Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T08:08:45.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Which psychotic experiences are associated with a need for clinical care?

Published online by Cambridge University Press:  15 April 2020

C.M.C. Brett ,
E.R. Peters  and
P.K. McGuire
C.M.C. Brett
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Department of Psychosis Studies, London, United Kingdom Sussex Partnership NHS Foundation Trust, Brighton, United Kingdom
E.R. Peters*
Affiliation:
King's College London, IoPPN, Department of Psychology, PO77, HWB, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust, London, United Kingdom
P.K. McGuire
Affiliation:
King's College London, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), Department of Psychosis Studies, London, United Kingdom National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust, London, United Kingdom OASIS, Psychosis Clinical Academic Group, South London and Maudsley NHS Foundation Trust, London, United Kingdom
*
⁎Corresponding author. King's College London, IoPPN, Department of Psychology, PO77, HWB, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, United Kingdom. Tel.: +44 0 207 848 0347; fax: +44 0 207 848 5006. E-mail address:[email protected] (E.R. Peters).
Get access

Abstract

Background

The aims of this study were to identify (1) the factor structure of anomalous experiences across the psychosis continuum; (2) qualitative and quantitative differences in psychotic experiences (PEs) between “non need-for-care” and two clinical groups: psychosis patients and individuals at ultra high risk (UHR) of psychosis. We aimed to distinguish which types of experiences would be related to malign (need-for-care and/or help-seeking) versus benign outcomes.

Methods

Component scores obtained from a Principal Components Analysis of PEs from lifetime scores on the Appraisals of Anomalous Experience Inventory (Brett et al., 2007) were compared across 96 participants: patients diagnosed with a psychotic disorder (n = 37), help-seeking UHR people (n = 21), and non-clinical individuals presenting with enduring PEs (n = 38).

Results

A five-component structure provided the best solution, comprising dissociative-type experiences, subjective cognitive deficits, and three separate components relating to “positive” symptoms. All groups reported “positive” experiences, such as ideas of reference and hallucinations, with the non-clinical group displaying more PEs in the Paranormal/Hallucinatory component than both clinical groups. “Cognitive/Attentional anomalies” was the only component where the clinical groups reported significantly more anomalies than the non-clinical group. However psychosis patients reported more frequent first-rank type symptoms and “hypomanic” type PEs than the other groups.

Discussion

“Positive” PEs were common across the psychosis spectrum, although first-rank type symptoms were particularly marked in participants diagnosed with a psychotic disorder. Help-seeking and need-for-care were associated with the presence of subjective cognitive disturbances. These findings suggest that anomalies of cognition and attention may be more relevant to poorer outcomes than the presence of anomalous experiences.

Keywords

Checking behaviorEye-trackingImage comparison taskSchizophreniaWorking memory
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 5 , July 2015 , pp. 648 - 654
Copyright
Copyright © Elsevier Masson SAS 2015

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

Allardyce, J., Suppes, T., Van Os, J.. Dimensions and the psychosis phenotype. Int J Meth Psych Res 2007;16:S34–S40.CrossRefGoogle ScholarPubMed
Andreasen, N.Scale for the assessment of negative symptoms (SANS). Iowa City, IA: University of Iowa; 1984.Google Scholar
Andreasen, N.Scale for the assessment of positive symptoms (SAPS). Iowa City, IA: University of Iowa; 1984.Google Scholar
Bak, M., Myin-Germeys, I., Hanssen, M., Bijl, R., Vollebergh, W., Delespaul, P., et al.When does experience of psychosis result in a need-for-care? A prospective general population study. Schizophr Bull 2003;29:349–358.CrossRefGoogle Scholar
Bola, J.R.. Medication-free research in early episode schizophrenia: evidence of long-term harm?. Schizophr Bull 2006;32:288–296.CrossRefGoogle ScholarPubMed
Brett, C.M.C.Transformative Crises. In: Clarke, I., editor. Psychosis and spirituality: consolidating the new paradigm. 2nd ed., Chichester: Wiley-Blackwell; 2010.Google Scholar
Brett, C.M.C., Peters, E.P., Johns, L.C., Tabraham, P., Valmaggia, L.R., McGuire, P.. Appraisals of anomalous experiences interview (AANEX): a multidimensional measure of psychological responses to anomalies associated with psychosis. Br J Psychiat 2007;191:S23–S30.CrossRefGoogle Scholar
Brett, C.M.C., Johns, L.C., Peters, E.P., McGuire, P.K.. The role of metacognitive beliefs in determining the impact of anomalous experiences: a comparison of help-seeking and non-help-seeking groups of people experiencing psychotic-like anomalies. Psychol Med 2009;39:939–950.CrossRefGoogle ScholarPubMed
Brett, C., Heriot-Maitland, C., McGuire, P., Peters, E.. Predictors of distress associated with psychotic-like anomalous experiences in clinical and non-clinical populations. Br J Clin Psychol 2014;53:213–227.CrossRefGoogle ScholarPubMed
Broome, M.R., Woolley, J.B., Johns, L.C., Valmaggia, L.R., Tabraham, P., Gafoor, R., et al.Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at-risk mental state. Eur Psychiat 2005;20:372–378.CrossRefGoogle ScholarPubMed
Claridge, G., McCreery, C., Mason, O., Bentall, R., Boyle, G., Slade, P., et al.The factor structure of “schizotypal’ traits: a large replication study. Br J Clin Psychol 1996;35(Pt. 1):103–115.CrossRefGoogle ScholarPubMed
Cullberg, J., Levander, S., Holmqvist, R., Mattsson, M., Wieselgren, I.M.. One-year outcome in first episode psychosis patients in the Swedish Parachute project. Acta Psychiat Scand 2002;106:276–285.CrossRefGoogle ScholarPubMed
David, A.S.. Why we need more debate on whether psychotic symptoms lie on a continuum with normality. Psychol Med 2010;40:1935–1942.CrossRefGoogle ScholarPubMed
Demjaha, A., Morgan, K., Morgan, C., Landau, S., Dean, K., Reichenberg, A., et al.Combining dimensional and categorical representation of psychosis: the way forward for DSM-V and ICD-11? Psychol Med 2009;39:1943–1955.CrossRefGoogle ScholarPubMed
Demjaha, A., Valmaggia, L., Stahl, D., Byrne, M., McGuire, P.. Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophr Bull 2012;38:351–359.CrossRefGoogle ScholarPubMed
DeVylder, J.E., Oh, H.Y., Corcoran, C.M., Lukens, E.P.. Treatment seeking and unmet need-for-care among persons reporting psychosis-like experiences. Psychiat Serv 2014;65:774–780.CrossRefGoogle ScholarPubMed
Drake, R.J., Lewis, S.W.. Valuing prodromal psychosis: what do we get and what is the price?. Schizophr Res 2010;120:38–41.CrossRefGoogle ScholarPubMed
Freeman, D., Garety, P.A., Bebbington, P.E., Smith, B., Rollinson, R., Fowler, D., et al.Psychological investigation of the structure of paranoia in a non-clinical population. Br J Psychiat 2005;186:427–435.CrossRefGoogle Scholar
Fusar-Poli, P., Deste, G., Smieskova, R., Barlati, S., Yung, A.R., Howes, O., et al.Cognitive functioning in prodromal psychosis a meta-analysis. Arch Gen Psychiat 2012;69:562–571.CrossRefGoogle ScholarPubMed
Gaynor, K., Ward, T., Garety, P., Peters, E.. The role of safety-seeking behaviours in maintaining threat appraisals in psychosis. Behav Res Ther 2013;51:75–81.CrossRefGoogle ScholarPubMed
Heriot-Maitland, C., Knight, M., Peters, E.. A qualitative comparison of psychotic-like phenomena in clinical and non-clinical populations. Br J Clin Psychol 2012;51:37–53.CrossRefGoogle ScholarPubMed
Hutcheson, G.D., Sofroniou, N.The multivariate social scientist: an introduction to generalised linear models. Sage Publications; 1999.CrossRefGoogle Scholar
Kaymaz, N., van Os, J.. Extended psychosis phenotype – yes: single continuum – unlikely. Psychol Med 2010;40:1963–1966.CrossRefGoogle ScholarPubMed
Kelleher, I., Keeley, H., Corcoran, P., Lynch, F., Fitzpatrick, C., Devlin, N., et al.Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies. Br J Psychiat 2012;201:26–32.CrossRefGoogle ScholarPubMed
Kendler, K.S., Gallagher, T.J., Abelson, J.M., Kessler, R.C.. Lifetime prevalence, demographic risk factors, and diagnostic validity of non-affective psychosis as assessed in a US community sample – The National Comorbidity Survey. Arch Gen Psychiat 1996;53:1022–1031.CrossRefGoogle Scholar
Kilcommons, A.M., Morrison, A.P.. Relationships between trauma and psychosis: an exploration of cognitive and dissociative factors. Acta Psychiat Scand 2005;112:351–359.CrossRefGoogle ScholarPubMed
Klosterkotter, J., Hellmich, M., Steinmeyer, E.M., Schultze-Lutter, F.. Diagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiat 2001;58:158–164.CrossRefGoogle ScholarPubMed
Kobayashi, H., Nemoto, T., Murakami, M., Kashima, H., Mizuno, M.. Lack of association between psychosis-like experiences and seeking help from professionals: a case-controlled study. Schizophr Res 2011;132:208–212.CrossRefGoogle ScholarPubMed
Lencz, T., Smith, C.W., McLaughlin, D., Auther, A., Nakayama, E., Hovey, L., et al.Generalized and specific neurocognitive deficits in prodromal schizophrenia. Biol Psychiat 2004;59:863–871.CrossRefGoogle Scholar
Liddle, P.F.. The symptoms of chronic-schizophrenia – a reexamination of the positive-negative dichotomy. Br J Psychiat 1987;151:145–151.CrossRefGoogle Scholar
Linney, Y.M., Murray, R.M., Peters, E.R., MacDonald, A.M., Rijsdijk, F., Sham, P.C.. A quantitative genetic analysis of schizotypal personality traits. Psychol Med 2003;33:803–816.CrossRefGoogle ScholarPubMed
Lovatt, A., Mason, O., Brett, C., Peters, E.. Psychotic-like experiences, appraisals, and trauma. J Nerv Ment Dis 2010;198:813–819.CrossRefGoogle ScholarPubMed
Mason, O., Claridge, G., Jackson, M.. New scales for the assessment of schizotypy. Pers Indiv Diff 1995;18:7–13.CrossRefGoogle Scholar
McGorry, P.D., Bell, R.C., Dudgeon, P.L., Jackson, H.J.. The dimensional structure of first episode psychosis: an exploratory factor analysis. Psychol Med 1998;28:935–947.CrossRefGoogle ScholarPubMed
Morita, K., Kobayashi, H., Takeshi, K., Tsujino, N., Nemoto, T., Mizuno, M.. Poor outcome associated with symptomatic deterioration among help-seeking individuals at-risk for psychosis: a naturalistic follow-up study. Early Interv Psychiatry 2014;8:24–31.CrossRefGoogle ScholarPubMed
Murphy, J., Shevlin, M., Houston, J., Adamson, G.. A population-based analysis of subclinical psychosis and help-seeking behavior. Schizophr Bull 2012;38:360–367.CrossRefGoogle ScholarPubMed
Nelson, B., Yuen, H.P., Wood, S.J., Lin, A., Spiliotacopoulos, D., Bruxner, A., et al.Long-term follow-up of a group at ultra high risk (“Prodroma”) for psychosis. The PACE 400 Study. JAMA Psychiat 2013;70:793–802.CrossRefGoogle Scholar
Peralta, V., Cuesta, M.J.. How many and which are the psychopathological dimensions in schizophrenia? Issues influencing their ascertainment. Schizophr Res 2001;49:269–285.CrossRefGoogle ScholarPubMed
Ruhrmann, S., Schultze-Lutter, F., Salokangas, R.K.R., Heinimaa, M., Linszen, D., Dingemans, P., et al.Prediction of psychosis in adolescents and young adults at high risk results from the prospective european prediction of psychosis study. Arch Gen Psychiat 2010;67:241–251.CrossRefGoogle Scholar
Schafer, I., Fisher, H.L., Aderhold, V., Huber, B., Hoffmann-Langer, L., Golks, D., et al.Dissociative symptoms in patients with schizophrenia: relationships with childhood trauma and psychotic symptoms. Compr Psychiat 2012;53:364–371.CrossRefGoogle ScholarPubMed
Schultze-Lutter, F.. Subjective symptoms of schizophrenia in research and the clinic: the basic symptom concept. Schizophr Bull 2009;35:5–8.CrossRefGoogle ScholarPubMed
Schultze-Lutter, F., Addington, J., Ruhrmann, S., Klosterkotter, J.The schizophrenia proneness instrument: adult version (SPI-A). Rome: Giovanni Fiority Editore; 2007.Google Scholar
Schultze-Lutter, F., Steinmeyer, E.M., Ruhrmann, S., Klosterkotter, J.. The dimensional structure of self-reported “prodromal” disturbances in schizophrenia. Clin Neuropsychiatr J Treat Eval 2008;5:140–150.Google Scholar
Schultze-Lutter, F., Ruhrmann, S., Berning, J., Maier, W., Klosterkotter, J.. Basic symptoms and ultra high risk criteria: symptom development in the initial prodromal state. Schizophr Bull 2010;36:182–191.CrossRefGoogle Scholar
Seikkula, J., Aaltonen, J., Rasingkangas, A., Alakare, B., Holma, J., Lehtinen, V.. Open-dialogue approach: treatment principles and preliminary results of a two year follow-up on first episode schizophrenia. Ethical Hum Sci Serv 2003;5:163–182.Google Scholar
Seikkula, J., Aaltonen, J., Alakare, B., Haarakangas, K., Keranen, J., Lehtinen, K.. Five-year experience of first episode non-affective psychosis in open-dialogue approach: Treatment principles, follow-up outcomes, and two case studies. Psychother Res 2006;16:214–228.CrossRefGoogle Scholar
Tabachnick, B., Fidell, L.Using multivariate statistics, 2nd ed., New York: Harper Collins; 1989.Google Scholar
Valmaggia, L.R., Stahl, D., Yung, A.R., Nelson, B., Fusar-Poli, P., McGorry, P.D., et al.Negative psychotic symptoms and impaired role functioning predict transition outcomes in the at-risk mental state: a latent class cluster analysis study. Psychol Med 2013;43:2311–2325.CrossRefGoogle ScholarPubMed
Van Os, J., McKenna, P.Does schizophrenia exist? Institute of Psychiatry, King's College London;. 2003.Google Scholar
Van Os, J., Gilvarry, C., Bale, R., Van Horn, E., Tattan, T., White, I., et al.A comparison of the utility of dimensional and categorical representations of psychosis. Psychol Med 1999;29:595–606.CrossRefGoogle Scholar
van Os, J., Hanssen, M., Bijl, R.V., Ravelli, A.. Strauss (1969) revisited: a psychosis continuum in the general population?. Schizophr Res 2000;45:11–20.CrossRefGoogle ScholarPubMed
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;39:179–195.CrossRefGoogle ScholarPubMed
Vollema, M.G., Vandenbosch, R.J.. The multidimensionality of schizotypy. Schizophr Bull 1995;21:19–31.CrossRefGoogle ScholarPubMed
Ward, T.A., Gaynor, K.J., Hunter, M.D., Woodruff, P.W.R., Garety, P.A., Peters, E.R.. Appraisals and responses to experimental symptom analogues in clinical and non-clinical individuals with psychotic experiences. Schizophr Bull 2014;40:845–855.CrossRefGoogle Scholar
Wechsler, D.Wechsler adult intelligence scale, 3rd Ed., San Antonio, TX: Harcourt Assessment; 1997.Google Scholar
Wickham, H., Walsh, C., Asherson, P., Taylor, C., Sigmundson, T., Gill, M., et al.Familiality of symptom dimensions in schizophrenia. Schizophr Res 2001;47:223–232.CrossRefGoogle Scholar
World Health Organisation International Classification of Diseases (ICD-10). Geneva: World Health Organisation; 1992.Google Scholar
Yung, A.R., Phillips, L.J., McGorry, P.D., McFarlane, C.A., Francey, S., Harrigan, S., et al.Prediction of psychosis – A step towards indicated prevention of schizophrenia. Br J Psychiat 1998;172:14–20.CrossRefGoogle ScholarPubMed
Yung, A.R., Yuen, H.P., McGorry, P.D., Phillips, L.J., Kelly, D., Dell’Olio, M., et al.Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust Nz J Psychiat 2005;39:964–971.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 Nz J Psychiat 2009;43:118–128.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.