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Rimvall MK, Simonsen E, Zhang J, Andersen ZJ, Hastrup LH, Jeppesen P, Austin SF, Koch SV. Examining psychotic experiences in two generations - findings from a rural household-based cohort study; the Lolland-Falster Health Study. Psychol Med 2024; 54:1382-1390. [PMID: 37997748 DOI: 10.1017/s0033291723003276] [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] [Indexed: 11/25/2023]
Abstract
BACKGROUND Psychotic disorders are highly heritable, yet the evidence is less clear for subclinical psychosis expression, such as psychotic experiences (PEs). We examined if PEs in parents were associated with PEs in offspring. METHODS As part of the Danish general population Lolland-Falster Health Study, families with youths aged 11-17 years were included. Both children and parents reported PEs according to the Psychotic Like Experiences Questionnaire, counting only 'definite' PEs. Parents additionally reported depressive symptoms, anxiety, and mental wellbeing. The associations between parental and child PEs were estimated using generalized estimating equations with an exchangeable correlation structure to account for the clustering of observations within families, adjusting for sociodemographic characteristics. RESULTS Altogether, 984 youths (mean age 14.3 years [s.d. 2.0]), 700 mothers, and 496 fathers from 766 households completed PEs-questionnaires. Offspring of parents with PEs were at an increased risk of reporting PEs themselves (mothers: adjusted risk ratio (aRR) 2.42, 95% CI 1.73-3.38; fathers: aRR 2.25, 95% CI 1.42-3.59). Other maternal problems (depression, anxiety, and poor mental well-being), but not paternal problems, were also associated with offspring PEs. In multivariate models adjusting for parental problems, PEs, but not other parental problems, were robustly associated with offspring PEs (mothers: aRR 2.25, 95% CI 1.60-3.19; fathers: aRR 2.44, 95% CI 1.50-3.96). CONCLUSIONS The current findings add novel evidence suggesting that specific psychosis vulnerability in families is expressed at the lower end of the psychosis continuum, underlining the importance of assessing youths' needs based on psychosis vulnerability broadly within the family systems.
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Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
| | - Erik Simonsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Mental Health Services East, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
| | - Jiawei Zhang
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lene Halling Hastrup
- Mental Health Services East, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Danish Centre for Health Economics, DaCHE, University of Southern Denmark, Odense, Denmark
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stephen F Austin
- Mental Health Services East, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Institute of Psychology, University of Southern Denmark, Odense, Denmark
| | - Susanne Vinkel Koch
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Naughton S, Clarke M. Debate: CAMHS will be at the forefront of the next generation of psychosis risk models, but further integration with early intervention psychosis services is needed to realise this potential: Re Debate: Prevention of psychosis in adolescents - does CAMHS have a role? Child Adolesc Ment Health 2024. [PMID: 38601982 DOI: 10.1111/camh.12713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 04/12/2024]
Abstract
The detection of psychosis and its prodrome have unique considerations in a child and adolescent population. Young people attending CAMHS are already a high-risk group, which confers significant limitations in applying the current clinical high-risk (CHR) model. This has catalysed calls for a transdiagnostic approach to psychosis risk prediction, but without a clear pathway forward. We contribute to the debate opened by Salazar de Pablo and Arango (2023, Child and Adolescent Mental Health) on the role of CAMHS in this initiative. CAMHS have a key role in developing comprehensive longitudinal datasets to inform risk models. Closer integration with early intervention in psychosis (EIP) services will be needed to realise this potential. This integration is also required to reliably detect prodromes and emerging psychosis in young people. Where there is robust evidence to support prevention initiatives, we should proceed with their implementation, even in the absence of enhanced risk models.
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Affiliation(s)
- Sean Naughton
- DETECT, Early Intervention in Psychosis Service, Co. Dublin, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Mary Clarke
- DETECT, Early Intervention in Psychosis Service, Co. Dublin, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
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Staines L, Dooley N, Healy C, Kelleher I, Cotter D, Cannon M. Examining the association between prenatal and perinatal adversity and the psychotic experiences in childhood. Psychol Med 2024:1-12. [PMID: 38433592 DOI: 10.1017/s0033291724000187] [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] [Indexed: 03/05/2024]
Abstract
BACKGROUND Prenatal and perinatal complications are established risk factors for psychotic disorder, but far less is known about these measures and psychotic experiences (PEs). We investigated the longitudinal effect of prenatal risk factors (maternal behavior, medication complications) and perinatal risk factors (birth weight, medical complications) on frequency of PEs. We also examined the cumulative risk of prenatal/perinatal risk factors, and differences between transient PE, persistent PE, and controls. METHODS The Adolescent Brain Cognitive Development study is a large child cohort (age 9-10 at baseline; n = 11 872 with PE data). PEs were measured longitudinally using the Prodromal Questionnaire-Brief, Child version, and included only if reported as distressing. Mixed-effects models were used for analysis, controlling for random effects, and a substantial number of fixed-effects covariates. RESULTS Urinary tract infection (β = 0.11, 95% confidence interval [CI] 0.03-0.19) and severe anemia (β = 0.18, 95% CI 0.07-0.29) increased frequency of distressing PEs in childhood. Number of prenatal complications increased frequency of PEs (β = 0.03, 95% CI 0.01-0.06) and risk of persistent PEs (odds ratio [OR] = 1.08, 95% CI 1.01-1.15). Maternal smoking was associated with an increased frequency of PEs (β = 0.11, 95% CI 0.04-0.18) and persistent PEs (OR = 1.31, 95% CI 1.04-1.66). Maternal substance use was a risk factor for a 48% increased risk of persistent PEs (OR = 1.48, 95% CI 1.08-2.01). Perinatal complications showed no effect on PEs. CONCLUSIONS This study provides evidence that certain prenatal medical complications (severe nausea, severe anemia), cumulative number of prenatal medical complications, and maternal behaviors (smoking during pregnancy), increased frequency of distressing PEs in childhood. Maternal smoking and substance use, as well as cumulative number of prenatal complications increased risk of persistent PEs.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH10 5HF, UK
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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Xu B, Chen C, Wang D. Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation. Psychol Res Behav Manag 2024; 17:799-811. [PMID: 38434958 PMCID: PMC10908336 DOI: 10.2147/prbm.s451889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. Methods A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Results Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Conclusion Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.
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Affiliation(s)
- Bingna Xu
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Dongfang Wang
- School of Psychology, South China Normal University, Guangzhou, People’s Republic of China
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People’s Republic of China
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Nyengaard R, Kallesøe KH, Rimvall MK, Ørnbøl E, Wellnitz KB, Olsen EM, Wyller VBB, Rask CU. Hair cortisol and self-perceived stress in adolescents with multi-system functional somatic disorders. BMC Psychiatry 2024; 24:101. [PMID: 38317120 PMCID: PMC10840144 DOI: 10.1186/s12888-024-05518-4] [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: 04/29/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Long-term stress causing altered hypothalamic-pituitary-adrenal (HPA) axis dynamics with cortisol dysfunction may be involved in the pathophysiology of functional somatic disorders (FSD), but studies on adolescents with multi-system FSD are lacking. Therefore, we investigated: 1) whether hair cortisol concentration (HCC) differentiates adolescents with multi-system FSD from a) a population-based sample and b) a subgroup derived from the sample reporting a high physical symptom load, and 2) whether FSD population HCC is associated with primary symptom presentations and self-perceived stress. METHODS We used data from a clinical sample with multi-system FSD (N = 91, age 15-19 years) and a population-based sample (N = 1,450, age 16-17 years) including a subgroup with top 10% total scores on physical symptoms (N = 147). Density plots and multiple linear regression were applied to compare HCC between groups. In the clinical sample, multiple linear regression was employed to assess the association between HCC and primary symptom clusters and self-perceived stress. RESULTS Median HCC was lower in the clinical sample than in the population-based sample (β = 0.80 (95%CI: 0.66, 0.97)), but not significantly different from median HCC in the derived subgroup (β = 0.84 (95%CI: 0.66, 1.07)). In the clinical sample, HCC was not significantly associated with primary symptom clusters (F(2, 82) = 0.13, p = 0.88) or self-perceived stress (F(4, 83) = 1.18, p = 0.33). CONCLUSION Our findings indicate that HCC is lowered in adolescents with multi-system FSD but not significantly associated with primary symptom presentations or self-perceived stress. Future studies including multiple measures of HPA axis dynamics alongside psychological measures may further elucidate the role of long-term stress in FSD. TRIAL REGISTRATION The AHEAD study was pre-registered at ClinicalTrials.gov (NCT02346071), 26/01/2015.
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Affiliation(s)
- Rebecca Nyengaard
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
| | - Karen Hansen Kallesøe
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark.
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services in the Capital Region of Denmark, Kildegaardsvej 28, Entrance 3A, 1st Floor, 2900, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Ny Østergade 12, 4000, Roskilde, Denmark
| | - Eva Ørnbøl
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Kaare Bro Wellnitz
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, Aarhus N, 8200, Denmark
| | - Else Marie Olsen
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Ndr. Fasanvej 57, 1st Floor, Building 14, 2000, Frederiksberg, Denmark
- Psychiatric Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Maglevænget 2, 2750, Ballerup, Denmark
| | - Vegard Bruun Bratholm Wyller
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Postboks 1000, 1478, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Blindern, P.O box 1171, 0318, Oslo, Norway
| | - Charlotte Ulrikka Rask
- Research Unit Department of Child and Adolescent Psychiatry, Psychiatry, Aarhus University Hospital, Palle Juul-Jensens Boulevard 175, Aarhus N, 8200, Denmark
- Department of Clinical Medicine, Aarhus University, Incuba Skejby, building 2, Palle Juul-Jensens Boulevard 82, 8200, Aarhus N, Denmark
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Rimvall MK, Vassard D, Christensen R, Nielsen SM, Pagsberg AK, Correll CU, Jeppesen P. Do psychotic experiences act as effect modifiers in youths with common mental health problems allocated to transdiagnostic cognitive behavioural therapy versus management as usual? Secondary analyses of the Mind-My-Mind randomized trial. Early Interv Psychiatry 2024; 18:26-33. [PMID: 37078563 DOI: 10.1111/eip.13423] [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: 04/30/2022] [Revised: 12/28/2022] [Accepted: 03/28/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Psychotic experiences (PEs) are common in help-seeking youths with non-psychotic mental health problems, yet the clinical importance of PEs as potential effect modifiers of psychotherapy interventions has been scarcely examined. We examined if PEs were associated with a differential response to transdiagnostic cognitive behavioural therapy (CBT) aimed at common emotional and behavioural problems. METHODS We present secondary analyses from the Mind My Mind (MMM) trial that randomized 396, 6-16-year-old youths to either 9-13 sessions of transdiagnostic modular community-based CBT (MMM) or community-based management as usual (MAU). MMM was superior to MAU in reducing parent-reported impact of mental health problems according to the Strengths and Difficulties Questionnaire (SDQ). PEs were assessed by semi-structured screening interviews at baseline. The contrast between subgroups (presence/absence of PEs) was calculated to test if PEs are potential effect modifiers regarding the change in parent-reported SDQ-impact (primary outcome, rated 0[low]-10[high]) and other SDQ-related outcomes. RESULTS Baseline PEs were present in 74 (19%) of youths. The superior effect of MMM on changes in SDQ-impact from baseline to week 18 was not effect modified by the presence of PEs (PEs[yes] -0.89 [95%CI -1.77;-0.01] vs. PEs[no] -1.10 [95%CI -1.52;-0.68], p-value for interaction .68). For secondary outcomes similar patterns were observed. Limitations Statistical power was limited to show if PEs modified treatment response. Replication and meta-analytic evidence are needed. CONCLUSIONS The beneficial effects of MMM transdiagnostic CBT did not differ by PE-status, indicating that youths with emotional and behavioural problems could be offered such psychotherapy irrespective of co-occurring PEs.
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Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital-Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
| | - Ditte Vassard
- Child and Adolescent Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Sabrina Mai Nielsen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christoph U Correll
- Department of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, New York, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Pia Jeppesen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital-Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital-Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Austin SF, Hastrup LH, van Os J, Simonsen E. Psychotic experiences and mental health outcomes in the general population: The Lolland-Falster Health Study. Schizophr Res 2023; 260:85-91. [PMID: 37633127 DOI: 10.1016/j.schres.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/28/2023] [Accepted: 08/13/2023] [Indexed: 08/28/2023]
Affiliation(s)
- Stephen F Austin
- Psychiatric Research Unit, Psychiatry Region Zealand, Faelledvej 6, 4200 Slagelse, Denmark; Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Lene Halling Hastrup
- Psychiatric Research Unit, Psychiatry Region Zealand, Faelledvej 6, 4200 Slagelse, Denmark; Danish Centre for Health Economics, University of Southern Denmark, Odense, Denmark.
| | - Jim van Os
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Psychosis Studies and King's Health Partners, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Erik Simonsen
- Mental Health Services, East, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Rammou A, Berry C, Fowler D, Hayward M. What's the impact of voice-hearing experiences on the social relating of young people: A comparison between help-seeking young people who did and did not hear voices. PLoS One 2023; 18:e0290641. [PMID: 37751433 PMCID: PMC10522017 DOI: 10.1371/journal.pone.0290641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/12/2023] [Indexed: 09/28/2023] Open
Abstract
Limited research has explored the specific impact of voice-hearing experiences upon the social relating of adolescents. This study examined the associations of voice-hearing in youth with social relating, and putative explanatory factors. An observational, cross-sectional design using a clinical comparison group was employed to examine historical and concurrent associations with voice-hearing. Thirty-four young people (age 14-18 years) with voice-hearing experiences and 34 young people who did not hear voices were recruited from NHS mental health services. Participants completed measures about social relating and potential explanatory factors. Analyses of covariance were used to examine between-group differences. Voice-hearers scored higher on negative schematic beliefs (self-beliefs, partial η2 = .163, p = .001; other-beliefs, partial η2 = .152, p =. 002) and depressive and anxiety symptoms (partial η2 = .23 and partial η2 = .24, p-s <. 001 respectively). The two groups did not differ significantly on childhood trauma levels (partial η2 = .02, p = .273), however, the voice-hearing group scored lower on premorbid adjustment (partial η2 = .19, p < .001). Hearing voices in help-seeking youth could be an indicator for social relating issues and holding negative schematic beliefs, and may be an indicator for of increased psychopathological complexity. Although poorer premorbid adjustment might indicate an early vulnerability to social relating difficulties, voice-hearing might be an aggravating factor and one that requires treatment.
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Affiliation(s)
- Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
| | - Clio Berry
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, United Kingdom
- Research and Development Department, Sussex Partnership NHS Foundation Trust, Worthing, United Kingdom
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Staines L, Healy C, Kelleher I, Cotter D, Burns A, Cannon M. The association between transient childhood psychotic experiences and psychosocial outcomes in young adulthood: Examining the role of mental disorders and adult attachment. Early Interv Psychiatry 2023; 17:901-909. [PMID: 36646439 PMCID: PMC10947326 DOI: 10.1111/eip.13382] [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: 04/19/2022] [Revised: 10/13/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023]
Abstract
AIM Evidence suggest individuals with mental disorders and psychotic experiences (PE), even transient PE, show poorer psychosocial outcomes relative to those with mental disorders. The concept of "attachment" is hypothesized as the mechanism by which people seek support in times of need. This can be measured as discrete styles or as positive (low avoidance/anxiety)/negative (high avoidance/anxiety) dimensions. Adult attachment has previously been examined on PE risk factors, but not outcomes. This study aimed to examine the relationship between transient childhood PE and adult psychosocial outcomes, comparing those with and without mental disorders. Second, to examine the role of adult attachment. METHOD Participants (n = 103) attended baseline (age 11-13) and 10-year follow-up. PE and mental disorders were measured using the Schedule for Affective Disorders and Schizophrenia for School-aged Children. Attachment and outcomes were measured using self-report measures. Analysis compared those with PE (with/without mental disorders), and mental disorders without PE, to controls, using linear and Poisson regression. RESULTS PE was associated with lower self-esteem (β = -2.28, p = .03), perceived social support from friends (β = -2.80, p = .01), and higher stress in platonic relationships (IRR = 1.64). PE and mental disorders were associated with lower self-esteem (β = -5.74, p = .002), higher stress in romantic (IRR = 1.40) and platonic (IRR = 1.59) relationships, general stress (β = 5.60, p = .006), and mental distress (β = 5.67, p = .001). Mental disorders alone was not associated with any measure. Adult attachment dimensions attenuated some results. CONCLUSIONS This paper illustrates the association between transient PE and adult psychosocial outcomes, with & without co-occurring mental disorders, and demonstrates the role of adult attachment.
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Affiliation(s)
- Lorna Staines
- Royal College of Surgeons in Ireland, Psychiatry, Education and Research CentreBeaumont HospitalDublinIreland
| | - Colm Healy
- Royal College of Surgeons in Ireland, Psychiatry, Education and Research CentreBeaumont HospitalDublinIreland
| | - Ian Kelleher
- Royal College of Surgeons in Ireland, Psychiatry, Education and Research CentreBeaumont HospitalDublinIreland
- Division of PsychiatryCentre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
| | - David Cotter
- Royal College of Surgeons in Ireland, Psychiatry, Education and Research CentreBeaumont HospitalDublinIreland
- Department of PsychiatryBeaumont HospitalDublinIreland
| | - Annette Burns
- Bamford Centre for Mental Health and Well BeingUlster UniversityColeraineUK
| | - Mary Cannon
- Royal College of Surgeons in Ireland, Psychiatry, Education and Research CentreBeaumont HospitalDublinIreland
- Department of PsychiatryBeaumont HospitalDublinIreland
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Luo X, Yu T, Yang Z, Wang D. Psychotic-Like Experiences and Suicidal Ideation Among Adolescents: The Chain Mediating Role of Insomnia Symptoms and Resilience. Psychol Res Behav Manag 2023; 16:3519-3530. [PMID: 37675191 PMCID: PMC10478937 DOI: 10.2147/prbm.s426363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
Background Individuals who experience psychotic-like experiences (PLEs) are at significant risk of suicide-related behaviors. This two-wave longitudinal study aimed to investigate the relationships among PLEs, insomnia symptoms, resilience, and suicidal ideation (SI) among adolescents. Methods A total of 2231 college students [mean age (standard deviation) = 20.02 (1.39) years] completed two web-based surveys. Participants completed self-report measures of sample characteristics, PLEs, insomnia symptoms, resilience, and SI. Results The findings indicated a significantly positive correlation between PLEs and SI that was sequentially mediated by insomnia symptoms and resilience. Furthermore, insomnia symptoms and resilience played a chain-mediating role between PLEs and adolescent SI. Conclusion These findings suggest potential mechanism for the PLEs-SI link, which helps us better understand how PLEs can influence individual SI and provides important information for early prevention.
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Affiliation(s)
- Xi Luo
- School of Educational Science, Hunan Normal University, Changsha, Hunan Province, People’s Republic of China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha, Hunan Province, People’s Republic of China
- Hunan First Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Taowen Yu
- Department of Applied Psychology, Changsha Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Zilu Yang
- College of Education, Hunan Agricultural University, Changsha, Hunan Province, People’s Republic of China
| | - Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, Guangdong Province, People’s Republic of China
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11
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Fekih-Romdhane F, Stambouli M, Malaeb D, Farah N, Cheour M, Obeid S, Hallit S. Insomnia and distress as mediators on the relationship from cyber-victimization to self-reported psychotic experiences: a binational study from Tunisia and Lebanon. BMC Psychiatry 2023; 23:524. [PMID: 37475011 PMCID: PMC10360279 DOI: 10.1186/s12888-023-05019-w] [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: 02/16/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND While expansive research has accumulated concerning the association between traditional, face-to-face peer victimization and psychosis, a paucity of empirical research has been undertaken so far to investigate these associations with experiences of new and evolving ways of victimization through the digital world. Exploring these associations is highly relevant and timely, given that emerging adults are heavy users of digital technologies, highly exposed to online risks, and are at the peak age of onset of psychosis. This study aimed to test the hypothesis that psychological distress and insomnia symptoms have a significant indirect mediating effect on the association between cyber-victimization and self-reported positive psychotic experiences (SRPEs) in a binational sample of Tunisian and Lebanese community adults. METHOD The total sample was composed of 3766 participants; 3103 were from Lebanon (Mean age: 21.73 ± 3.80 years, 63.6% females) and 663 from Tunisia (Mean age: 26.32 ± 4.86 years, 59.9% females). Online anonymous self-report questionnaires were administered to all participants. RESULTS Higher SRPEs were found in Lebanese participants compared to Tunisians, in single participants compared to married ones, in those with a university level of education compared to secondary or less, in those who live in rural areas compared to urban, in those who do not smoke, do not drink alcohol and do not use marijuana or any other illegal drug. Furthermore, more cyber-victimization, a higher insomnia severity and psychological distress were significantly associated with higher SRPEs. After adjusting for potential confounders, mediation analysis demonstrated that higher cyber-victimization was significantly associated with more insomnia severity/psychological distress; which were, in turn, significantly associated with greater SRPEs. Finally, more cyber-victimization was significantly and directly associated with more positive dimension. CONCLUSION Identifying insomnia and distress as mediators could provide novel insight for psychosis prevention efforts and intervention targets for cyber-victimized individuals prone to experience subclinical psychotic symptoms.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospital, Manouba, 2010 Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospital, Manouba, 2010 Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi hospital, Manouba, 2010 Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
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12
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Staines L, Healy C, Murphy F, Byrne J, Murphy J, Kelleher I, Cotter D, Cannon M. Incidence and Persistence of Psychotic Experiences in the General Population: Systematic Review and Meta-Analysis. Schizophr Bull 2023; 49:1007-1021. [PMID: 37402250 DOI: 10.1093/schbul/sbad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND HYPOTHESIS Psychotic experiences (PEs) are associated with increased risk for mental disorders, in particular persistent PEs. PEs therefore might be useful within intervention research. We sought to systematically determine the incidence and persistence of PEs in the general population. STUDY DESIGN A double-blind search of databases (Embase, Pubmed PMC, Psychinfo, Medline, and Web of Science) from inception to January 2023 and data extraction, were conducted. Study quality was assessed using the NIH assessment tool. Random effects models were conducted to calculate pooled incidence rate per person-year and proportion of persistent PEs per year. Age and study design were all examined using subgroup analyses. Demographic, risk factors, and outcomes for incidence and persistence of PEs were reported in a narrative synthesis. STUDY RESULTS Using a double-blind screening method for abstract (k = 5763) and full text (k = 250) were screened. In total 91 samples from 71 studies were included, of which 39 were included in a meta-analysis (incidence: k = 17, n = 56 089; persistence: k = 22, n = 81 847). Incidence rate was 0.023 per person-year (95% CI [0.0129;0.0322]). That is, for every 100 people, 2 reported first onset PEs in a year. This was highest in adolescence at 5 per 100(13-17 years). The pooled persistence rate for PEs was 31.0% (95% CI [26.65,35.35]) This was highest in adolescence at 35.8%. Cannabis was particularly associated with incidence of PEs, and persistence of PEs were associated with multiple mental disorders. CONCLUSIONS Each year incidence of PEs is 2 of every 100 people, and persists each year in 31% of cases, this risk is highest in adolescents.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Felim Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Jonah Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Jennifer Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ian Kelleher
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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13
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Fekih-Romdhane F, Malaeb D, Loch AA, Farah N, Stambouli M, Cheour M, Obeid S, Hallit S. Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study. Int J Ment Health Addict 2023:1-18. [PMID: 36820017 PMCID: PMC9930705 DOI: 10.1007/s11469-023-01028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
The present study followed the newly hypothesized "suicidal drive for psychosis" suggesting that psychosis may be consequential to suicidal ideation (SI) and behavior and attempted to explain parts of the pathway between these variables. To this end, we aimed to test whether problematic smartphone use (PSU) has an indirect mediating effect in the cross-sectional relationship between SI and positive psychotic experiences (PEs). Lebanese community young adults (N=4158; 64.4% females; mean age 21.91±3.79) have been invited to participate to a cross-sectional, web-based study in the period from June to September 2022. After adjusting for potential confounders (i.e., the living situation, marital status, household crowding index, economic pressure, cannabis use, other drugs use, and past history of mental illness other than psychosis), we found that higher levels of suicidal ideation was significantly associated with greater PSU, which was also positively and significantly associated with more positive PEs. Finally, greater suicidal ideation was significantly and directly associated with more positive PEs. Our findings suggest that SPU may be regarded as a potential target for prevention and intervention in psychosis. Clinicians, educators, and school administrators ought to give greater attention to PSU among vulnerable young people who present with SI.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478 Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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14
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Staines L, Healy C, Corcoran P, Keeley H, Coughlan H, McMahon E, Cotter P, Cotter D, Kelleher I, Wasserman C, Brunner R, Kaess M, Sarchiapone M, Hoven CW, Carli V, Wasserman D, Cannon M. Investigating the effectiveness of three school based interventions for preventing psychotic experiences over a year period - a secondary data analysis study of a randomized control trial. BMC Public Health 2023; 23:219. [PMID: 36726107 PMCID: PMC9890687 DOI: 10.1186/s12889-023-15107-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Psychotic experiences (PEs) are associated with increased risk of later mental disorders and so could be valuable in prevention studies. However, to date few intervention studies have examined PEs. Given this lack of evidence, in the current study a secondary data analysis was conducted on a clustered-randomized control trial (RCT) of 3 school based interventions to reduce suicidal behaviour, to investigate if these may reduce rates of PEs, and prevent PE, at 3-month and 1-year follow-up. METHODS The Irish site of the Saving and Empowering Young Lives in Europe study, trial registration (DRKS00000214), a cluster-RCT designed to examine the effect of school-based interventions on suicidal thoughts and behaviour. Seventeen schools (n = 1096) were randomly assigned to one of three intervention arms or a control arm. The interventions included a teacher training (gate-keeper) intervention, an interactive educational (universal-education) intervention, and a screening and integrated referral (selective-indicative) intervention. The primary outcome of this secondary data-analysis was reduction in point-prevalence of PEs at 12 months. A second analysis excluding those with PEs at baseline was conducted to examine prevention of PEs. Additional analysis was conducted of change in depression and anxiety scores (comparing those with/without PEs) in each arm of the intervention. Statistical analyses were conducted using mixed-effects modelling. RESULTS At 12-months, the screening and referral intervention was associated with a significant reduction in PEs (OR:0.12,95%CI[0.02-0.62]) compared to the control arm. The teacher training and education intervention did not show this effect. Prevention was also observed only in the screening and referral arm (OR:0.30,95%CI[0.09-0.97]). Participants with PEs showed higher levels of depression and anxiety symptoms, compared to those without, and different responses to the screening and referral intervention & universal-education intervention. CONCLUSIONS This study provides the first evidence for a school based intervention that reduce & prevent PEs in adolescence. This intervention is a combination of a school-based screening for psychopathology and subsequent referral intervention significantly reduced PEs in adolescents. Although further research is needed, our findings point to the effectiveness of school-based programmes for prevention of future mental health problems.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland.
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Helen Keeley
- Child and Adolescent Mental Health Services North Cork, Health Service Executive, Cork, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
| | - Elaine McMahon
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Padraig Cotter
- Research Society of Process Oriented Psychology United Kingdom (RSPOPUK), Old Hampstead Townhall 213 Haverstock Hill, NW3 4QP, London, UK
- Park Royal Centre for Mental Health, Central and North West London (CNWL) NHS Trust, Central Way, Off Acton Lane, NW10 7NS, London, UK
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, EH10 5HF, Edinburgh, UK
| | - Camilla Wasserman
- Department of Child and Adolescent Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Romuald Brunner
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Christina W Hoven
- Department of Child and Adolescent Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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15
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Rodriguez KM, Sharifi V, Eaton WW. Association of Psychotic Experiences and Incident Depression in a Longitudinal Population-Based Community Survey. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2023; 5:16-23. [PMID: 36909140 PMCID: PMC9997072 DOI: 10.1176/appi.prcp.20220021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/31/2023] Open
Abstract
Objective The present study aims to determine if psychotic experiences in a general population sample are a risk factor for depressive disorders at a 15-year follow-up visit. Method A longitudinal population cohort of adults over age 18 from East Baltimore were followed from 1981 to 1996 with 1409 participants included in analyses. Delusions and hallucinations and depressive disorders were assessed using DSM-III criteria. Odds ratios were obtained using logistic regression with psychotic experiences modeled both dichotomously and as count variables as predictors of major and minor depressive disorders at wave three. Age, race, and sex were included as covariates in the model. Results Both delusions and hallucinations were associated with an increased odds of incident depressive disorders. Delusions, but not hallucinations, were associated with increased odds of major depressive disorder (adjusted odds ratio, 3.04 [95% CI = 1.29-7.13]) and both delusions and hallucinations were associated with increased odds of minor depressive disorder (adjusted odds ratios, 4.6 [95% CI = 2.11-10.04] and 3.93 [95% CI = 2.11-7.32]). There was a dose-response relationship in number of psychotic experiences reported and odds of depressive disorders. Conclusions Lifetime psychotic experiences, particularly delusions, in the absence of mental disorders, are associated with later depressive disorders. Results persist in a dose-response manner. Future research should determine whether transitory versus persistent psychotic experiences have a differential effect on later depression.
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Affiliation(s)
- Katrina M. Rodriguez
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Vandad Sharifi
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - William W. Eaton
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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16
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Wang D, Ma Z, Zhai S, Sun M, Fan F. Sleep disturbance and psychotic-like experiences among urban adolescents with and without parental migration. Front Public Health 2023; 10:1037963. [PMID: 36684951 PMCID: PMC9846600 DOI: 10.3389/fpubh.2022.1037963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023] Open
Abstract
Aim Sleep disturbance was closely associated with an increased risk of psychotic-like experiences (PLEs). This study aims to explore the association between sleep disturbance and PLEs among urban adolescents with and without parental migration. Methods A total of 67, 532 urban Chinese adolescents were recruited in a large web-based survey during April 21st to May 12th, 2021. In our study, sleep disturbance, PLEs, family function, school climate, and a series of socio-demographic were assessed. And hierarchical logistic regression analyses were performed to examine influential factors associated with PLEs. Results Urban left-behind children (LBC) had a higher prevalence of sleep disturbance and PLEs than non-LBC. After controlling for confounders, parental migration was associated to PLEs with weak significance (OR = 1.19). Meanwhile, sleep disturbance was found to be a robust risk factor for PLEs (OR = 3.84 and 4.09), with or without the effect of parental migration. In addition, better family function and school climate has significant association with decreased risk of PLEs. Conclusion Adolescents with sleep disturbance are more likely to report PLEs. Adolescents' PLEs preventive strategies could focus on reducing sleep disturbance related symptoms as well as improving family function and school climate.
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Affiliation(s)
- Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
| | - Shuyi Zhai
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, China
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17
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Bolhuis K, Steenkamp LR, Tiemeier H, Blanken L, Pingault JB, Cecil CAM, El Marroun H. A Prospective Cohort Study on the Intergenerational Transmission of Childhood Adversity and Subsequent Risk of Psychotic Experiences in Adolescence. Schizophr Bull 2022; 49:799-808. [PMID: 36548471 PMCID: PMC10154714 DOI: 10.1093/schbul/sbac195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND HYPOTHESIS Previous studies have shown a robust relationship between childhood adversity and subsequent psychotic symptoms. However, the role of familial risk factors underlying this relationship remains largely unclear. Here, we tested whether offspring childhood adversity and postnatal maternal psychopathology mediated the relationship between maternal childhood adversity and offspring psychotic experiences. STUDY DESIGN N = 3068 mother-offspring dyads were included. Maternal history of childhood adversity was retrospectively assessed using the Childhood Trauma Questionnaire during pregnancy. Maternal psychopathology was assessed during and after pregnancy. Twenty-four offspring childhood adversities were assessed by maternal interview when the child was 10 years old. Offspring psychotic experiences were examined using self-report at 14 years. Structural equation mediation models were conducted to explore whether maternal postnatal psychopathology and offspring childhood adversities sequentially mediated the relationship between maternal childhood adversity and offspring psychotic experiences. Analyses were adjusted for sociodemographic confounders. STUDY RESULTS Maternal history of childhood adversity was associated with offspring childhood adversities (β = 0.12, 95% CI: 0.09 to 0.16). Offspring childhood adversity mediated the association of maternal childhood adversity with offspring hallucinations (βindirect effect = 0.008, 95% CI: 0.002 to 0.014, proportion mediated = 16.3%) and delusions (βindirect effect = 0.006, 95% CI: 0.000 to 0.012, proportion mediated = 13.1%). CONCLUSIONS Intergenerational transmission of childhood adversity can be considered of relevance in the etiology of psychosis vulnerability and can potentially serve as a modifiable risk factor.
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Affiliation(s)
- Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Lisa R Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
| | - Laura Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychiatry, Amsterdam UMC - location AMC, Amsterdam, The Netherlands
| | - Jean-Baptiste Pingault
- Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, Faculty of Brain Sciences, University College London, London, UK
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus Medical Center - Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
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18
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Hallucinations and Brain Morphology Across Early Adolescence: A Longitudinal Neuroimaging Study. Biol Psychiatry 2022; 92:781-790. [PMID: 35871096 DOI: 10.1016/j.biopsych.2022.05.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 05/09/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Psychotic disorders have been widely associated with structural brain abnormalities. However, it is unclear whether brain structure predicts psychotic experiences in youth from the general population, owing to an overall paucity of studies and predominantly cross-sectional designs. Here, the authors investigated longitudinal associations between brain morphology and hallucinations from childhood to early adolescence. METHODS This study was embedded in the population-based Generation R Study. Children underwent structural neuroimaging at age 10 years (N = 2042); a subsample received a second scan at age 14 years (n = 964). Hallucinations were assessed at ages 10 and 14 years and studied as a binary variable. Cross-lagged panel models and generalized linear mixed-effects models were fitted to examine longitudinal associations between brain morphology and hallucinations. RESULTS Smaller total gray and white matter volumes and total cortical surface area at baseline were associated with a higher occurrence of hallucinations between ages 10 and 14 years. The regions associated with hallucinations were widespread, including the frontal, parietal, temporal, and occipital lobes, as well as the insula and cingulate cortex. Analyses of subcortical structures revealed that smaller baseline hippocampal volumes were longitudinally associated with hallucinations, although this association was no longer significant following adjustment for intracranial volume. No evidence for reverse temporality was observed (i.e., hallucinations predicting brain differences). CONCLUSIONS The findings from this longitudinal study suggest that global structural brain differences are associated with the development of hallucinations. These results extend findings from clinical populations and provide evidence for a neurodevelopmental vulnerability across the psychosis continuum.
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19
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Karcher NR, Klaunig MJ, Elsayed NM, Taylor RL, Jay SY, Schiffman J. Understanding Associations Between Race/Ethnicity, Experiences of Discrimination, and Psychotic-like Experiences in Middle Childhood. J Am Acad Child Adolesc Psychiatry 2022; 61:1262-1272. [PMID: 35378237 PMCID: PMC9525459 DOI: 10.1016/j.jaac.2022.03.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 01/06/2022] [Accepted: 03/25/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The present study aimed to examine factors that may account for race/ethnicity differences in psychotic-like experiences (PLEs) in a middle childhood sample, including evidence for experiences of discrimination as a psychosocial mediator of these differences. METHOD In a sample of 9- to 10-year-olds (N = 10,839) from the Adolescent Brain Cognitive Development Study, we compared PLEs across racial/ethnic groups. We also examined whether experiences of discrimination indirectly linked racial/ethnic identity and PLEs and whether social support moderated this indirect association. RESULTS Differences between racial/ethnic groups were found in the endorsement of PLEs, such that Black and Hispanic participants endorsed higher levels of PLEs compared with Asian, multiracial/multiethnic, and White participants. These differences were accounted for in part by experiences of discrimination, an indirect effect that was in turn attenuated by increased social support. CONCLUSION This is the first study to suggest that the experience of discrimination may indirectly link the association between racial/ethnic differences and endorsement of PLEs using the Prodromal Questionnaire-Brief Child Version and additionally that social support may act as a moderator of this mediation. Results provide evidence that social inequities such as racial discrimination may contribute to increases in PLEs. These findings shed further light on the links between structural racism and mental health inequities for people in minoritized groups.
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Affiliation(s)
| | - Mallory J Klaunig
- University of Maryland, Baltimore County; University of California, Irvine
| | | | | | | | - Jason Schiffman
- University of Maryland, Baltimore County; University of California, Irvine
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Gregersen M, Møllegaard Jepsen JR, Rohd SB, Søndergaard A, Brandt JM, Ellersgaard D, Hjorthøj C, Ohland J, Krantz MF, Wilms M, Andreassen AK, Veddum L, Knudsen CB, Greve AN, Bliksted V, Mors O, Clemmensen L, Nordentoft M, Hemager N, Elgaard Thorup AA. Developmental Pathways and Clinical Outcomes of Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder: A Prospective, Longitudinal Cohort Study - The Danish High Risk and Resilience Study, VIA 11. Am J Psychiatry 2022; 179:628-639. [PMID: 36048497 DOI: 10.1176/appi.ajp.21101076] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Psychotic experiences are common in children and adolescents and are associated with concurrent and subsequent psychopathology. Most findings originate from general population studies, whereas little is known of the clinical outcomes of psychotic experiences in children and adolescents at familial high risk of psychosis. We examined the prevalence of psychotic experiences in middle childhood and whether early childhood psychotic experiences and developmental pathways of psychotic experiences predicted mental disorders in middle childhood in children at familial high risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and a population-based control group. METHODS In a longitudinal population-based cohort study children at FHR-SZ (N=170), FHR-BP (N=103), and the control group (N=174) were assessed for psychotic experiences and axis I disorders with face-to-face interviews in early and middle childhood (at 7 and 11 years of age). RESULTS Psychotic experiences were more prevalent in children at FHR-SZ (31.8%, odds ratio 2.1, 95% CI 1.3-3.4) than in the control group (18.4%) in middle childhood. Early childhood psychotic experiences predicted mental disorders in middle childhood after adjusting for early childhood disorders and familial risk (odds ratio 2.0, 95% CI 1.2-3.1). Having three or more psychotic experiences increased odds the most (odds ratio 2.5, 95% CI 1.1-5.7). Persistent psychotic experiences were associated with increased odds of middle childhood disorders (odds ratio 4.1, 95% CI 2.1-8.4). Psychotic experiences were nondifferentially associated with mental disorders across the three familial risk groups. CONCLUSIONS Early childhood psychotic experiences predict mental disorders in middle childhood. Psychotic experiences index vulnerability for psychopathology nondifferentially in children at familial high risk and the control group. Psychotic experiences should be included in mental health screenings including children at familial high risk.
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Affiliation(s)
- Maja Gregersen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Jens Richardt Møllegaard Jepsen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Sinnika Birkehøj Rohd
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anne Søndergaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Julie Marie Brandt
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Ditte Ellersgaard
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Jessica Ohland
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Mette Falkenberg Krantz
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Martin Wilms
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anna Krogh Andreassen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Lotte Veddum
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Christina Bruun Knudsen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Aja Neergaard Greve
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Vibeke Bliksted
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Ole Mors
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Lars Clemmensen
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Nicoline Hemager
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
| | - Anne Amalie Elgaard Thorup
- Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors)
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Cotter D, Healy C, Staines L, Mongan D, Cannon M. Broadening the Parameters of Clinical High Risk for Psychosis. Am J Psychiatry 2022; 179:593-595. [PMID: 36048484 DOI: 10.1176/appi.ajp.20220612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- David Cotter
- RCSI University of Medicine and Health Sciences, Dublin (Cotter, Healy, Staines, Cannon); Queen's University Belfast, Belfast (Mongan)
| | - Colm Healy
- RCSI University of Medicine and Health Sciences, Dublin (Cotter, Healy, Staines, Cannon); Queen's University Belfast, Belfast (Mongan)
| | - Lorna Staines
- RCSI University of Medicine and Health Sciences, Dublin (Cotter, Healy, Staines, Cannon); Queen's University Belfast, Belfast (Mongan)
| | - David Mongan
- RCSI University of Medicine and Health Sciences, Dublin (Cotter, Healy, Staines, Cannon); Queen's University Belfast, Belfast (Mongan)
| | - Mary Cannon
- RCSI University of Medicine and Health Sciences, Dublin (Cotter, Healy, Staines, Cannon); Queen's University Belfast, Belfast (Mongan)
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22
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Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D, Cannon M. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med 2022; 52:1-12. [PMID: 36004805 PMCID: PMC9772919 DOI: 10.1017/s0033291722002550] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/31/2022]
Abstract
Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College, Dublin 4, Ireland
- Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin 6, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
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23
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Wang D, Chen H, Chen Z, Liu W, Wu L, Chen Y, Sun M, Fan F. Current psychotic-like experiences among adolescents in China: Identifying risk and protective factors. Schizophr Res 2022; 244:111-117. [PMID: 35661996 DOI: 10.1016/j.schres.2022.05.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 04/22/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aim to explore the prevalence of current PLEs over past month and relevant influential factors among adolescents. METHODS A total of 67,538 students completed one online survey between April 21st and May 12th, 2021. Current PLEs were assessed using the 8-item Positive Subscale of the Community Assessment of Psychic Experiences (CAPE-P8). Participants were defined as having frequent PLEs if they selected "often" or "nearly always" on one or more items of CAPE-P8. Family function, school climate and a series of socio-demographic were also evaluated. RESULTS In this sample, 49.3% adolescents reported having at least one PLE over the past month, while 15.4% experienced high frequent PLEs. Alcohol intake was positively associated with high frequent PLEs (OR = 2.61, 95% CI = 2.37-2.88). Adolescents with chronic physical illness (OR = 1.94, 95% CI = 1.73-2.18) or family history of psychiatric illness (OR = 2.61, 95% CI = 2.22-2.77) were more likely to suffer from high frequent PLEs. Dysfunction family function (OR moderate = 1.98, 95% CI = 1.98-2.09; OR severe = 6.98, 95% CI = 6.48-7.53) or poor school climate (OR = 3.14, 95% CI = 2.93-3.37) was associated with elevated high frequent PLEs. CONCLUSIONS Several factors of socio-demographics, unhealthy lifestyle, family and school environments are found to be related to frequent PLEs. These factors should also be taken into consideration for effective psychosocial intervention in adolescents.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Huilin Chen
- Department of Psychology, University of Bath, UK
| | - Zihao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Lili Wu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yao Chen
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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24
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Karcher NR, Loewy RL, Savill M, Avenevoli S, Huber RS, Makowski C, Sher KJ, Barch DM. Persistent and distressing psychotic-like experiences using adolescent brain cognitive development℠ study data. Mol Psychiatry 2022; 27:1490-1501. [PMID: 34782711 PMCID: PMC9106814 DOI: 10.1038/s41380-021-01373-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 02/03/2023]
Abstract
Childhood psychotic-like experiences (PLEs) are associated with a range of impairments; a subset of children experiencing PLEs will develop psychiatric disorders, including psychotic disorders. A potential distinguishing factor between benign PLEs versus PLEs that are clinically relevant is whether PLEs are distressing and/or persistent. The current study used three waves of Adolescent Brain Cognitive Development℠ (ABCD) study PLEs assessments to examine the extent to which persistent and/or distressing PLEs were associated with relevant baseline risk factors (e.g., cognition) and functioning/mental health service utilization domains. Four groups varying in PLE persistence and distress endorsement were created based on all available data in ABCD Release 3.0, with group membership not contingent on complete data: persistent distressing PLEs (n = 272), transient distressing PLEs (n = 298), persistent non-distressing PLEs (n = 221), and transient non-distressing PLEs (n = 536) groups. Using hierarchical linear models, results indicated youth with distressing PLEs, whether transient or persistent, showed delayed developmental milestones (β = 0.074, 95%CI:0.013,0.134) and altered structural MRI metrics (β = -0.0525, 95%CI:-0.100,-0.005). Importantly, distress interacted with PLEs persistence for the domains of functioning/mental health service utilization (β = 0.079, 95%CI:0.016,0.141), other reported psychopathology (β = 0.101, 95%CI:0.030,0.170), cognition (β = -0.052, 95%CI:0.-0.099,-0.002), and environmental adversity (β = 0.045, 95%CI:0.003,0.0.86; although no family history effects), with the interaction characterized by greatest impairment in the persistent distressing PLEs group. These results have implications for disentangling the importance of distress and persistence for PLEs with regards to impairments, including functional, pathophysiological, and environmental outcomes. These novel longitudinal data underscore that it is often only in the context of distress that persistent PLEs were related to impairments.
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Affiliation(s)
- Nicole R Karcher
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA.
| | - Rachel L Loewy
- University of California, San Francisco, Dept. of Psychiatry, San Francisco, CA, USA
| | - Mark Savill
- University of California, San Francisco, Dept. of Psychiatry, San Francisco, CA, USA
| | | | - Rebekah S Huber
- University of Utah, Dept. of Psychiatry, Salt Lake City, UT, USA
| | - Carolina Makowski
- University of California San Diego, Dept. of Radiology, San Diego, CA, USA
| | - Kenneth J Sher
- University of Missouri, Dept. of Psychological Sciences, Columbia, MO, USA
| | - Deanna M Barch
- Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA
- Washington University in St. Louis, Dept. of Psychological and Brain Sciences, St. Louis, MO, USA
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DeLuca JS, Novacek DM, Adery LH, Herrera SN, Landa Y, Corcoran CM, Walker EF. Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2022; 7:176-197. [PMID: 35815004 PMCID: PMC9258423 DOI: 10.1080/23794925.2022.2042874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status.
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Affiliation(s)
- Joseph S. DeLuca
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Derek M. Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, , Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Laura H. Adery
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shaynna N. Herrera
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
| | - Yulia Landa
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Cheryl M. Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, , New York, NY, USA
- New York Mental Illness Research, Education and Clinical Center, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
| | - Elaine F. Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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26
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Barnes GL, Stewart C, Browning S, Bracegirdle K, Laurens KR, Gin K, Hirsch C, Abbott C, Onwumere J, Banerjea P, Kuipers E, Jolley S. Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8-18 years. Soc Psychiatry Psychiatr Epidemiol 2022; 57:461-472. [PMID: 34480219 PMCID: PMC8934329 DOI: 10.1007/s00127-021-02168-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/26/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Neurocognitive difficulties and early childhood speech/motor delays are well documented amongst older adolescents and young adults considered at risk for psychosis-spectrum diagnoses. We aimed to test associations between unusual or psychotic-like experiences (PLEs), co-occurring distress/emotional symptoms, current cognitive functioning and developmental delays/difficulties in young people (aged 8-18 years) referred to Child and Adolescent Mental Health Services in South London, UK. METHODS Study 1 examined receptive language, verbal learning and caregiver-reported speech and motor delays/difficulties in a sample of 101 clinically-referred children aged 8-14 years, comparing those reporting no PLEs (n = 19), PLEs without distress (n = 16), and PLEs with distress (n = 66). Study 2 tested associations of severity of distressing PLEs with vocabulary, perceptual reasoning, word reading and developmental delays/difficulties in a second sample of 122 adolescents aged 12-18 years with distressing PLEs. RESULTS In Study 1, children with distressing PLEs had lower receptive language and delayed recall and higher rates of developmental delays/difficulties than the no-PLE and non-distressing PLE groups (F values: 2.3-2.8; p values: < 0.005). Receptive language (β = 0.24, p = 0.03) and delayed recall (β = - 0.17, p = 0.02) predicted PLE distress severity. In Study 2, the cognitive-developmental variables did not significantly predict PLE distress severity (β values = 0.01-0.22, p values: > 0.05). CONCLUSION Findings may be consistent with a cognitive-developmental model relating distressing PLEs in youth with difficulties in cognitive functioning. This highlights the potential utility of adjunctive cognitive strategies which target mechanisms associated with PLE distress. These could be included in cognitive-behavioural interventions offered prior to the development of an at-risk mental state in mental health, educational or public health settings.
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Affiliation(s)
- G L Barnes
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK.
| | - C Stewart
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - S Browning
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - K Bracegirdle
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - K R Laurens
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, QLD, 4059, Australia
- University of New South Wales, School of Psychiatry, Sydney, NSW, 2052, Australia
| | - K Gin
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - C Hirsch
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - C Abbott
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - J Onwumere
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - P Banerjea
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - E Kuipers
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - S Jolley
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
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Carey E, Gillan D, Burke T, Burns A, Murphy TM, Kelleher I, Cannon M. Social cognition and self-reported ASD traits in young adults who have reported psychotic experiences: A population-based, longitudinal study. Schizophr Res 2021; 237:54-61. [PMID: 34500376 DOI: 10.1016/j.schres.2021.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 07/14/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Social cognition is considered a trait marker of psychosis, and has rarely been investigated in young adults who have reported psychotic experiences (PE). The aim of the present study was to explore whether social cognition, self-reported Autism Spectrum Disorder (ASD) traits and functioning were associated with PE. METHODS Participants were invited to take part in a 10-year follow-up study (mean age 20.9 years), of whom 103 participants returned, including 41 who had reported PE either past or current. Social cognition (theory of mind, social perception and locus of control) was assessed and a self-report measure of ASD traits was administered. Psychopathology and global functioning were assessed using the SCID-5. Analyses investigated group differences between PE and controls, and the association between social cognition and functioning in the PE group. A mediation analysis investigated if the association between PE and social cognition was explained by ASD traits. RESULTS The PE group had poorer theory of mind scores (F = 4.22, p = .043), specifically for neutral and negative stimuli, and an external locus of control (F = 5.73, p = .019) in young adulthood. The PE group had a significantly greater number of self-reported ASD traits than the controls (χ2(2) = 10.65). External locus of control had a significant negative correlation with current role functioning in the PE group. The association between PE and social cognition abilities was not mediated by ASD traits. CONCLUSION Psychotic experiences are associated with poorer theory of mind and an external locus of control, as well as proportionally more self-reported ASD traits, in young adulthood.
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Affiliation(s)
- Eleanor Carey
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Trinity College Institute of Neuroscience, Dublin, Ireland.
| | - Diane Gillan
- Dept. of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Tom Burke
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Annette Burns
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya M Murphy
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Ian Kelleher
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Dept. of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland; Dept. of Psychiatry, Beaumont Hospital, Dublin, Ireland
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The Community Assessment of Psychic Experiences-Positive scale (CAPE-P15) accurately classifies and differentiates psychotic experience levels in adolescents from the general population. PLoS One 2021; 16:e0256686. [PMID: 34437593 PMCID: PMC8389461 DOI: 10.1371/journal.pone.0256686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 08/12/2021] [Indexed: 02/05/2023] Open
Abstract
Background There is increasing interest in studying psychotic symptoms in non-clinical populations, with the Community Assessment of Psychic Experiences-Positive scale (CAPE-P15) being one of the self-screening questionnaires used most commonly for this purpose. Further research is needed to evaluate the ability of the scale to accurately identify and classify positive psychotic experiences (PE) in the general population. Aim To provide psychometric evidence about the accuracy of the CAPE-P15 for detecting PE in a sample of Chilean adolescents from the general population and classifying them according to their PE severity levels. Method We administered the CAPE-P15 to a general sample of 1594 students aged 12 to 19. Based on Item Response Theory (IRT), we tested the accuracy of the instrument using two main parameters: difficulty and discrimination power of the 15 items. Results We found that the scale provides very accurate information about PE, particularly for high PE levels. The items with the highest capability to determine the presence of the latent trait were those assessing perceptual anomalies (auditory and visual hallucinations), bizarre experiences (a double has taken the place of others; being controlled by external forces), and persecutory ideation (conspiracy against me). Conclusions The CAPE-P15 is an accurate and suitable tool to screen PE and to accurately classify and differentiate PE levels in adolescents from the general population. Further research is needed to better understand how maladaptive psychological mechanisms influence relationships between PE and suicidal ideation (SI) in the general population.
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29
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Affiliation(s)
- Ian Kelleher
- School of Medicine, University College Dublin, Dublin, Ireland
- Lucena Clinic, Rathgar, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Beaumont Hospital, Dublin, Ireland
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Nielsen LG, Køster Rimvall M, Van Os J, Verhulst F, Rask CU, Skovgaard AM, Olsen EM, Jeppesen P. Precursors of self-reported subclinical hypomania in adolescence: A longitudinal general population study. PLoS One 2021; 16:e0253507. [PMID: 34143836 PMCID: PMC8213158 DOI: 10.1371/journal.pone.0253507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/05/2021] [Indexed: 12/16/2022] Open
Abstract
Symptoms of subclinical hypomania (SHM) are common in the general population of adolescents and young adults. SHM are most often transient yet might be risk markers of later bipolar disorder. The current study aimed to assess the clinical correlates of SHM at age 11 in the general population, examine the continuity of SHM from age 11-age 16 and explore the clinical precursors of age 16 SHM. As part of the Copenhagen Child Cohort 2000, 1,632 preadolescents participated in the examination of SHM and various clinical correlates at age 11, 893 were re-assessed for SHM at age 16 years. At age 11, SHM, psychotic experiences and depressive symptoms were assessed by semi-structured psychopathological interviews. Furthermore, the participants were diagnostically assessed by the Development and Well-Being Assessment and interviewed about sleep length. At age 16, SHM was assessed by self-report, using the Hypomania Checklist-32. Cannabis use occurring at age 15 or earlier was assessed at age 16. At age 11, SHM was associated with depressive disorders (Relative Risk [RR] = 2.96 [95% CI 1.26–6.96]), interview-based depressive symptoms (RR = 9.22 [5.93–14.34]), neurodevelopmental disorders (RR = 2.94 [1.66–5.20]), psychotic experiences (RR = 4.51 [2.90–7.01]) and insufficient sleep (RR = 2.10 [1.28–3.43]. In the longitudinal analyses, age 16 SHM was preceded by age 11 SHM (RR = 1.89 [1.02–3.49]), psychotic experiences (RR = 2.06, [1.28–3.33]), emotional disorders (RR = 1.77, [1.02–3.09]) and cannabis use (RR = 3.14, [1.93–5.10]), after mutual adjustment and adjustment for sex, and sociodemographic factors. In conclusion, age 11 SHM was statistically significantly associated with other types of psychopathology in cross-sectional analyses and showed some continuity with later self-reported SHM at age 16. Particularly early psychotic experiences and cannabis use stood out as independent precursors of self-reported SHM and might constitute important risk markers for the development of future SHM and bipolar disorder. An important potential caveat of the current study includes the self-report assessment of SHM.
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Affiliation(s)
- Louise Gunhard Nielsen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- * E-mail:
| | - Martin Køster Rimvall
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- Department of Child and Adolescent Psychiatry, Psychiatry Region Zealand, Roskilde, Denmark
| | - Jim Van Os
- Department of Psychiatry, University Medical Centre Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, United Kingdom
| | - Frank Verhulst
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Charlotte Ulrikka Rask
- Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Else Marie Olsen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, the Capital Region of Denmark, Copenhagen, Denmark
| | - Pia Jeppesen
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Steenkamp LR, Tiemeier H, Bolhuis K, Hillegers MHJ, Kushner SA, Blanken LME. Peer-reported bullying, rejection and hallucinatory experiences in childhood. Acta Psychiatr Scand 2021; 143:503-512. [PMID: 33524175 PMCID: PMC8248258 DOI: 10.1111/acps.13282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/07/2021] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Psychotic experiences, such as hallucinations, occur commonly in children and have been related to bullying victimization. However, whether bullying perpetration, peer rejection, or peer acceptance are related to hallucinatory experiences has remained under-examined. We used a novel peer nomination method to examine whether (i) bullying perpetration and (ii) social positions within peer networks were associated with future hallucinatory experiences. METHODS This prospective study was embedded in the population-based Generation R Study. Bullying perpetration, peer rejection, and peer acceptance were assessed using peer nominations at age 7 years (N = 925). Using a social network analysis, we estimated social positions within peer rejection and acceptance networks. Bullying victimization was assessed using self-reports. Self-reported hallucinatory experiences were assessed at age 10 years. Analyses were adjusted for sociodemographic covariates. RESULTS Higher levels of bullying perpetration were prospectively associated with an increased burden of hallucinatory experiences (OR = 1.22, 95% CI 1.05-1.43, p = 0.011). Bullies had a 50% higher, and bully-victims had a 89% higher odds, of endorsing hallucinatory experiences three years later than children who were not involved in bullying (ORbully = 1.50, 95% CI 1.01-2.24, p = 0.045; ORbully-victim = 1.89, 95% CI 1.15-3.10, p = 0.012). Unfavorable positions within peer rejection networks, but not peer acceptance networks, were associated with an increased risk for hallucinatory experiences (ORpeer rejection = 1.24, 95% CI 1.07-1.44, pFDR-corrected = 0.024). CONCLUSION Using peer reports, we observed that bullies and socially rejected children have a higher likelihood to report hallucinatory experiences in pre-adolescence. Children who are both a bully and a victim of bullying (ie, bully-victims) may be particularly vulnerable for psychotic experiences.
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Affiliation(s)
- Lisa R. Steenkamp
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands,Department of Social and Behavioral SciencesHarvard TH. Chan School of Public HealthBostonMAUSA
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Steven A. Kushner
- Department of PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
| | - Laura M. E. Blanken
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
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Rimvall MK, van Os J, Jeppesen P. Promoting a patient-centered, transdiagnostic approach to prevention of severe mental illness. Eur Child Adolesc Psychiatry 2021; 30:823-824. [PMID: 32468436 DOI: 10.1007/s00787-020-01563-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/20/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Martin Køster Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark. .,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Jim van Os
- Department of Psychiatry, University Medical Centre Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands.,Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Rimvall MK, Wolf RT, Olsen EM, Skovgaard AM, Clemmensen L, Oxholm AS, Verhulst F, Rask CU, van Os J, Jeppesen P. Healthcare Costs, School Performance, and Health-related Quality of Life in Adolescence Following Psychotic Experiences in Preadolescence: A Longitudinal Cohort Study. Schizophr Bull 2020; 47:682-691. [PMID: 33345286 PMCID: PMC8673435 DOI: 10.1093/schbul/sbaa175] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychotic experiences (PEs) are common in the general population in preadolescence. The implications of PEs on socioeconomic outcomes, including educational attainment, are scarcely described. We aimed to estimate how preadolescent PEs were associated with later healthcare costs, school performance, and health-related quality of life (HRQoL) in adolescence. A total of 1607 preadolescents from the general population Copenhagen Child Cohort 2000 were assessed for PEs at age 11-12 years and followed up over 5 years using register-based data on mental and somatic healthcare costs, and school performance at age 16. Furthermore, HRQoL was assessed for a subsample of the children at age 16-17. We adjusted for perinatal and family sociodemographic adversities, prior parental mental illness and healthcare use, child IQ-estimate at age 11-12, and parent-rated general psychopathology of their child. PEs were associated with slightly poorer school performance. However, preadolescents with PEs more often reported HRQoL within the lowest 10th percentile (OR = 2.74 [95% CI 1.71-4.37]). Preadolescents who reported PEs had higher average total healthcare costs over the following 5 years. The costs for individuals with PEs were higher for mental healthcare services across primary to tertiary care, but not for somatic care. After adjustments, PEs remained independently associated with higher costs and poorer HRQoL, but not with poorer school performance. In conclusion, PEs are important in mental health screening of preadolescents and identify a group of young people with increased healthcare service-use throughout adolescence and who report poorer HRQoL in adolescence, over and above parent-rated general psychopathology of their child.
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Affiliation(s)
- Martin Køster Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,To whom correspondence should be addressed; Gentofte Hospitalsvej 3A, 1. sal, 2900 Hellerup, Denmark; tel: 0045-38-66-50-00, e-mail:
| | - Rasmus Trap Wolf
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark,Department of Public Health, Danish Centre for Health Economics (DaCHE), University of Southern Denmark, Odense, Denmark
| | - Else Marie Olsen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Center for Clinical Research and Prevention, Capital Region of Denmark, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Lars Clemmensen
- Center for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Anne Sophie Oxholm
- Department of Public Health, Danish Centre for Health Economics (DaCHE), University of Southern Denmark, Odense, Denmark
| | - Frank Verhulst
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Charlotte Ulrikka Rask
- Aarhus University Hospital, Department of Child and Adolescent Psychiatry, Research Unit, Aarhus, Denmark,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jim van Os
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands,Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands,Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, UK
| | - Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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34
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Affiliation(s)
- Donald McLawhorn
- Department of Psychiatry, State University of New York, Upstate Medical University, Syracuse
| | - Daniel Jackson
- Department of Psychiatry, State University of New York, Upstate Medical University, Syracuse
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Rimvall MK, van Os J, Jeppesen P. Are All Psychotic-Like Experiences Really "Psychotic"?: Response to McLawhorn and Jackson. Am J Psychiatry 2020; 177:1179-1180. [PMID: 33256440 DOI: 10.1176/appi.ajp.2020.20040485r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Martin Køster Rimvall
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark (Rimvall, Jeppesen); Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen (Rimvall, Jeppesen); Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands (van Os); Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands (van Os); Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London (van Os)
| | - Jim van Os
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark (Rimvall, Jeppesen); Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen (Rimvall, Jeppesen); Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands (van Os); Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands (van Os); Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London (van Os)
| | - Pia Jeppesen
- Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark (Rimvall, Jeppesen); Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen (Rimvall, Jeppesen); Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands (van Os); Department of Psychiatry and Psychology, Maastricht University Medical Center, Maastricht, the Netherlands (van Os); Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London (van Os)
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Abstract
PURPOSE OF REVIEW Childhood and adolescence are a crucial time window for the early identification of perspectival risk for adult psychopathology. This article reviews current advances in the field. RECENT FINDINGS Converging developmentally focused and predictive approaches are rapidly expanding in the field of early identification of children and adolescents at risk for psychiatric illness. Although the former emphasizes early phenotypic trajectories emerging in childhood and adolescence, the latter operate in terms of clinical risk staging. Decisive advances in the field include the metaanalytical evidence of the predictive value of clinical high-risk criteria in childhood-adolescence; the systematization of premorbid manifestations of psychotic vulnerability and bipolar prodromes; the corroboration of certain sets of anomalous subjective experiences as transdiagnostic index of familial genetic risk (i.e., basic symptoms) and early developmental expression of schizophrenia spectrum vulnerability (i.e., self-disorders). SUMMARY Childhood phenotypic manifestations of liability to mental disorders are often cooccurrent and undergo a plastic, heterotypic modification along the transition to adolescence. In general, they represent epiphenomenic flags of a broad vulnerability for the subsequent structuration of mental illness. This perspective coheres with the p-factor model of psychopathology and complements the clinical staging model which informs the early detection paradigm of severe mental disorders.
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Affiliation(s)
- Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Healy, Cannon)
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin (Healy, Cannon)
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Kalin NH. Psychotic Experiences, Cognitive Decline, and Genetic Vulnerabilities in Relation to Developing Psychotic Disorders. Am J Psychiatry 2020; 177:279-281. [PMID: 32233681 DOI: 10.1176/appi.ajp.2020.20020162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ned H Kalin
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison
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