N Kaymaz1, M Drukker1, R Lieb2, H-U Wittchen2, N Werbeloff3, M Weiser3, T Lataster1, J van Os1. 1. Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands. 2. Division of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany. 3. Department of Psychiatry, Sheba Medical Centre, Tel-Hashomer, Israel.
Abstract
BACKGROUND: The base rate of transition from subthreshold psychotic experiences (the exposure) to clinical psychotic disorder (the outcome) in unselected, representative and non-help-seeking population-based samples is unknown. METHOD: A systematic review and meta-analysis was conducted of representative, longitudinal population-based cohorts with baseline assessment of subthreshold psychotic experiences and follow-up assessment of psychotic and non-psychotic clinical outcomes. RESULTS: Six cohorts were identified with a 3-24-year follow-up of baseline subthreshold self-reported psychotic experiences. The yearly risk of conversion to a clinical psychotic outcome in exposed individuals (0.56%) was 3.5 times higher than for individuals without psychotic experiences (0.16%) and there was meta-analytic evidence of dose-response with severity/persistence of psychotic experiences. Individual studies also suggest a role for motivational impairment and social dysfunction. The evidence for conversion to non-psychotic outcome was weaker, although findings were similar in direction. CONCLUSIONS: Subthreshold self-reported psychotic experiences in epidemiological non-help-seeking samples index psychometric risk for psychotic disorder, with strong modifier effects of severity/persistence. These data can serve as the population reference for selected and variable samples of help-seeking individuals at ultra-high risk, for whom much higher transition rates have been indicated.
BACKGROUND: The base rate of transition from subthreshold psychotic experiences (the exposure) to clinical psychotic disorder (the outcome) in unselected, representative and non-help-seeking population-based samples is unknown. METHOD: A systematic review and meta-analysis was conducted of representative, longitudinal population-based cohorts with baseline assessment of subthreshold psychotic experiences and follow-up assessment of psychotic and non-psychotic clinical outcomes. RESULTS: Six cohorts were identified with a 3-24-year follow-up of baseline subthreshold self-reported psychotic experiences. The yearly risk of conversion to a clinical psychotic outcome in exposed individuals (0.56%) was 3.5 times higher than for individuals without psychotic experiences (0.16%) and there was meta-analytic evidence of dose-response with severity/persistence of psychotic experiences. Individual studies also suggest a role for motivational impairment and social dysfunction. The evidence for conversion to non-psychotic outcome was weaker, although findings were similar in direction. CONCLUSIONS: Subthreshold self-reported psychotic experiences in epidemiological non-help-seeking samples index psychometric risk for psychotic disorder, with strong modifier effects of severity/persistence. These data can serve as the population reference for selected and variable samples of help-seeking individuals at ultra-high risk, for whom much higher transition rates have been indicated.
Authors: Mackenzie S Mills; Christine M Embury; Alicia K Klanecky; Maya M Khanna; Vince D Calhoun; Julia M Stephen; Yu-Ping Wang; Tony W Wilson; Amy S Badura-Brack Journal: J Child Adolesc Trauma Date: 2019-08-19
Authors: Jadon R Webb; Jean Addington; Diana O Perkins; Carrie E Bearden; Kristin S Cadenhead; Tyrone D Cannon; Barbara A Cornblatt; Robert K Heinssen; Larry J Seidman; Sarah I Tarbox; Ming T Tsuang; Elaine F Walker; Thomas H McGlashan; Scott W Woods Journal: Schizophr Bull Date: 2015-09 Impact factor: 9.306
Authors: Lotta-Katrin Pries; Sinan Guloksuz; Margreet Ten Have; Ron de Graaf; Saskia van Dorsselaer; Nicole Gunther; Christian Rauschenberg; Ulrich Reininghaus; Rajiv Radhakrishnan; Maarten Bak; Bart P F Rutten; Jim van Os Journal: Schizophr Bull Date: 2018-06-06 Impact factor: 9.306
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