S Guloksuz1, M van Nierop1, R Lieb2, R van Winkel1, H-U Wittchen3, J van Os1. 1. Department of Psychiatry and Psychology,Maastricht University Medical Centre, EURON,Maastricht,The Netherlands. 2. Epidemiology and Health Psychology, Institute of Psychology, University of Basel,Basel,Switzerland. 3. Institute of Clinical Psychology and Psychotherapy, Technical University Dresden,Dresden,Germany.
Abstract
BACKGROUND: Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. METHOD: In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive-compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. RESULTS: The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose-response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56-68%, all p < 0.001). Within individuals with MD/OCD, the association between PEs and help-seeking behaviour, as an index of severity, was moderated by trauma (ICR = 1.87, p = 0.009) and urbanicity (ICR = 1.48, p = 0.005), but not by cannabis use. CONCLUSIONS: In non-psychotic disorder, environmental factors increase the likelihood of psychosis admixture and help-seeking behaviour through an increase in general psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network.
BACKGROUND: Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. METHOD: In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive-compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. RESULTS: The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose-response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56-68%, all p < 0.001). Within individuals with MD/OCD, the association between PEs and help-seeking behaviour, as an index of severity, was moderated by trauma (ICR = 1.87, p = 0.009) and urbanicity (ICR = 1.48, p = 0.005), but not by cannabis use. CONCLUSIONS: In non-psychotic disorder, environmental factors increase the likelihood of psychosis admixture and help-seeking behaviour through an increase in general psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network.
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: Sinan Guloksuz; Bart P F Rutten; Lotta-Katrin Pries; Margreet Ten Have; Ron de Graaf; Saskia van Dorsselaer; Boris Klingenberg; Jim van Os; John P A Ioannidis Journal: Schizophr Bull Date: 2018-10-17 Impact factor: 9.306
Authors: Iria Mendez; David Axelson; Josefina Castro-Fornieles; Danella Hafeman; Tina R Goldstein; Benjamin I Goldstein; Rasim Diler; Roger Borras; John Merranko; Kelly Monk; Mary Beth Hickey; Boris Birmaher Journal: J Am Acad Child Adolesc Psychiatry Date: 2018-11-03 Impact factor: 8.829
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Authors: Lotta-Katrin Pries; Agustin Lage-Castellanos; Philippe Delespaul; Gunter Kenis; Jurjen J Luykx; Bochao D Lin; Alexander L Richards; Berna Akdede; Tolga Binbay; Vesile Altinyazar; Berna Yalinçetin; Güvem Gümüş-Akay; Burçin Cihan; Haldun Soygür; Halis Ulaş; Eylem Şahin Cankurtaran; Semra Ulusoy Kaymak; Marina M Mihaljevic; Sanja Andric Petrovic; Tijana Mirjanic; Miguel Bernardo; Bibiana Cabrera; Julio Bobes; Pilar A Saiz; María Paz García-Portilla; Julio Sanjuan; Eduardo J Aguilar; José Luis Santos; Estela Jiménez-López; Manuel Arrojo; Angel Carracedo; Gonzalo López; Javier González-Peñas; Mara Parellada; Nadja P Maric; Cem Atbaşoğlu; Alp Ucok; Köksal Alptekin; Meram Can Saka; Celso Arango; Michael O'Donovan; Bart P F Rutten; Jim van Os; Sinan Guloksuz Journal: Schizophr Bull Date: 2019-09-11 Impact factor: 9.306