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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

Published online by Cambridge University Press:  20 January 2012

N. Kaymaz ,
M. Drukker ,
R. Lieb ,
H.-U. Wittchen ,
N. Werbeloff ,
M. Weiser ,
T. Lataster  and
J. van Os
N. Kaymaz
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands Mediant GGZ/Mental Health Care, Enschede, The Netherlands
M. Drukker
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
R. Lieb
Affiliation:
Division of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany Department of Psychology, Division of Epidemiology and Health Psychology, University of Basel, Switzerland
H.-U. Wittchen
Affiliation:
Division of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Germany
N. Werbeloff
Affiliation:
Department of Psychiatry, Sheba Medical Centre, Tel-Hashomer, Israel
M. Weiser
Affiliation:
Department of Psychiatry, Sheba Medical Centre, Tel-Hashomer, Israel
T. Lataster
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
J. van Os*
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
*
*Address for correspondence: J. van Os, Ph.D., Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (DRT 12), 6200MD Maastricht, The Netherlands. (Email: [email protected])
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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.

Keywords

Delusionshallucinationsmeta-analysispreventionpsychotic disordersrisk
Type
Review Article
Information
Psychological Medicine , Volume 42 , Issue 11 , November 2012 , pp. 2239 - 2253
Copyright
Copyright © Cambridge University Press 2012

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References

Achenbach, TM (1991). Manual for the Youth Self-Report and 1991 Profile (with Dutch translation). University of Vermont: Burlington, VT.Google Scholar
Bak, M, Delespaul, P, Hanssen, M, de Graaf, R, Vollebergh, W, van Os, J (2003). How false are ‘false’ positive psychotic symptoms? Schizophrenia Research 62, 187–189.CrossRefGoogle ScholarPubMed
Bijl, RV, Ravelli, A, van Zessen, G (1998 a). Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 33, 587–595.CrossRefGoogle ScholarPubMed
Bijl, RV, van Zessen, G, Ravelli, A, de Rijk, C, Langendoen, Y (1998 b). The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design. Social Psychiatry and Psychiatric Epidemiology 33, 581–586.CrossRefGoogle ScholarPubMed
Chapman, LJ, Chapman, JP, Kwapil, TR, Eckblad, M, Zinser, MC (1994). Putatively psychosis-prone subjects 10 years later. Journal of Abnormal Psychology 103, 171–183.CrossRefGoogle ScholarPubMed
Costello, A, Edelbrock, C, Kalas, R, Kessler, M, Klaric, S (1982). NIMH Diagnostic Interview for Children: Child Version. National Institute of Mental Health: Rockville, MD.Google Scholar
Derogatis, LR, Cleary, PA (1977). Confirmation of the dimensional structure of the SCL-90: a study in construct validation. Journal of Clinical Psychology 33, 981–989.3.0.CO;2-0>CrossRefGoogle Scholar
Dominguez, MD, Saka, MC, Lieb, R, Wittchen, HU, van Os, J (2010). Early expression of negative/disorganized symptoms predicting psychotic experiences and subsequent clinical psychosis: a 10-year study. American Journal of Psychiatry 167, 1075–1082.CrossRefGoogle Scholar
Dominguez, MD, Wichers, M, Lieb, R, Wittchen, HU, van Os, J (2011). Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophrenia Bulletin 37, 84–93.CrossRefGoogle ScholarPubMed
Endicott, J, Spitzer, RL (1978). A diagnostic interview: the schedule for affective disorders and schizophrenia. Archives of General Psychiatry 35, 837–844.CrossRefGoogle ScholarPubMed
Hanssen, M, Bak, M, Bijl, R, Vollebergh, W, van Os, J (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology 44, 181–191.CrossRefGoogle ScholarPubMed
Higgins, JP, Thompson, SG (2004). Controlling the risk of spurious findings from meta-regression. Statistics in Medicine 23, 1663–1682.CrossRefGoogle ScholarPubMed
Kapur, S (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry 160, 13–23.CrossRefGoogle ScholarPubMed
Kelleher, I, Harley, M, Murtagh, A, Blanchard, M, Cannon, M (2009). Screening for subclinical psychosis in the general adolescent population [Conference Abstract]. Schizophrenia Bulletin 35 (Suppl. 1), 71.Google Scholar
Kwapil, TR, Miller, MB, Zinser, MC, Chapman, J, Chapman, LJ (1997). Magical ideation and social anhedonia as predictors of psychosis proneness: a partial replication. Journal of Abnormal Psychology 106, 491–495.CrossRefGoogle ScholarPubMed
Lieb, R, Isensee, B, von Sydow, K, Wittchen, HU (2000). The Early Developmental Stages of Psychopathology Study (EDSP): a methodological update. European Addiction Research 6, 170–182.CrossRefGoogle ScholarPubMed
Linscott, RJ, van Os, J (2010). Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annual Review of Clinical Psychology 6, 391–419.CrossRefGoogle ScholarPubMed
Overall, JE, Gorham, DR (1962). The Brief Psychiatric Rating Scale. Psychological Report 10, 799–812.CrossRefGoogle Scholar
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Regeer, EJ, Krabbendam, L, de Graaf, R, ten Have, M, Nolen, WA, van Os, J (2006). A prospective study of the transition rates of subthreshold (hypo)mania and depression in the general population. Psychological Medicine 36, 619–627.CrossRefGoogle ScholarPubMed
Regeer, EJ, Krabbendam, L, de Graaf, R, ten Have, MT, Nolen, WA, van Os, J (2009). Berkson's bias and the mood dimensions of bipolar disorder. International Journal of Methods in Psychiatric Research 18, 279–286.CrossRefGoogle ScholarPubMed
Roberts, RE, Vernon, SW (1981). Usefulness of the PERI demoralization scale screen for psychiatric disorder in a community sample. Psychiatry Research 5, 183–193.CrossRefGoogle Scholar
Robins, LN, Cottler, L, Bucholz, K, Compton, W (1995). Diagnostic Interview Schedule for DSM-IV. Washington University: St Louis, MO.Google Scholar
Robins, LN, Wing, J, Wittchen, HU, Helzer, JE, Babor, TF, Burke, J, Farmer, A, Jablenski, A, Pickens, R, Regier, DA (1988). The Composite International Diagnostic Interview. An epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Archives of General Psychiatry 45, 1069–1077.CrossRefGoogle ScholarPubMed
Saha, S, Barendregt, JJ, Vos, T, Whiteford, H, McGrath, J (2008). Modelling disease frequency measures in schizophrenia epidemiology. Schizophrenia Research 104, 246–254.CrossRefGoogle ScholarPubMed
Shrout, PE, Dohrenwend, BP, Levav, I (1986). A discriminant rule for screening cases of diverse diagnostic types: preliminary results. Journal of Consulting Clinical Psychology 54, 314–319.CrossRefGoogle ScholarPubMed
Slade, M, Phelan, M, Thornicroft, G, Parkman, S (1996). The Camberwell Assessment of Need (CAN): comparison of assessments by staff and patients of the needs of the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology 31, 109–113.CrossRefGoogle ScholarPubMed
StataCorp (2009). STATA Statistical Software: Release 11. Stata Corporation: College Station, TX.Google Scholar
Stroup, DF, Berlin, JA, Morton, SC, Olkin, I, Williamson, GD, Rennie, D, Moher, D, Becker, BJ, Sipe, TA, Thacker, SB (2000). Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Journal of the American Medical Association 283, 2008–2012.CrossRefGoogle ScholarPubMed
Tijssen, MJ, van Os, J, Wittchen, HU, Lieb, R, Beesdo, K, Mengelers, R, Krabbendam, L, Wichers, M (2010 a). Evidence that bipolar disorder is the poor outcome fraction of a common developmental phenotype: an 8-year cohort study in young people. Psychological Medicine 40, 289–299.CrossRefGoogle ScholarPubMed
Tijssen, MJ, van Os, J, Wittchen, HU, Lieb, R, Beesdo, K, Mengelers, R, Wichers, M (2010 b). Prediction of transition from common adolescent bipolar experiences to bipolar disorder: 10-year study. British Journal of Psychiatry 196, 102–108.CrossRefGoogle Scholar
van Nierop, M, van Os, J, Gunther, N, Myin-Germeys, I, de Graaf, R, ten Have, M, van Dorsselaer, S, Bak, M, van Winkel, R (2011). Phenotypically continuous with clinical psychosis, discontinuous in need for care: evidence for an extended psychosis phenotype. Schizophrenia Bulletin. Published online: 9 September 2011. doi:10.1093/schbul/sbr129.CrossRefGoogle Scholar
van Os, J, Hanssen, M, Bijl, R, Ravelli, A (2000). Straus (1969) revisited: a psychosis continuum in the general population? Schizophrenia Research 45, 11–20.CrossRefGoogle Scholar
van Os, J, Hanssen, M, Bijl, RV, Vollebergh, W (2001). Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. Archives of General Psychiatry 58, 663–668.CrossRefGoogle ScholarPubMed
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179–195.CrossRefGoogle ScholarPubMed
Welham, J, Scott, J, Williams, G, Najman, J, Bor, W, O'Callaghan, M, McGrath, J (2009). Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study. Psychological Medicine 39, 625–634.CrossRefGoogle ScholarPubMed
Werbeloff, N, Drukker, M, Dohrenwend, BP, Levav, I, Yoffe, R, van Os, J, Davidson, M, Weiser, M (2012). Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Archives of General Psychiatry. Published online: 2 January 2012. doi:10.1001/archgenpsychiatry.2011.1580. CrossRefGoogle ScholarPubMed
WHO (1990). Composite International Diagnostic Interview (CIDI), Version 1.0. World Health Organization: Geneva.Google Scholar
Wittchen, HU, Perkonigg, A, Lachner, G, Nelson, CB (1998). Early Developmental Stages of Psychopathology Study (EDSP): objectives and design. European Addiction Research 4, 18–27.CrossRefGoogle ScholarPubMed
Wittchen, HU, Pfister, H (1997). DIS-X-Interviews: Manual für Screening-Verfahren und Interview; Interviewheft Längsschnittuntersuchung (DIA-X-Lifetime); Ergänzungsheft (DIA-X-Lifetime); Interviewheft Querschnittsuntersuchung (DIA-X-12 Monats-Version); Ergänzungsheft (DIA-X-12 Monats-Version); PC-Programm zur Durchführung der Interviews (Längsund Querschnittsuntersuchung). Auswertungsprogramm. Swets & Zeitlinger: Frankfurt.Google Scholar
Zimmermann, P, Wittchen, HU, Hofler, M, Pfister, H, Kessler, RC, Lieb, R (2003). Primary anxiety disorders and the development of subsequent alcohol use disorders: a 4-year community study of adolescents and young adults. Psychological Medicine 33, 1211–1222.CrossRefGoogle ScholarPubMed