1
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
2
|
Rimvall MK, Rask CU, Jensen JS, Olsen EM, Clemmensen L, Skovgaard AM, Verhulst F, van Os J, Jeppesen P. Exploring the interplay between psychotic experiences, functional somatic symptoms and health anxiety in childhood and adolescence - A longitudinal cohort study. Schizophr Res 2024; 267:322-329. [PMID: 38613863 DOI: 10.1016/j.schres.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/20/2024] [Accepted: 03/18/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Similarities exist between contemporary explanatory models underlying psychosis development, functional somatic symptoms, and health anxiety. The current study aimed to examine the potential interplay between psychotic experiences (and alternate measures of anomalous self-experiences and aberrant attribution of salience) and functional somatic symptoms on the outcome of health anxiety in youths. METHODS In a prospective general-population birth cohort, the Copenhagen Child Cohort 2000 (CCC2000), data from two time-points were available for 1122 individuals. We assessed the associations between psychotic experiences and functional somatic symptoms with health anxiety both cross-sectionally at ages 11- and 16-years, and longitudinally from age 11 to 16. Further, we examined if there was an interaction between these two domains on the outcome of health anxiety using the interaction contrast ratio. RESULTS Functional somatic symptoms and psychotic experiences were strongly cross-sectionally associated with health anxiety at both ages 11 and 16, even after adjustment for general psychopathology. In the longitudinal analyses, functional somatic symptoms, and psychotic experiences at age 11 were not individually associated with health anxiety at age 16 but having both functional somatic symptoms and psychotic experiences was: odds ratio 3.90, 95%CI 1.7-8.9, with suggestion of evidence for interaction beyond the additive effects. This association was attenuated after adjustment for general psychopathology: odds ratio 2.6, 95 % CI 1.0-6.4. CONCLUSION The strong associations between the domains support the idea of possible overlapping mechanisms underlying psychotic experiences, functional somatic symptoms, and health anxiety.
Collapse
Affiliation(s)
- Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Charlotte Ulrikka Rask
- Aarhus University Hospital Psychiatry, Department of Child and Adolescent Psychiatry, Research Unit, Aarhus, Denmark; Aarhus University, Department of Clinical Medicine, Aarhus, Denmark
| | - Jens Søndergaard Jensen
- Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark
| | - Else Marie Olsen
- Psychiatric Center Ballerup, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Center for Clinical Research and Prevention, the Capital Region of Denmark, Denmark
| | - Lars Clemmensen
- VIRTU Research Group, Copenhagen Research Center on Mental Health (CORE), Copenhagen University Hospital, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Copenhagen, Denmark
| | - Frank Verhulst
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - 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
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark; Child and Adolescent Mental Health Centre, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
3
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
4
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
5
|
Bouter DC, Ravensbergen SJ, Lakerveld J, Hoogendijk WJG, Grootendorst-van Mil NH. Associations between the urban environment and psychotic experiences in adolescents. Schizophr Res 2023; 260:123-131. [PMID: 37639836 DOI: 10.1016/j.schres.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 06/28/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE In 2050 two-thirds of the world's population is predicted to live in cities, which asks for a better understanding of how the urban environment affects mental health. Urbanicity has repeatedly been found to be a risk factor, in particular for psychosis. Here, we explored what factors of the urban exposome underlie the association between urban characteristics and psychotic experiences (PE) in adolescents. METHODS Participants were 815 adolescents (mean age 14.84 years, SD 0.78) from an at-risk cohort (greater Rotterdam area, the Netherlands) oversampled on their self-reported emotional and behavioral problems. We used linear regression analysis to examine the association with detailed geodata on urbanicity (surrounding address density), green space density (high and low vegetation), and mixed noise levels (road, rail, air, industry, and wind power) with PE in adolescents. Analyses were adjusted for multiple socio-economic and parental confounders. Furthermore, we explored sex-interaction effects. RESULTS Higher surrounding address density and low greenspace density were each independently associated with more PE (B = 0.18, 95 % CI 0.02; 0.34 and B = 0.17, 95 % CI 0.01; 0.32, respectively). High mixed noise levels were only associated with more PE in boys (B = 0.23, 95 % CI 0.01; 0.46). A sex-interaction effect was found for high urbanicity (B = -0.46, 95 % CI -0.77; -0.14) and low greenspace density (B = -0.49, 95 % CI -0.73; -0.11), illustrating that these associations with PE were specific for boys. CONCLUSION Multiple characteristics of living in an urban area are associated with more PE in adolescent boys. Our observations provide leads for prevention of mental health problems via urban designing.
Collapse
Affiliation(s)
- D C Bouter
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - S J Ravensbergen
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - J Lakerveld
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands
| | - W J G Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - N H Grootendorst-van Mil
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands; Epidemiological and Social Psychiatric Research Institute (ESPRi), Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, the Netherlands.
| |
Collapse
|
6
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
7
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
8
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
9
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|