Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-13T00:43:56.291Z Has data issue: false hasContentIssue false

Dimensional and discrete variations on the psychosis continuum in a Dutch crowd-sourcing population sample

Published online by Cambridge University Press:  23 March 2020

J.T.W. Wigman*
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands Mental Health Service (GGZ) Friesland, 8932 PALeeuwarden, The Netherlands
K.J. Wardenaar
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
R.B.K. Wanders
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
S.H. Booij
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands Mental Health Service (GGZ) Friesland, 8932 PALeeuwarden, The Netherlands Centre for Integrative Psychiatry, 9725 AG, Groningen, The Netherlands
B.F. Jeronimus
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
L. van der Krieke
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
M. Wichers
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
P. de Jonge
Affiliation:
University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Hanzeplein 1, 9713 GZGroningen, The Netherlands
*
*Corresponding author. University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, The Netherlands. E-mail address:[email protected] (J.T.W. Wigman).
Get access

Abstract

Background

Mild psychotic experiences are common in the general population. Although transient and benign in most cases, these experiences are predictive of later mental health problems for a significant minority. The goal of the present study was to perform examinations of the dimensional and discrete variations in individuals’ reporting of subclinical positive and negative psychotic experiences in a unique Dutch internet-based sample from the general population.

Methods

Positive and negative subclinical psychotic experiences were measured with the Community Assessment of Psychic Experiences in 2870 individuals. First, the prevalence of these experiences and their associations with demographics, affect, psychopathology and quality of life were investigated. Next, latent class analysis was used to identify data-driven subgroups with different symptom patterns, which were subsequently compared on aforementioned variables.

Results

Subclinical psychotic experiences were commonly reported. Both positive and negative psychotic experiences were associated with younger age, more negative affect, anxiety and depression as well as less positive affect and poorer quality of life. Seven latent classes (‘Low psychotic experiences’, ‘Lethargic’, ‘Blunted’, ‘Distressed’, ‘Paranormal’, ‘Distressed_grandiose’ and ‘Distressed/positive psychotic experiences’) were identified that demonstrated both dimensional differences in the number/severity of psychotic experiences and discrete differences in the patterns of reported experiences.

Conclusion

Subclinical psychotic experiences show both dimensional severity variations and discrete symptom-pattern variations across individuals. To understand and capture all interindividual variations in subclinical psychotic experiences, their number, nature and context (co-occurrence patterns) should be considered at the same time. Only some psychotic experiences may lay on a true psychopathological psychosis continuum.

Type
Original article
Copyright
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Haslam, N., Holland, E., Kuppens, P.Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research. Psychol Med 2011;1(1):118.Google Scholar
Krueger, R.F., Piasecki, T.M.Toward a dimensional and psychometrically-informed approach to conceptualizing psychopathology. Behav Res Ther 2002;40(5):485499.CrossRefGoogle Scholar
Angst, J., Gamma, A., Benazzi, F., Ajdacic, V., Eich, D., Rössler, W.Toward a redefinition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. J Aff Dis 2003;73(1):133146.CrossRefGoogle Scholar
Kendler, K.S., Gardner, C.O.Boundaries of major depression: an evaluation of DSM-IV criteria. Am J Psychiatry 1998;155(2):172177.Google ScholarPubMed
Kelleher, I., Cannon, M.Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychol Med 2011;41(01):16.CrossRefGoogle Scholar
Kaymaz, N., Van Os, J.Extended psychosis phenotype–yes: single continuum–unlikely. Psychol Med 2010;40(12):19631966.CrossRefGoogle Scholar
Van Os, J., Linscott, R.J., Myin-Germeys, I., Delespaul, P., Krabbendam, L.A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychol Med 2009;39(02):179195.CrossRefGoogle ScholarPubMed
Linscott, R., Van Os, J.An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 2013;43(06):11331149.CrossRefGoogle ScholarPubMed
Hanssen, M., Bak, M., Bijl, R., Vollebergh, W., Os, J.The incidence and outcome of subclinical psychotic experiences in the general population. Br J Clin Psychol 2005;44(2):181191.CrossRefGoogle ScholarPubMed
McGrath, J.J., Saha, S., Al-Hamzawi, A., Alonso, J., Bromet, E.J., Bruffaerts, R.et al.Psychotic experiences in the general population: a cross-national analysis based on 31,261 respondents from 18 countries. JAMA Psychiatr 2015;72(7):697705.CrossRefGoogle ScholarPubMed
Nuevo, R., Chatterji, S., Verdes, E., Naidoo, N., Arango, C., Ayuso-Mateos, J.L.The continuum of psychotic symptoms in the general population: a cross-national study. Schizophr Bull 2012;38(3):475485.CrossRefGoogle ScholarPubMed
Yung, A.R., Buckby, J.A., Cotton, S.M., Cosgrave, E.M., Killackey, E.J., Stanford, C.et al.Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression and disability. Schizophr Bull 2006;32(2):352359.CrossRefGoogle ScholarPubMed
Wigman, J.T.W.Persistence of the extended psychosis phenotype in young people: link between vulnerability and clinical need. Utrecht: Ridderprint BV; 2011.Google Scholar
Fusar-Poli, P., Yung, A., McGorry, P., van Os, J.Lessons learned from the psychosis high-risk state: towards a general staging model of prodromal intervention. Psychol Med 2013;44(1):18.Google ScholarPubMed
Kaymaz, N., Drukker, M., Lieb, R., Wittchen, H.U., Werbeloff, N., Weiser, M.et al.Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychol Med 2012;1(1):115.Google Scholar
Cannon, T.D., Cadenhead, K., Cornblatt, B., Woods, S.W., Addington, J., Walker, E.et al.Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatr 2008;65(1):2837.CrossRefGoogle ScholarPubMed
Ruhrmann, S., Schultze-Lutter, F., Klosterkötter, J.Intervention in the at-risk state to prevent transition to psychosis. Curr Opin Psychiatr 2222009 177CrossRefGoogle ScholarPubMed
Fusar-Poli, P., Bonoldi, I., Yung, A.R., Borgwardt, S., Kempton, M.J., Valmaggia, L.et al.Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatr 2012;69(3):220CrossRefGoogle ScholarPubMed
Lin, A., Wood, S.J., Nelson, B., Beavan, A., McGorry, P., Yung, A.R.Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. Am J Psychiatry 2014;172(3):249258.CrossRefGoogle Scholar
Yung, A.R., Phillips, L.J., Yuen, H.P., Francey, S.M., McFarlane, C.A., Hallgren, M.et al.Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophr Res 2003;60(1):2132.CrossRefGoogle ScholarPubMed
Addington, J., Liu, L., Buchy, L., Cadenhead, K.S., Cannon, T.D., Cornblatt, B.A.et al.North American prodrome longitudinal study (NAPLS 2): the prodromal symptoms. J Nerv Ment Dis 2015;203(5):328335.CrossRefGoogle ScholarPubMed
Addington, J., Cornblatt, B.A., Cadenhead, K.S., Cannon, T.D., McGlashan, T.H., Perkins, D.O.et al.At clinical high risk for psychosis: outcome for nonconverters. Am J Psychiatry 2011;168:800805.CrossRefGoogle ScholarPubMed
Simon, A.E., Velthorst, E., Nieman, D.H., Linszen, D., Umbricht, D., de Haan, L.Ultra high-risk state for psychosis and non-transition: a systematic review. Schizophr Res 2011;132(1):817.CrossRefGoogle ScholarPubMed
Armando, M., Nelson, B., Yung, A.R., Saba, R., Monducci, E., Dario, C.et al.Psychotic experience subtypes, poor mental health status and help-seeking behaviour in a community sample of young adults. Early Interv Psychiatr 2011;6:300308.CrossRefGoogle Scholar
Saha, S., Scott, J.G., Varghese, D., McGrath, J.J.The association between general psychological distress and delusional-like experiences: a large population-based study. Schizophr Res 2011;127(1):246251.CrossRefGoogle ScholarPubMed
Wigman, J.T.W., van Nierop, M., Vollebergh, W.A.M., Lieb, R., Beesdo-Baum, K., Wittchen, H.U.et al.Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity – implications for diagnosis and ultra–high risk research. Schizophr Bull 2012;38(2):247257.CrossRefGoogle ScholarPubMed
Varghese, D., Scott, J., Welham, J., Bor, W., Najman, J., O’Callaghan, M.et al.Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophr Bull 2011;37(2):389393.CrossRefGoogle ScholarPubMed
Kelleher, I., Keeley, H., Corcoran, P., Lynch, F., Fitzpatrick, C., Devlin, N.et al.Clinicopathological significance of psychotic experiences in nonpsychotic young people: evidence from four population-based studies. Br J Psychiatr 2012;201(1):2632.CrossRefGoogle Scholar
DeVylder, J., Burnette, D., Yang, L.Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples. Psychol Med 2014;44(16):35033513.CrossRefGoogle ScholarPubMed
Kelleher, I., Devlin, N., Wigman, J.T., Kehoe, A., Murtagh, A., Fitzpatrick, C.et al.Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning. Psychol Med 2013;44(8):110.Google Scholar
DeVylder, J.E., Lukens, E.P., Link, B.G., Lieberman, J.A.Suicidal ideation and suicide attempts among adults with psychotic experiences: data from the collaborative psychiatric epidemiology surveys. JAMA Psychiatr 2015;72(3):219225.CrossRefGoogle ScholarPubMed
Zammit, S., Kounali, D., Cannon, M., David, A.S., Gunnell, D., Heron, J.et al.Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study. Am J Psychiatry 2013;170:742750.CrossRefGoogle Scholar
Chapman, L.J., Chapman, J.P., Kwapil, T.R., Eckblad, M., Zinser, M.C.Putatively psychosis-prone subjects 10 years later. J Abnorm Psychol 1994;103(2):171CrossRefGoogle ScholarPubMed
Poulton, R., Caspi, A., Moffitt, T.E., Cannon, M., Murray, R., Harrington, H.L.Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatr 2000;57(11):1053CrossRefGoogle ScholarPubMed
Webb, J.R., Addington, J., Perkins, D.O., Bearden, C.E., Cadenhead, K.S., Cannon, T.D.et al.Specificity of incident diagnostic outcomes in patients at clinical high risk for psychosis. Schizophr Bull 2015;41(5):10661075.CrossRefGoogle ScholarPubMed
Rössler, W., Hengartner, M.P., Ajdacic-Gross, V., Haker, H., Gamma, A., Angst, J.Subclinical psychosis symptoms in young adults are risk factors for subsequent common mental disorders. Schizophr Res 2011;131(1):1823.CrossRefGoogle Scholar
Werbeloff, N., Drukker, M., Dohrenwend, B.P., Levav, I., Yoffe, R., van Os, J.et al.Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Arch Gen Psychiatr 2012;69(5):467475.CrossRefGoogle ScholarPubMed
van Os, J.The many continua of psychosis. JAMA Psychiatr 2014;71(9):985986.CrossRefGoogle Scholar
Yung, A.R., Woods, S.W., Ruhrmann, S., Addington, J., Schultze-Lutter, F., Cornblatt, B.A.et al.Whither the attenuated psychosis syndrome?. Schizophr Bull 2012;38(6):11301134.CrossRefGoogle ScholarPubMed
van Os, J., Kapur, S.Schizophrenia. Lancet 2009;274:635645.CrossRefGoogle Scholar
Vollema, M.G., Hoijtink, H.The multidimensionality of self-report schizotypy in a psychiatric population: an analysis using multidimensional Rasch models. Schizophr Bull 2000;26(3):565575.CrossRefGoogle Scholar
Vollema, M.G., van den Bosch, , Robert, J.The multidimensionality of schizotypy. Schizophr Bull 1995;21(1):19CrossRefGoogle ScholarPubMed
Johns, L.C., van Os, J.The continuity of psychotic experiences in the general population. Clin Psychol Rev 2001;21(8):11251141.CrossRefGoogle ScholarPubMed
Krabbendam, L., Myin-Germeys, I., De Graaf, R., Vollebergh, W., Nolen, W., Iedema, J.et al.Dimensions of depression, mania and psychosis in the general population. Psychol Med 2004;34(7):11771186.CrossRefGoogle ScholarPubMed
Stefanis, N., Hanssen, M., Smirnis, N., Avramopoulos, D., Evdokimidis, I., Stefanis, C.et al.Evidence that three dimensions of psychosis have a distribution in the general population. Psychol Med 2002;32(02):347358.CrossRefGoogle ScholarPubMed
Lin, A., Wood, S.J., Yung, A.R.Measuring psychosocial outcome is good. Curr Opin Psychiatr 2013;26(2):138143.CrossRefGoogle Scholar
Lin, A., Wood, S., Nelson, B., Brewer, W., Spiliotacopoulos, D., Bruxner, A.et al.Neurocognitive predictors of functional outcome two to 13 years after identification as ultra-high risk for psychosis. Schizophr Res 2011;132(1):17.CrossRefGoogle ScholarPubMed
Piskulic, D., Addington, J., Cadenhead, K.S., Cannon, T.D., Cornblatt, B.A., Heinssen, R.et al.Negative symptoms in individuals at clinical high risk of psychosis. Psychiatr Res 2012;196(2):220224.CrossRefGoogle ScholarPubMed
Wigman, J.T., Vollebergh, W.A., Raaijmakers, Q.A., Iedema, J., van Dorsselaer, S., Ormel, J.et al.The structure of the extended psychosis phenotype in early adolescence – a cross-sample replication. Schizophr Bull 2011;37(4):850860.CrossRefGoogle ScholarPubMed
Yung, A.R., Nelson, B., Baker, K., Buckby, J.A., Baksheev, G., Cosgrave, E.M.Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia. Aust N Z J Psychiatry 2009;43(2):118128.CrossRefGoogle Scholar
McGorry, P.D., Hickie, I.B., Yung, A.R., Pantelis, C., Jackson, H.J.Clinical staging of psychiatric disorders: a heuristic framework for choosing earlier, safer and more effective interventions. Aust N Z J Psychiatry 2006;40(8):616622.CrossRefGoogle ScholarPubMed
David, A.Why we need more debate on whether psychotic symptoms lie on a continuum with normality. Psychol Med 2010;40(12):19351942.CrossRefGoogle ScholarPubMed
Van der Krieke, L., Jeronimus, B.F., Blaauw, F.J., Wanders, R.B., Emerencia, A.C., Schenk, H.M.et al.How nuts are the Dutch (HoeGekIsNL): a crowdsourcing study of mental symptoms and strengths. Int J Methods Psychiatr Res 2016;25(2):123144.CrossRefGoogle Scholar
Lovibond, P.F., Lovibond, S.H.The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck depression and anxiety inventories. Behav Res Ther 1995;33(3):335343.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L.A., Tellegen, A.Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 5461988 1063CrossRefGoogle ScholarPubMed
Priebe, S., Huxley, P., Knight, S., Evans, S.Application and results of the Manchester Short Assessment of Quality of Life (MANSA). Int J Soc Psychiatry 1999;45(1):712.CrossRefGoogle Scholar
Muthén, L., Muthén, B.5th ed, Mplus user's guide, Los Angeles: Muthén & Muthén; 2007.Google Scholar
Kelleher, I., Connor, D., Clarke, M.C., Devlin, N., Harley, M., Cannon, M.Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychol Med 2012;1(1):17.Google Scholar
Maric, N., Krabbendam, L., Vollebergh, W., de Graaf, R., van Os, J.Sex differences in symptoms of psychosis in a nonselected, general population sample. Schizophr Res 2003;63(1):8995.CrossRefGoogle Scholar
Krabbendam, L., van Os, J.Schizophrenia and urbanicity: a major environmental influence – conditional on genetic risk. Schizophr Bull 2005;31(4):795799.CrossRefGoogle Scholar
van Os, J., Hanssen, M., Bijl, R.V., Vollebergh, W.Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Arch Gen Psychiatry 2001;58(7):663668.CrossRefGoogle Scholar
Wardenaar, K.J., Giltay, E.J., van Veen, T., Zitman, F.G., Penninx, B.W.Symptom dimensions as predictors of the two-year course of depressive and anxiety disorders. J Affect Disord 2012;136(3):11981203.CrossRefGoogle ScholarPubMed
Peters, E., Day, S., McKenna, J., Orbach, G.Delusional ideation in religious and psychotic populations. Br J Clin Psychol 1999;38(1):8396.CrossRefGoogle ScholarPubMed
Loewy, R.L., Johnson, J.K., Cannon, T.D.Self-report of attenuated psychotic experiences in a college population. Schizophr Res 2007;93(1):144151.CrossRefGoogle Scholar
Therman, S., Suvisaari, J., Hultman, C.M.Dimensions of psychotic experiences among women in the general population. Int J Methods Psychiatr Res 2014;23(1):6268.CrossRefGoogle ScholarPubMed
Wiltink, S., Nelson, B., Velthorst, E., Wigman, J., Lin, A., Baksheev, G.et al.The relationship between personality traits and psychotic like experiences in a large non-clinical adolescent sample. Person Ind Diff 2015;73:9297.CrossRefGoogle Scholar
Cougnard, A., Marcelis, M., Myin-Germeys, I., De Graaf, R., Vollebergh, W., Krabbendam, L.et al.Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness – persistence model. Psychol Med 2007;37(04):513527.CrossRefGoogle ScholarPubMed
Shevlin, M., Boyda, D., Houston, J., Murphy, J.Measurement of the psychosis continuum: modelling the frequency and distress of subclinical psychotic experiences. Psychosis 2015;7(2):108118.CrossRefGoogle Scholar
McGorry, P., van Os, J.Redeeming diagnosis in psychiatry: timing versus specificity. Lancet 2013;381(9863):343345.CrossRefGoogle ScholarPubMed
Supplementary material: File

Wigman et al. supplementary material

Appendix 1

Download Wigman et al. supplementary material(File)
File 19.5 KB
Supplementary material: File

Wigman et al. supplementary material

Appendix 2

Download Wigman et al. supplementary material(File)
File 17.8 KB
Supplementary material: File

Wigman et al. supplementary material

Appendix 3

Download Wigman et al. supplementary material(File)
File 18.1 KB
Supplementary material: File

Wigman et al. supplementary material

Appendix 4

Download Wigman et al. supplementary material(File)
File 405.2 KB
Submit a response

Comments

No Comments have been published for this article.