CONTEXT: It has been suggested that attenuated psychotic symptoms (APSs) reported by people who do not have psychotic disorders signal risk for later severe mental illness. OBJECTIVE: To investigate this suggestion using follow-up assessments of hospitalization for clinical diagnoses of nonaffective psychotic and other psychiatric disorders. DESIGN: Longitudinal cohort study of self-reported APSs with outcome assessment of severe mental illness obtained through linkage with a national hospitalization case registry. SETTING: Israel. PARTICIPANTS: A stratified full probability sample of 4914 persons aged 25 to 34 years who were screened for psychopathology in the 1980s. MAIN OUTCOME MEASURE: Subsequent psychiatric hospitalization was ascertained using the psychiatric hospitalization registry, with a mean follow-up of 24 years. RESULTS: After removing subjects with diagnosable psychotic disorders at baseline, 57.2% of the remaining sample reported at least 1 weak (infrequent) APS and 14.3% reported at least 1 strong (frequent) APS in the year preceding the assessment. Self-reported APSs predicted risk of later hospitalization for nonaffective psychotic disorders, mostly during the 5 years after baseline (adjusted odds ratio = 4.31; 95% CI, 2.21-8.41; positive predictive value = 1.27%; population attributable risk fraction = 33%). Also, APSs increased the risk of later hospitalization for other psychiatric disorders, albeit to a lesser extent (adjusted odds ratio = 2.21; 95% CI, 1.02-4.82). CONCLUSIONS: Self-reported APSs signal risk for later nonaffective psychotic disorders but are not clinically useful as predictors. The difference between these population-based data and the high-risk literature in terms of the positive predictive value (1% vs 10%, respectively) and the time window of transition (5 years vs 12 months, respectively) can be attributed to the selective enrichment strategies that produce high-risk samples.
CONTEXT: It has been suggested that attenuated psychotic symptoms (APSs) reported by people who do not have psychotic disorders signal risk for later severe mental illness. OBJECTIVE: To investigate this suggestion using follow-up assessments of hospitalization for clinical diagnoses of nonaffective psychotic and other psychiatric disorders. DESIGN: Longitudinal cohort study of self-reported APSs with outcome assessment of severe mental illness obtained through linkage with a national hospitalization case registry. SETTING: Israel. PARTICIPANTS: A stratified full probability sample of 4914 persons aged 25 to 34 years who were screened for psychopathology in the 1980s. MAIN OUTCOME MEASURE: Subsequent psychiatric hospitalization was ascertained using the psychiatric hospitalization registry, with a mean follow-up of 24 years. RESULTS: After removing subjects with diagnosable psychotic disorders at baseline, 57.2% of the remaining sample reported at least 1 weak (infrequent) APS and 14.3% reported at least 1 strong (frequent) APS in the year preceding the assessment. Self-reported APSs predicted risk of later hospitalization for nonaffective psychotic disorders, mostly during the 5 years after baseline (adjusted odds ratio = 4.31; 95% CI, 2.21-8.41; positive predictive value = 1.27%; population attributable risk fraction = 33%). Also, APSs increased the risk of later hospitalization for other psychiatric disorders, albeit to a lesser extent (adjusted odds ratio = 2.21; 95% CI, 1.02-4.82). CONCLUSIONS: Self-reported APSs signal risk for later nonaffective psychotic disorders but are not clinically useful as predictors. The difference between these population-based data and the high-risk literature in terms of the positive predictive value (1% vs 10%, respectively) and the time window of transition (5 years vs 12 months, respectively) can be attributed to the selective enrichment strategies that produce high-risk samples.
Authors: Y van der Steen; I Myin-Germeys; M van Nierop; M Ten Have; R de Graaf; S van Dorsselaer; J van Os; R van Winkel Journal: Epidemiol Psychiatr Sci Date: 2018-04-16 Impact factor: 6.892
Authors: Jordan E DeVylder; Courtney Cogburn; Hans Y Oh; Deidre Anglin; Melissa Edmondson Smith; Tanya Sharpe; Hyun-Jin Jun; Jason Schiffman; Ellen Lukens; Bruce Link Journal: Schizophr Bull Date: 2017-09-01 Impact factor: 9.306
Authors: Esther M B Horrevorts; Karin Monshouwer; Johanna T W Wigman; Wilma A M Vollebergh Journal: Eur Child Adolesc Psychiatry Date: 2014-02-12 Impact factor: 4.785
Authors: Jordina Tor; Montserrat Dolz; Anna Sintes; Daniel Muñoz; Marta Pardo; Elena de la Serna; Olga Puig; Gisela Sugranyes; Inmaculada Baeza Journal: Eur Child Adolesc Psychiatry Date: 2017-09-15 Impact factor: 4.785
Authors: John J McGrath; Sukanta Saha; Ali Al-Hamzawi; Laura Andrade; Corina Benjet; Evelyn J Bromet; Mark Oakley Browne; Jose M Caldas de Almeida; Wai Tat Chiu; Koen Demyttenaere; John Fayyad; Silvia Florescu; Giovanni de Girolamo; Oye Gureje; Josep Maria Haro; Margreet Ten Have; Chiyi Hu; Viviane Kovess-Masfety; Carmen C W Lim; Fernando Navarro-Mateu; Nancy Sampson; José Posada-Villa; Kenneth S Kendler; Ronald C Kessler Journal: Am J Psychiatry Date: 2016-03-17 Impact factor: 18.112