11% of the participants endorsed at least one psychotic experience on the PSQ, and almost half of them (49%) occurred within the last 12 months. A unidimensional model demonstrated good fit (root mean square error of approximation [RMSEA] = 0.023, comparative fit index [CFI] = 0.977 and Tucker-Lewis Index [TLI] = 0.954). The mania item had the weakest association with a single latent factor (standardised factor loading = 0.14). Model fit improved after removing the mania item (RMSEA = 0.025, CFI = 0.991 and TLI = 0.972). With item response theory analysis, the PSQ provided more information at higher latent trait levels. Conclusion Consistent with prior literature, the PSQ demonstrated a unidimensional factor structure among South Africans. In our study, the PSQ in screening for psychosis performed better without the mania item, but future criterion validity studies are warranted. Contribution This study highlights that PSQ can be used to screen for early psychosis.
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Affiliation(s)
- Yanga Thungana
- Department of Psychiatry, Faculty of Health, Walter Sisulu University, Mthatha, South Africa
| | - Zukiswa Zingela
- Faculty of Health, Nelson Mandela University, Port Elizabeth, South Africa
| | - Stefan van Wyk
- Department of Psychiatry, Faculty of Health, Walter Sisulu University, Mthatha, South Africa
| | - Hannah H. Kim
- Department of Social and Behavioral Sciences, Faculty of Public Health, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Amantia Ametaj
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
| | - Anne Stevenson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rocky E. Stroud
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, United States of America
- Department of Psychiatry, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, United States of America
- Division of Global Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, United States of America
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Ghanem M, Evangeli-Dawson C, Georgiades A. The role of culture on the phenomenology of hallucinations and delusions, explanatory models, and help-seeking attitudes: A narrative review. Early Interv Psychiatry 2023; 17:843-863. [PMID: 37458202 DOI: 10.1111/eip.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/23/2023] [Accepted: 07/02/2023] [Indexed: 09/07/2023]
Abstract
AIM Culture has been posited to be involved in the formation and maintenance of delusions and hallucinations. The extent of these differences and how they affect explanatory models of psychosis and help-seeking attitudes remains to be understood. This review aims to present a cultural formulation to account for psychosis onset, symptom maintenance, and help-seeking attitudes. METHODS A narrative review was conducted to summarize the existing evidence base regarding cross-cultural differences in hallucinatory and delusional prevalence, explanatory models, and help-seeking attitudes in First Episode Psychosis (FEP) and Non-FEP Schizophrenia samples. RESULTS Sixteen studies were eligible for inclusion. In terms of positive symptom specificity, cross-cultural differences were found. Specifically, auditory and visual hallucinations occurred most frequently in African patients, persecutory and grandiose delusions occurred at higher rates in African, Pakistani, and Latino patients, while delusions of reference were most prevalent in White-British groups. Three explanatory models were identified. Westerners tended to endorse a bio-psychosocial explanation, which was associated with increased help-seeking, engagement, and positive medication attitudes. Asian, Latino, Polish, and Māori patients endorsed religious-spiritual explanatory models, while African patients opted for a bewitchment model. The religious-spiritual and bewitchment models were associated with a longer duration of untreated psychosis (DUP) and poorer engagement with mental health services. CONCLUSIONS These findings highlight the important influence of culture in the formation and maintenance of positive symptoms of psychosis, engagement, and help-seeking attitudes across different ethnic groups. The incorporation of cultural beliefs in formulation development could facilitate enriched CBTp practices and improved engagement amongst different cultural groups with Early Intervention Services.
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Affiliation(s)
- Mawada Ghanem
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
| | - Christian Evangeli-Dawson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
| | - Anna Georgiades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
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Theisen C, Rosen M, Meisenzahl E, Koutsouleris N, Lichtenstein T, Ruhrmann S, Kambeitz J, Kambeitz-Ilankovic L, Riecher-Rössler A, Chisholm K, Upthegrove R, Antonucci LA, Bertolino A, Pigoni A, Salokangas RKR, Pantelis C, Wood SJ, Lencer R, Falkai P, Hietala J, Brambilla P, Schmidt A, Andreou C, Borgwardt S, Osman N, Schultze-Lutter F. The heterogeneity of attenuated and brief limited psychotic symptoms: association of contents with age, sex, country, religion, comorbidities, and functioning. Front Psychiatry 2023; 14:1209485. [PMID: 37484669 PMCID: PMC10361815 DOI: 10.3389/fpsyt.2023.1209485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/13/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction The Attenuated Psychosis Symptoms (APS) syndrome mostly represents the ultra-high-risk state of psychosis but, as does the Brief Intermittent Psychotic Symptoms (BIPS) syndrome, shows a large variance in conversion rates. This may be due to the heterogeneity of APS/BIPS that may be related to the effects of culture, sex, age, and other psychiatric morbidities. Thus, we investigated the different thematic contents of APS and their association with sex, age, country, religion, comorbidity, and functioning to gain a better understanding of the psychosis-risk syndrome. Method A sample of 232 clinical high-risk subjects according to the ultra-high risk and basic symptom criteria was recruited as part of a European study conducted in Germany, Italy, Switzerland, and Finland. Case vignettes, originally used for supervision of inclusion criteria, were investigated for APS/BIPS contents, which were compared for sex, age, country, religion, functioning, and comorbidities using chi-squared tests and regression analyses. Result We extracted 109 different contents, mainly of APS (96.8%): 63 delusional, 29 hallucinatory, and 17 speech-disorganized contents. Only 20 contents (18.3%) were present in at least 5% of the sample, with paranoid and referential ideas being the most frequent. Thirty-one (28.5%) contents, in particular, bizarre ideas and perceptual abnormalities, demonstrated an association with age, country, comorbidity, or functioning, with regression models of country and obsessive-compulsive disorders explaining most of the variance: 55.8 and 38.3%, respectively. Contents did not differ between religious groups. Conclusion Psychosis-risk patients report a wide range of different contents of APS/BIPS, underlining the psychopathological heterogeneity of this group but also revealing a potential core set of contents. Compared to earlier reports on North-American samples, our maximum prevalence rates of contents were considerably lower; this likely being related to a stricter rating of APS/BIPS and cultural influences, in particular, higher schizotypy reported in North-America. The various associations of some APS/BIPS contents with country, age, comorbidities, and functioning might moderate their clinical severity and, consequently, the related risk for psychosis and/or persistent functional disability.
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Affiliation(s)
- Christian Theisen
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Eva Meisenzahl
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Research Center Jülich, Institute for Cognitive Neuroscience (INM-3), Jülich, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | | | - Katharine Chisholm
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Department of Psychology, Aston University, Birmingham, United Kingdom
| | - Rachel Upthegrove
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Linda A. Antonucci
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- MoMiLab Research Unit, IMT School for Advanced Studies Lucca, Lucca, Italy
| | | | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Stephen J. Wood
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
- Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - Jarmo Hietala
- Department of Psychiatry, Medical Faculty, University of Turku, Turku, Finland
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Mental Health, University of Milan, Milan, Italy
| | - André Schmidt
- Department of Psychiatry, University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Stefan Borgwardt
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France.,Institut de Psychiatrie (CNRS GDR 3557), Paris, France.,Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Jaguga F, Ametaj A, Kim HH, Stroud RE, Newton CR, Kariuki SM, Kwobah EK, Atwoli L, Gelaye B, Korte KJ. Factor structure and item response of psychosis symptoms among Kenyan adults. J Affect Disord 2022; 317:136-141. [PMID: 36028013 PMCID: PMC10131230 DOI: 10.1016/j.jad.2022.08.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/10/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the construct validity of the psychosis module of the Mini International Neuropsychiatric Interview version 7.0.2 (MINI-7). METHOD We utilized data collected from 2738 participants with a primary psychotic or bipolar disorder. Participants were drawn from two Kenyan sites of a large multi-center neuropsychiatric genetic study. The factor structure of the MINI-7 psychosis items were explored using confirmatory factor analyses (CFA) and Item Response Theory approach, for the full sample and by gender. RESULTS The CFA revealed that a 1-factor model provided adequate fit for the MINI-7 psychosis items for the full sample (x2 = 397.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.90) as well as for the female (x2 = 185.16.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.93; TLI = 0.91) and male groups (x2 = 242.09, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.89). Item thresholds for the full sample, and female and male groups were highest for 'odd beliefs' (-1.42, -1.33, and -1.51 respectively) and lowest for 'visual hallucinations' (-0.03, -0.04, and -0.01 respectively). LIMITATIONS Our study used a hospital-based population, which may have excluded patients with milder psychotic symptoms. Findings may therefore not be generalizable to the community setting. CONCLUSIONS Our findings indicate good construct validity of the MINI-7 psychosis module, and provides support for use of the tool in diagnosing psychotic disorders in clinical settings in Kenya.
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Affiliation(s)
- Florence Jaguga
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya.
| | - Amantia Ametaj
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Hannah H Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rocky E Stroud
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Charles R Newton
- Neuroscience Department, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Symon M Kariuki
- Neuroscience Department, Kenya Medical Research Institute - Wellcome Trust Research Program, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, United Kingdom; Department of Public Health, Pwani University, Kilifi, Kenya
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Lukoye Atwoli
- Department of Internal Medicine, Medical College East Africa, Aga Khan University, Nairobi, Kenya
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research at Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kristina J Korte
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Valle R. Validity, reliability and clinical utility of mental disorders: The case of ICD-11 schizophrenia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:61-70. [PMID: 35210207 DOI: 10.1016/j.rcpeng.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/09/2020] [Indexed: 06/14/2023]
Abstract
Diagnostic classification systems categorise mental psychopathology in mental disorders. Although these entities are clinical constructs developed by consensus, it has been pointed out that in practice they are usually managed as natural entities and without evaluating aspects related to their nosological construction. The objectives of the study are to review a) the conceptualisation of mental disorders, b) the indicators of validity, reliability and clinical utility, and c) the values of these indicators in ICD-11 schizophrenia. The results show that mental disorders are conceptualised as discrete entities, like the diseases of other areas of medicine; however, differences are observed between these diagnostic categories in clinical practice. The reliability and clinical utility of mental disorders are adequate; however, the validity is not yet clarified. Similarly, ICD-11 schizophrenia demonstrates adequate reliability and clinical utility, but its validity remains uncertain. The conceptualisation of psychopathology in discrete entities may be inadequate for its study, therefore dimensional and mixed models have been proposed. The indicators of validity, reliability and clinical utility enable us to obtain an accurate view of the nosological state of mental disorders when evaluating different aspects of their nosological construction.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Peru; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Peru.
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7
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Adewuya AO, Wright K, Njokanma F. Psychotic like experiences among Nigerian school adolescents: Findings from the Lagos Schools Emotional and Behavioral Health Survey. Early Interv Psychiatry 2021; 15:906-913. [PMID: 32881400 DOI: 10.1111/eip.13032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/03/2020] [Accepted: 08/02/2020] [Indexed: 12/30/2022]
Abstract
AIM This study aimed to explore the presence of psychotic like experience (PLE) symptoms and evaluate for the possible socio-demographic, family, school and mental health variables associated with clinically significant PLE symptoms in Nigeria school adolescent. METHODS A total of 9441 adolescents from 47 secondary schools in Lagos Nigeria completed questionnaire detailing sociodemographic, family and school related variables. Mental health was assessed with the Mini International Diagnostic Interview for children and adolescents (MINI-KID). PLE was assessed using the 16-item version of Prodromal Questionnaire (PQ-16). RESULTS The mean age in years was 15.6 (SD 1.5) and 50.4% were females. The mean PQ-16 score was 2.18 (SD 2.38) with 95% CI 2-15-2.21. A total of 2878 (30.5%) adolescents had no PLE symptoms while 990 (10.5%) had clinically significant PLE symptoms. The most experienced symptoms were "déjà vu" (35.5%) and loss of interest (29.6%). The variables independently associated with clinically significant PLE symptoms were "having no close friend in school" (OR 2.66, 95% CI 2.08-3.41), "often beaten by parents" (OR 1.98, 95% CI 1.67-2.34) "from a polygamous family" (OR 1.80, 95% CI 1.49-2.18), and "diagnosis of depression" (OR 1.33, 95% CI 1.09-1.63). CONCLUSION We have shown that PLE symptoms are relatively common in non-help seeking Nigerian school adolescents and that personal and family factors are significantly associated. Longitudinal studies will be needed to chart the path of symptoms and determinants of distress, help seeking and development of psychosis.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioural Medicine, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.,Centre for Mental Health Research and Initiative (CEMHRI), Ikeja, Lagos, Nigeria
| | - Kilelomo Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Fidelis Njokanma
- Department of Pediatrics and Child Health, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
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8
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Mamah D, Mutiso VN, Ndetei DM. Psychotic-like experiences among 9,564 Kenyan adolescents and young adults. Psychiatry Res 2021; 302:113994. [PMID: 34029986 DOI: 10.1016/j.psychres.2021.113994] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 05/07/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To investigate the prevalence and characteristics of psychotic-like experiences (PLE) in a large cohort of Kenyan adolescents and young adults. METHOD The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen was used to the study the 12-month prevalence of PLE's among 9,564 Kenyan youths (aged 15-25 yrs), and the rates of psychosis high-risk (HR) and medium-risk (MR) cases, based on cut-off scores. Relationships with clinical, demographic and economic profiles were investigated. RESULTS Across all participants, 72% reported having had at least one PLE over the last year. 4.6% and 30.6% were HR and MR based on symptom scores. There were similar PLE rates in females and males. PLE severity correlated with mood (r=0.67), stress (r=0.46), and autistic traits (r=0.18). PLE severity was also related to poverty, lower education attainment, and underemployment. Compared to controls, HR and MR youths were more likely to report lifetime substance use and to have more significant use. CONCLUSION Psychosis screening can provide valuable information about individuals and may help identify those who may require clinical assessment and intervention to improve outcomes. This is particularly relevant in many parts of Africa where the resources are limited for treating more advanced illness.
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Affiliation(s)
- Daniel Mamah
- Department of Psychiatry, Washington University Medical School, 660 S. Euclid, Saint Louis, Missouri, 63110, USA.
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya
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9
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Mohammadi-Nejad AR, Hossein-Zadeh GA, Shahsavand Ananloo E, Soltanian-Zadeh H. The effect of groupness constraint on the sensitivity and specificity of canonical correlation analysis, a multi-modal anatomical and functional MRI study. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Valle R. Validity, Reliability and Clinical Utility of Mental Disorders: The Case of ICD-11 Schizophrenia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30084-6. [PMID: 33735020 DOI: 10.1016/j.rcp.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/18/2020] [Accepted: 09/09/2020] [Indexed: 06/12/2023]
Abstract
Diagnostic classification systems categorise mental psychopathology in mental disorders. Although these entities are clinical constructs developed by consensus, it has been pointed out that in practice they are usually managed as natural entities and without evaluating aspects related to their nosological construction. The objectives of the study are to review a) the conceptualisation of mental disorders, b) the indicators of validity, reliability and clinical utility, and c) the values of these indicators in ICD-11 schizophrenia. The results show that mental disorders are conceptualised as discrete entities, like the diseases of other areas of medicine; however, differences are observed between these diagnostic categories in clinical practice. The reliability and clinical utility of mental disorders are adequate; however, the validity is not yet clarified. Similarly, ICD-11 schizophrenia demonstrates adequate reliability and clinical utility, but its validity remains uncertain. The conceptualisation of psychopathology in discrete entities may be inadequate for its study, therefore dimensional and mixed models have been proposed. The indicators of validity, reliability and clinical utility enable us to obtain an accurate view of the nosological state of mental disorders when evaluating different aspects of their nosological construction.
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Affiliation(s)
- Rubén Valle
- Centro de Investigación en Epidemiología Clínica y Medicina Basada en Evidencias, Facultad de Medicina Humana, Universidad de San Martín de Porres, Lima, Perú; DEIDAE de Adultos y Adultos Mayores, Instituto Nacional de Salud Mental Honorio Delgado-Hideyo Noguchi, Lima, Perú.
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Association of the soluble CTLA4 with schizophrenia: an observational study. JOURNAL OF BIO-X RESEARCH 2020. [DOI: 10.1097/jbr.0000000000000070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Association between paternal age and risk of schizophrenia: a nationwide population-based study. J Assist Reprod Genet 2020; 38:85-93. [PMID: 32862335 DOI: 10.1007/s10815-020-01936-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/26/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To study the association between paternal age and schizophrenia in offspring. METHODS This report describes a nationwide population-based cohort study from 1997 to 2013. Data from Taiwan's National Health Insurance Research Database were utilized to answer the research question. A total of 17,649 offspring with schizophrenia were selected from 11 million offspring in the general population. Additionally, we established the offspring without schizophrenia as the comparison group by matching the study cohort by age, gender in a 1:4 ratio (n = 70,596). RESULTS The median age at first presentation with schizophrenia was 20 years (interquartile range (IQR), 17 to 24). Comparison of the schizophrenia and non-schizophrenia groups indicated that father's age at birth (30.0 (IQR), 27 to 33 vs. 29.0 (IQR), 26 to 32 years), mother's age at birth (26.0 (IQR), 24 to 29 vs. 26.0 (IQR), 23 to 29 years), paternal schizophrenia (2.6% vs. 0.6%), and maternal schizophrenia (4.4% vs. 0.7%) were all significantly greater in the schizophrenia group. In addition, each 5-year increase in father's age increased the odds of being diagnosed with schizophrenia (model 1: aOR = 1.22; 95% CI 1.20, 1.24; model 2: aOR = 1.20; 95% CI 1.18, 1.23). Subgroup analysis showed that each 5-year increase in father's age increased the odds of being diagnosed with schizophrenia in male and female offspring, as well as in offspring of mothers and fathers with or without schizophrenia (aOR = 1.20 to 2.20, all p values < 0.01). CONCLUSION This study indicated that advanced paternal age increased the risk of schizophrenia in offspring. Offspring born to fathers older by 5-year increments were at heightened risk of schizophrenia.
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Prevalence and Correlates of Psychotic Like Experiences in a Large Community Sample of Young Adults in Tunisia. Community Ment Health J 2020; 56:991-1003. [PMID: 31900754 DOI: 10.1007/s10597-019-00542-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/31/2019] [Indexed: 01/23/2023]
Abstract
Despite the increased focus on non-clinical psychosis populations, no community surveys have properly investigated the phenotypal expression of Psychotic like experiences (PLEs) in the Arab-Muslim world. We aimed to examine the prevalence and correlates of PLEs in a large sample of Tunisian college students. A total of 1489 students (64.3% female, aged 18-40) participated in a cross-sectional survey. The Positive Subscale of Community Assessment of Psychotic Experiences was used to measure PLEs. The rates of PLEs found in our work were relatively high compared with those found in previous international studies, with 51.4% of the participants reporting at least one positive PLE 'nearly-always'. After controling for confounding variables, other drug use in the past year represented the only substance use variable among the significant predictors in the final model. Our findings should raise awareness of the need for implementing an early intervention programs in our region.
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Vermeiden M, Janssens M, Thewissen V, Akinsola E, Peeters S, Reijnders J, Jacobs N, van Os J, Lataster J. Cultural differences in positive psychotic experiences assessed with the Community Assessment of Psychic Experiences-42 (CAPE-42): a comparison of student populations in the Netherlands, Nigeria and Norway. BMC Psychiatry 2019; 19:244. [PMID: 31387566 PMCID: PMC6685165 DOI: 10.1186/s12888-019-2210-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 07/11/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequently endorsed by, and (ii) cause less distress in Nigerian vs. Dutch and Norwegian students. METHODS Psychology students, aged 18 to 30 years, from universities in the Netherlands (n = 245), Nigeria (n = 478), and Norway (n = 162) were assessed cross-sectionally with regard to the frequency of subclinical positive psychotic experiences and related distress, using the Community Assessment of Psychic Experiences (CAPE-42). Multi-group confirmatory factor analysis and multivariate analysis of covariance were performed to assess measurement invariance of the positive symptom dimension (CAPE-Pos) and compare mean frequency and associated distress of positive psychotic experiences across study samples. RESULTS Only CAPE-Pos items pertaining to the dimensions 'strange experiences' and 'paranoia' met assumptions for (partial) measurement invariance. Frequencies of these experiences were higher in the Nigerian sample, compared to both the Dutch and Norwegian samples, which were similar. In addition, levels of experience-related distress were similar or higher in the Nigerian sample compared to respectively the Dutch and Norwegian samples. CONCLUSION Although positive psychotic experiences may be more commonly endorsed in non-Western societies, our findings do not support the notion that they represent a more benign, and hence less distressing aspect of human experience. Rather, the experience of psychotic phenomena may be just as, if not more, distressing in African than in European culture. However, observed differences in CAPE-Pos frequency and distress between samples from different cultural settings may partly reflect differences in the measure rather than in the latent trait. Future studies may therefore consider further cross-cultural adaptation of CAPE-42, in addition to explicitly examining cultural acceptance of psychotic phenomena, and environmental and other known risk factors for psychosis, when comparing and interpreting subclinical psychotic phenomena across cultural groups.
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Affiliation(s)
- Margriet Vermeiden
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
| | - Mayke Janssens
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Viviane Thewissen
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Esther Akinsola
- Department of Psychology, Faculty of Social Sciences, University of Lagos, Akoka, Lagos Nigeria
| | - Sanne Peeters
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jennifer Reijnders
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
| | - Nele Jacobs
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, psychology and Neuroscience, King’s College, London, UK
| | - Johan Lataster
- Faculty of Psychology and Educational Sciences, Open University, Valkenburgerweg 177, Heerlen, 6419 AT The Netherlands
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
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Badcock JC, Clark M, Morgan VA. Hallucinations in Indigenous and non-Indigenous Australians: Findings from the second Australian national survey of psychosis. Schizophr Res 2018; 197:581-582. [PMID: 29195748 DOI: 10.1016/j.schres.2017.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth, WA 6000, Australia.
| | - Melanie Clark
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth, WA 6000, Australia.
| | - Vera A Morgan
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth, WA 6000, Australia; Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, The University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth, WA 6000, Australia.
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Maura J, Weisman de Mamani A. Culturally Adapted Psychosocial Interventions for Schizophrenia: A Review. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2017.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Rathod S, Pinninti N, Irfan M, Gorczynski P, Rathod P, Gega L, Naeem F. Mental Health Service Provision in Low- and Middle-Income Countries. Health Serv Insights 2017; 10:1178632917694350. [PMID: 28469456 PMCID: PMC5398308 DOI: 10.1177/1178632917694350] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/27/2017] [Indexed: 11/16/2022] Open
Abstract
This article discusses the provision of mental health services in low- and middle-income countries (LMICs) with a view to understanding the cultural dynamics-how the challenges they pose can be addressed and the opportunities harnessed in specific cultural contexts. The article highlights the need for prioritisation of mental health services by incorporating local population and cultural needs. This can be achieved only through political will and strengthened legislation, improved resource allocation and strategic organisation, integrated packages of care underpinned by professional communication and training, and involvement of patients, informal carers, and the wider community in a therapeutic capacity.
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Affiliation(s)
- Shanaya Rathod
- Clinical Trials Facility, Southern Health NHS Foundation Trust, Southampton, UK
| | - Narsimha Pinninti
- School of Osteopathic Medicine, Rowan University and Oaks Integrated Care, Stratford, NJ, USA
| | - Muhammed Irfan
- Department of Mental Health, Psychiatry & Behavioral Sciences, Peshawar Medical College, Peshawar, Pakistan
| | - Paul Gorczynski
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Pranay Rathod
- Department of Economics, The London School of Economics and Political Science, London, UK
| | - Lina Gega
- Department of Health Sciences and Hull York Medical School, University of York, York, UK
| | - Farooq Naeem
- Department of Psychiatry, Queen’s University, Kingston, ON, Canada
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Chandra RM, Arora L, Mehta UM, Asnaani A, Radhakrishnan R. Asian Indians in America: The influence of values and culture on mental health. Asian J Psychiatr 2016; 22:202-9. [PMID: 26442987 DOI: 10.1016/j.ajp.2015.09.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/18/2015] [Accepted: 09/19/2015] [Indexed: 11/30/2022]
Abstract
Asian Indians represent a significant portion of the largest growing race of Asians in the past decade in the United States. This selective review examines major cultural themes related to first- and second-generation Asian Indians living in the United States as they impact psychological and psychiatric dysfunction in this population. Specifically, we review the impact of Asian Indian culture on mental health, discuss the impact of acculturation and ethnic identity development on the mental health of Indian-Americans, and focus on typical mental health problems of Asian Indian adolescents, women and elderly in America. Finally, we provide a brief overview of empirically-supported treatment approaches and cultural considerations for additional treatments relevant to this population. This review is intended to provide an important foundation for more systematic empirically-driven investigation into better understanding how Asian Indian cultural themes impact mental health for Indian-Americans, and how to develop effective treatments for these issues in this cultural group.
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Affiliation(s)
| | - Lily Arora
- Rutgers University - New Jersey Medical School, Newark, NJ, United States
| | - Urvakhsh M Mehta
- Beth Israel Deaconess Medical Center, Boston, MA, United States; National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Anu Asnaani
- Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, 3535 Market St, Suite 600 North, Philadelphia, PA 19104, United States.
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Kirmayer LJ, Ryder AG. Culture and psychopathology. Curr Opin Psychol 2016; 8:143-148. [DOI: 10.1016/j.copsyc.2015.10.020] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 10/08/2015] [Indexed: 02/06/2023]
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Koelkebeck K, Uwatoko T, Tanaka J, Kret ME. How culture shapes social cognition deficits in mental disorders: A review. Soc Neurosci 2016; 12:102-112. [PMID: 26899265 DOI: 10.1080/17470919.2016.1155482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Social cognitive skills are indispensable for successful communication with others. Substantial research has determined deficits in these abilities in patients with mental disorders. In neurobiological development and continuing into adulthood, cross-cultural differences in social cognition have been demonstrated. Moreover, symptomatic patterns in mental disorders may vary according to the cultural background of an individual. Cross-cultural studies can thus help in understanding underlying (biological) mechanisms and factors that influence behavior in health and disease. In addition, studies that apply novel paradigms assessing the impact of culture on cognition may benefit and advance neuroscience research. In this review, the authors give an overview of cross-cultural research in the field of social cognition in health and in mental disorders and provide an outlook on future research directions, taking a neuroscience perspective.
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Affiliation(s)
- Katja Koelkebeck
- a Department of Psychiatry and Psychotherapy , School of Medicine, University of Muenster , Muenster , Germany
| | - Teruhisa Uwatoko
- b Department of Psychiatry , Graduate School of Medicine, Kyoto University , Sakyo-ku, Kyoto , Japan.,c Kyoto University Health Service , Sakyo-ku, Kyoto , Japan
| | - Jiro Tanaka
- d Faculty of Modern Languages and Cultures , Santa Monica College , Santa Monica , CA , USA.,e Adjunct Faculty in Foreign Languages , Los Angeles Valley College , Valley Glen , CA , USA
| | - Mariska Esther Kret
- f The Cognitive Psychology Unit , Leiden University, Institute of Psychology , AK , Leiden
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