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DSM outcomes of psychotic experiences and associated risk factors: 6-year follow-up study in a community-based sample

Published online by Cambridge University Press:  13 August 2018

Umut Kırlı Open the ORCID record for Umut Kırlı [Opens in a new window] ,
Tolga Binbay ,
Marjan Drukker ,
Hayriye Elbi ,
Bülent Kayahan ,
Duygu Keskin Gökçelli ,
Ferda Özkınay ,
Hüseyin Onay ,
Köksal Alptekin  and
Jim van Os
Umut Kırlı
Affiliation:
Education and Research Hospital, Van, Turkey Department of Psychiatry and Psychology, Maastricht University Medical Centre, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, PO Box 616, Vijverdal 6200 MD, Maastricht, The Netherlands
Tolga Binbay*
Affiliation:
Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, 35340, Izmir, Turkey
Marjan Drukker
Affiliation:
Department of Psychiatry and Psychology, Maastricht University Medical Centre, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, PO Box 616, Vijverdal 6200 MD, Maastricht, The Netherlands
Hayriye Elbi
Affiliation:
Faculty of Medicine, Department of Psychiatry, Ege University, 35140, Izmir, Turkey
Bülent Kayahan
Affiliation:
Faculty of Medicine, Department of Psychiatry, Ege University, 35140, Izmir, Turkey
Duygu Keskin Gökçelli
Affiliation:
Faculty of Medicine, Department of Psychiatry, Ege University, 35140, Izmir, Turkey
Ferda Özkınay
Affiliation:
Faculty of Medicine, Department of Medical Genetics, Ege University, 35140, Izmir, Turkey
Hüseyin Onay
Affiliation:
Faculty of Medicine, Department of Medical Genetics, Ege University, 35140, Izmir, Turkey
Köksal Alptekin
Affiliation:
Faculty of Medicine, Department of Psychiatry, Dokuz Eylül University, 35340, Izmir, Turkey
Jim van Os
Affiliation:
Department of Psychiatry and Psychology, Maastricht University Medical Centre, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, PO Box 616, Vijverdal 6200 MD, Maastricht, The Netherlands Department of Psychosis Studies, King's College, King's Health Partners, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London, UK Department of Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, PO BOX 85500, 3508 GA Utrecht, The Netherlands
*
Author for correspondence: Tolga Binbay, E-mail: [email protected]
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Abstract

Background

Psychotic experiences (PEs) may predict a range of common, non-psychotic disorders as well as psychotic disorders. In this representative, general population-based cohort study, both psychotic and non-psychotic disorder outcomes of PE were analysed, as were potential moderators.

Methods

Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011). Participants were interviewed with the Composite International Diagnostic Interview (CIDI) both at baseline and at 6-year follow-up. Participants with PE at baseline were clinically re-interviewed with the SCID-I at follow-up. The role of socio-demographics, characteristics of PE, co-occurrence of mood disorders and family history of mental disorders were tested in the association between baseline PE and follow-up diagnosis.

Results

In the participants with baseline PE, the psychotic disorder diagnosis rate at follow up was 7.0% – much lower than the rates of DSM-IV mood disorders without psychotic features (42.8%) and other non-psychotic disorders (24.1%). Within the group with baseline PE, female sex, lower socio-economic status, co-occurrence of mood disorders, family history of a mental disorder and persistence of PE predicted any follow-up DSM diagnosis. Furthermore, onset of psychotic v. non-psychotic disorder was predicted by younger age (15–30 years), co-presence of delusional and hallucinatory PE and family history of severe mental illness.

Conclusion

The outcome of PE appears to be a consequence of baseline severity of multidimensional psychopathology and familial risk. It may be useful to consider PE as a risk indicator that has trans-diagnostic value.

Keywords

Community-based populationfamily history of mental disordersfollow-up studymood disordersnon-psychotic disorderspersistence of psychotic experiencespsychotic disorderspsychotic experiencessocio-demographic factorstype of psychotic experiences
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 8 , June 2019 , pp. 1346 - 1356
Copyright
Copyright © Cambridge University Press 2018 

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