1
|
Mason AJC, Jung P, Kim S, Sim H, Greene T, Burgess N, Brewin CR, Bisby J, Kim E, Bloomfield M. Associations between post-traumatic stress disorders and psychotic symptom severity in adult survivors of developmental trauma: a multisite cross-sectional study in the UK and South Korea. Lancet Psychiatry 2023; 10:760-767. [PMID: 37739583 DOI: 10.1016/s2215-0366(23)00228-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Childhood maltreatment is a risk factor for the development of post-traumatic stress disorders and psychosis. However, the association between post-traumatic stress disorder (PTSD), including complex PTSD, and psychotic symptoms is unknown. We investigated whether the presence of PTSD and complex PTSD was associated with psychotic symptom severity within survivors of developmental trauma. METHODS As part of the Investigating Mechanisms underlying Psychosis Associated with Childhood Trauma (IMPACT) study, from Aug 20, 2020, to Jan 24, 2021, and from Sept 9, 2022, to Feb 21, 2023, using study advertisement on online platforms we recruited adult (≥18 years) participants who had experienced developmental trauma without a psychiatric diagnosis in the UK and South Korea. We measured whether participants met diagnostic thresholds for PTSD and complex PTSD using the self-reported International Trauma Questionnaire, and psychotic symptoms using the self-reported Community Assessment of Psychic Experiences. We used linear regression, adjusting for sociodemographic variables such as age, sex, ethnicity, educational attainment, and socioeconomic status, to examine whether there was an association between PTSD and complex PTSD and psychotic symptoms. The study is registered in the UK (University College London Research Ethics Committee [14317/001] and the National Health Service Research Ethics Committee [22/YH/0096]) and South Korea (Institutional Review Board of Seoul National University Bundang Hospital [B-2011-648-306]), and is ongoing. FINDINGS Of the 2675 participants who took part in the study, 1273 had experienced developmental trauma and were included in the study in the UK (n=475) and South Korea (n=798), comprising 422 (33%) men and 851 (67%) women with a mean age of 26·9 years (SD 6, range 18-40), mostly of White British (n=328) or South Korean (n=798) ethnicity. We found no significant association between PTSD and psychotic symptom severity (total severity β=-2·40 [SE 3·28], p=0·47), compared with participants who did not meet PTSD or complex PTSD caseness. We found a significant relationship between complex PTSD and psychotic symptom severity (total severity β=22·62 [SE 1·65], p<0·0001), including for positive (β=12·07 [SE 0·99], p<0·0001) and negative symptoms (β=10·5 [SE 0·95], p<0·0001), compared with participants who did not meet PTSD or complex PTSD caseness. INTERPRETATION Health systems must assess individuals with previous developmental trauma for complex PTSD and treat those affected. These individuals should also be assessed for psychotic symptoms, and if necessary, preventative measures should be taken to reduce risk of conversion. Further work should assess whether treating complex PTSD modifies the risk of conversion to psychosis. FUNDING UKRI Future Leaders Fellowship, British Medical Association Margaret Temple Award for Schizophrenia Research, and the National Research Foundation of Korea-Korea Government.
Collapse
Affiliation(s)
- Ava J C Mason
- Division of Psychiatry, University College London, London, UK
| | - Paul Jung
- Division of Psychiatry, University College London, London, UK
| | - Seoyoung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea
| | - Hyejin Sim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Talya Greene
- Clinical, Education and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - Neil Burgess
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Chris R Brewin
- Clinical, Education and Health Psychology, Division of Psychology and Language Sciences, University College London, London, UK
| | - James Bisby
- Division of Psychiatry, University College London, London, UK
| | - Euitae Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea; Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea; Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea.
| | - Michael Bloomfield
- Division of Psychiatry, University College London, London, UK; University College London Hospitals National Institute for Health Research Biomedical Research Centre, London, UK
| |
Collapse
|
2
|
Fekih-Romdhane F, Farah N, Malaeb D, Cheour M, Obeid S, Hallit S. Validation of the Arabic Version of the Community Assessment of Psychic Experiences (CAPE-42) in a Large Sample of Young Adults from the General Population. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01011-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
|
3
|
Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
Collapse
Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France.,Institut de Psychiatrie (CNRS GDR 3557), Paris, France.,Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| |
Collapse
|
4
|
Kim SW, Kim JK, Jhon M, Lee HJ, Kim H, Kim JW, Lee JY, Kim JM, Shin IS. Mindlink: A stigma-free youth-friendly community-based early-intervention centre in Korea. Early Interv Psychiatry 2021; 15:1389-1394. [PMID: 33233027 PMCID: PMC8451763 DOI: 10.1111/eip.13076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023]
Abstract
AIM In many Asian countries, youth mental health services are not well-developed and access to treatment is generally delayed. Here, we present a community-based service model based on our experience with Mindlink, the first early-intervention centre of its kind in Korea. METHODS We describe the history of this mental health early-intervention service and the characteristics of users, as well as its intervention programmes and research directions. We also propose ways to further develop youth mental health services. RESULTS A community-based early-intervention service for youth was first introduced in 2012, when a special team was formed in a community mental health centre of Korea. As the numbers of young clients increased, a youth-friendly, early-intervention centre called Mindlink was opened in 2016. Mindlink targets those aged 15-30 years with mental illness less than 5 years in duration. Its goal is to detect mental illness in young people early and provide comprehensive multidisciplinary interventions. It provides intensive case management and group programmes including cognitive-behavioural therapy, family intervention, psychoeducation, behavioural activation and physical health promotion. The Korean government has officially announced that the Mindlink model is effective and is currently in the process of scaling it up on a national level. CONCLUSION An accessible, youth-friendly, stigma-free, community mental health centre such as Mindlink allows early detection and appropriate management of mental illness in young patients.
Collapse
Affiliation(s)
- Sung-Wan Kim
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwanjgu Mental Health Welfare Commission, Gwangju, Republic of Korea
| | - Jae-Kyeong Kim
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea
| | - Min Jhon
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwanjgu Metropolitan Mental Health and Welfare Center, Gwangju, Republic of Korea
| | - Hee-Joon Lee
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Honey Kim
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Republic of Korea.,Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.,Gwanjgu Mental Health Welfare Commission, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| |
Collapse
|