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Liu L. The direct and indirect effects of the COVID-19 pandemic on the mental health of confined youth. HEALTH & JUSTICE 2024; 12:14. [PMID: 38589594 PMCID: PMC11003086 DOI: 10.1186/s40352-024-00267-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 03/13/2024] [Indexed: 04/10/2024]
Abstract
The COVID-19 pandemic posed an unprecedented threat to the mental health of youth due to its attendant, drastic changes in everyday life brought about by restrictions such as social distancing and the cancelation of in-person classes. Although numerous articles have discussed the impact of the pandemic on youths' mental health, most of them have been opinion pieces. This study used state-wide empirical data to quantify the direct and indirect effect of the pandemic on the mental health of confined youth, a vulnerable social group that is rarely represented in school survey data. Group comparisons of youth who entered juvenile justice facilities during pandemic and non-pandemic times were also conducted. Findings revealed that youth who entered residential facilities during the pandemic due to criminal offenses had higher rates of prior mental health problems and victimization. With major confounders controlled, multivariate regression results showed that the impact of the pandemic on confined youths' mental health is indirect: it conditioned the effect of underage drinking on the youths' mental health. Youth who were admitted into facilities during the pandemic were more likely to experience mental health problems than their peers who entered facilities during non-pandemic times. Implications for policymaking are discussed.
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Affiliation(s)
- Lin Liu
- Department of Sociology and Criminology & Law, University of Florida, Gainesville, FL, USA.
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2
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Xu B, Chen C, Wang D. Current Psychotic-Like Experiences Among Chinese College Students: Prevalence, Correlates, and Its Relationship with Suicidal Ideation. Psychol Res Behav Manag 2024; 17:799-811. [PMID: 38434958 PMCID: PMC10908336 DOI: 10.2147/prbm.s451889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Current psychotic-like experiences (PLEs) are prevalent among adolescents. However, epidemiological data on the prevalence rate of current PLEs among college students and its clinical correlates are scarce and limited. To address this study gap, this study aimed to investigate the prevalence and correlates of current PLEs among Chinese college students. Methods A cross-sectional study was designed with a sample of 18,578 college students in China. Each participant completed a survey on social-demographic characteristics variables, PLEs, sleep disturbance, depression, anxiety, and suicidal ideation. Logistic regression analyses were conducted to explore the influential factors for PLEs among all participants and suicidal ideation among those with PLEs. Results Among Chinese college students, 40.3% of the participants reported having at least one PLE in the past month, while 7.5% had frequent PLEs. Males, age, residence location in town, left-behind experiences, poor family economic status, chronic physical illness, family history of mental disorder, BMI ≥ 28 [obesity], sleep disturbance, depression, anxiety, and suicidal ideation were independent correlates for frequent PLEs. Furthermore, the prevalence of suicidal ideation among participants with frequent PLEs was 32.1%. Lower grades, sleep disturbance, depression, and anxiety were independent predictors of suicidal ideation among college students who experience PLEs frequently. Conclusion Current PLEs are widespread among Chinese college students. Suicidal ideation is largely prevalent among individuals who suffer frequent PLEs, suggesting that special measures and attention should be provided to these students based on relevant factors to prevent their suicidal ideation and behavior.
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Affiliation(s)
- Bingna Xu
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Chunping Chen
- Institute of Education, Xiamen University, Xiamen, People’s Republic of China
| | - Dongfang Wang
- School of Psychology, South China Normal University, Guangzhou, People’s Republic of China
- Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, People’s Republic of China
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Li R, Karukivi M, Lindblom J, Korja R, Karlsson L, Karlsson H, Nolvi S. Trajectories of COVID-19 pandemic-related depressive symptoms and potential predictors: the FinnBrain Birth Cohort Study. Soc Psychiatry Psychiatr Epidemiol 2024; 59:151-163. [PMID: 37668674 PMCID: PMC10799828 DOI: 10.1007/s00127-023-02559-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE In the context of the COVID-19 pandemic, mental health problems have been reported, and parents of young children may be more vulnerable to psychological distress due to increased caregiving responsibilities. However, research on the heterogeneity of the longitudinal course of psychological symptoms during the pandemic and the predispositions linked with these courses is still scarce. This study aimed to identify differential trajectories of depressive symptoms among the parents of young children and investigate the role of temperament traits, alexithymia, and coping styles in the heterogeneity of the symptom trajectories. METHODS The sample consists of 844 parents from the FinnBrain Birth Cohort Study. Latent growth mixture modeling was utilized to identify trajectories of depressive symptoms from pre-pandemic between 2014 and 2019 (T0, the closest available measurement was used) to May/June 2020 (T1) and December 2020 (T2) during the pandemic. Multinomial logistic regression was used to examine temperament, alexithymia, and coping as predictors of symptom trajectories, controlling for various background factors. RESULTS Four trajectories of depressive symptoms were identified. Most parents experienced low and stable depressive symptoms. Negative affect, effortful control, alexithymia, emotion-diverting coping (self-distraction and venting), and avoidant coping (denial and behavioral disengagement) were predictors for subclinical stable depressive symptoms. Constructive coping (positive reframing, acceptance, and humor) protected the cohort parents from increasing or moderately high depressive symptoms. CONCLUSIONS The findings have implications for identifying vulnerable individuals with specific traits and strengthening of constructive coping strategies as possible foci in interventions for depression during global crises.
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Affiliation(s)
- Ru Li
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland.
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Max Karukivi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Adolescent Psychiatry, University of Turku and Turku University Hospital, Turku, Finland
| | - Jallu Lindblom
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Riikka Korja
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Linnea Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Pediatrics and Adolescent Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Hasse Karlsson
- Department of Psychiatry, University of Turku and Turku University Hospital, Medisiina A, Kiinamyllynkatu 8-10, Turku, Finland
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Saara Nolvi
- FinnBrain Birth Cohort Study, Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Institute for Advanced Studies, University of Turku, Turku, Finland
- Department of Medical Psychology, Charité Universitätsmedizin, Berlin, Germany
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
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Rinaldi G, Osman N, Kaess M, Schimmelmann BG, Kindler J, Schultze-Lutter F, Michel C. Exploring the complex relationships between coping strategies, locus of control and self-esteem with psychopathology: structural equation modeling with a special focus on clinical high-risk of psychosis. Eur Psychiatry 2023; 66:e88. [PMID: 37848406 PMCID: PMC10755569 DOI: 10.1192/j.eurpsy.2023.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Coping strategies, competence, and locus of control (LOC) beliefs are important predictors of mental health (MH). However, research into their complex interactions has produced mixed results. Our study investigated them further in the previously unexplored context of clinical high-risk (CHR) of psychosis. METHODS We tested six alternative structural equation models in a community sample (N = 523), hypothesizing a mediating role of coping and treating CHR symptoms as (i) an additional mediator or (ii) a specific outcome. Our measurement model included two latent factors of MH: (1) psychopathology (PP), consisting of presence of mental disorders, global and psychosocial functioning, and (2) self-rated health (SRH) status. RESULTS In the model with the best Akaike Information Criterion and the latent factors as outcome variables, maladaptive coping completely mediated the impact of maladaptive LOC on PP and SRH. Additionally, CHR symptoms partially mediated the effect of maladaptive coping on PP and SRH in the community sample, as long as sex was not entered into the model. In the clinical sample (N = 371), the model did not support a mediation by CHR symptoms, despite significant pathways with both coping and MH outcomes; further, competence beliefs directly impacted SRH. CONCLUSIONS Coping strategies are an important intervention target for MH promotion, especially in the community. In clinical populations, interventions focusing on coping strategies may improve CHR symptoms, thus potentially supporting better MH, especially SRH. Additionally, due to their mostly cascading effects on MH, improving competence and LOC beliefs may also promote psychological well-being.
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Affiliation(s)
- Giulia Rinaldi
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Naweed Osman
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Benno G. Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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Stickley A, Shirama A, Sumiyoshi T. Psychotic experiences, perceived stress, and suicidal ideation among the general population during the COVID-19 pandemic: Findings from Japan. Schizophr Res 2023; 260:49-55. [PMID: 37625223 DOI: 10.1016/j.schres.2023.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/16/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Psychotic experiences (PEs) have been linked to suicidality. However, little is known about the mechanisms underlying this association. This cross-sectional study examined the role of perceived stress in the association between PEs and suicidal ideation in the general population during the COVID-19 pandemic, which has been linked to high levels of stress and an increase in suicidal behavior. METHODS Data were analyzed from an online sample of 1452 Japanese individuals aged 18 to 89 that were collected in February 2021. Information was obtained on past-year suicidal ideation and PEs, which were assessed with the PRIME Screen-Revised (PS-R). Perceived stress was measured with the Perceived Stress Scale (PSS-14). Logistic regression was used to examine associations. RESULTS In an analysis adjusted for sociodemographic factors, PEs were associated with 2.4 times higher odds for past-year suicidal ideation. However, further adjusting the analysis for mental health (depressive symptoms) attenuated the association (OR: 1.49, 95%CI: 0.76-2.93). In an analysis adjusted for mental health, individuals with PEs and perceived stress had significantly higher odds for suicidal ideation (OR: 4.77, 95%CI: 1.83-12.44), while PEs without perceived stress were not linked to suicidal thoughts (OR: 0.47, 95%Cl: 0.13-1.77). A further analysis showed that stress mediated the PEs-suicidal ideation association. CONCLUSIONS Self-perceived stress plays an important role in the association between PEs and suicidal ideation. The detection and management of stress in people with PEs may help prevent negative outcomes such as suicidal thoughts and behaviors in this population.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
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Luo X, Yu T, Yang Z, Wang D. Psychotic-Like Experiences and Suicidal Ideation Among Adolescents: The Chain Mediating Role of Insomnia Symptoms and Resilience. Psychol Res Behav Manag 2023; 16:3519-3530. [PMID: 37675191 PMCID: PMC10478937 DOI: 10.2147/prbm.s426363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
Background Individuals who experience psychotic-like experiences (PLEs) are at significant risk of suicide-related behaviors. This two-wave longitudinal study aimed to investigate the relationships among PLEs, insomnia symptoms, resilience, and suicidal ideation (SI) among adolescents. Methods A total of 2231 college students [mean age (standard deviation) = 20.02 (1.39) years] completed two web-based surveys. Participants completed self-report measures of sample characteristics, PLEs, insomnia symptoms, resilience, and SI. Results The findings indicated a significantly positive correlation between PLEs and SI that was sequentially mediated by insomnia symptoms and resilience. Furthermore, insomnia symptoms and resilience played a chain-mediating role between PLEs and adolescent SI. Conclusion These findings suggest potential mechanism for the PLEs-SI link, which helps us better understand how PLEs can influence individual SI and provides important information for early prevention.
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Affiliation(s)
- Xi Luo
- School of Educational Science, Hunan Normal University, Changsha, Hunan Province, People’s Republic of China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha, Hunan Province, People’s Republic of China
- Hunan First Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Taowen Yu
- Department of Applied Psychology, Changsha Normal University, Changsha, Hunan Province, People’s Republic of China
| | - Zilu Yang
- College of Education, Hunan Agricultural University, Changsha, Hunan Province, People’s Republic of China
| | - Dongfang Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Centre for Studies of Psychological Applications, School of Psychology, South China Normal University, Guangzhou, Guangdong Province, People’s Republic of China
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Havers L, von Stumm S, Cardno AG, Freeman D, Ronald A. Psychotic experiences and negative symptoms from adolescence to emerging adulthood: developmental trajectories and associations with polygenic scores and childhood characteristics. Psychol Med 2023; 53:5685-5697. [PMID: 36189779 PMCID: PMC10482726 DOI: 10.1017/s0033291722002914] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Psychotic experiences and negative symptoms (PENS) are common in non-clinical populations. PENS are associated with adverse outcomes, particularly when they persist. Little is known about the trajectories of PENS dimensions in young people, nor about the precursory factors associated with these trajectories. METHODS We conducted growth mixture modelling of paranoia, hallucinations, and negative symptoms across ages 16, 17, and 22 in a community sample (N = 12 049-12 652). We then described the emergent trajectory classes through their associations with genome-wide polygenic scores (GPS) for psychiatric and educational phenotypes, and earlier childhood characteristics. RESULTS Three trajectory classes emerged for paranoia, two for hallucinations, and two for negative symptoms. Across PENS, GPS for clinical help-seeking, major depressive disorder, and attention deficit hyperactivity disorder were associated with increased odds of being in the most elevated trajectory class (OR 1.07-1.23). Lower education GPS was associated with the most elevated trajectory class for hallucinations and negative symptoms (OR 0.77-0.91). Conversely for paranoia, higher education GPS was associated with the most elevated trajectory class (OR 1.25). Trajectory class associations were not significant for schizophrenia, obsessive-compulsive disorder, bipolar disorder, or anorexia GPS. Emotional/behaviour problems and life events in childhood were associated with increased odds of being in the most elevated trajectory class across PENS. CONCLUSIONS Our results suggest latent heterogeneity in the development of paranoia, hallucinations, and negative symptoms in young people that is associated with specific polygenic scores and childhood characteristics.
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Affiliation(s)
- Laura Havers
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
| | | | - Alastair G. Cardno
- Division of Psychological and Social Medicine, University of Leeds, Leeds, UK
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Angelica Ronald
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Staines L, Healy C, Murphy F, Byrne J, Murphy J, Kelleher I, Cotter D, Cannon M. Incidence and Persistence of Psychotic Experiences in the General Population: Systematic Review and Meta-Analysis. Schizophr Bull 2023; 49:1007-1021. [PMID: 37402250 DOI: 10.1093/schbul/sbad056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND AND HYPOTHESIS Psychotic experiences (PEs) are associated with increased risk for mental disorders, in particular persistent PEs. PEs therefore might be useful within intervention research. We sought to systematically determine the incidence and persistence of PEs in the general population. STUDY DESIGN A double-blind search of databases (Embase, Pubmed PMC, Psychinfo, Medline, and Web of Science) from inception to January 2023 and data extraction, were conducted. Study quality was assessed using the NIH assessment tool. Random effects models were conducted to calculate pooled incidence rate per person-year and proportion of persistent PEs per year. Age and study design were all examined using subgroup analyses. Demographic, risk factors, and outcomes for incidence and persistence of PEs were reported in a narrative synthesis. STUDY RESULTS Using a double-blind screening method for abstract (k = 5763) and full text (k = 250) were screened. In total 91 samples from 71 studies were included, of which 39 were included in a meta-analysis (incidence: k = 17, n = 56 089; persistence: k = 22, n = 81 847). Incidence rate was 0.023 per person-year (95% CI [0.0129;0.0322]). That is, for every 100 people, 2 reported first onset PEs in a year. This was highest in adolescence at 5 per 100(13-17 years). The pooled persistence rate for PEs was 31.0% (95% CI [26.65,35.35]) This was highest in adolescence at 35.8%. Cannabis was particularly associated with incidence of PEs, and persistence of PEs were associated with multiple mental disorders. CONCLUSIONS Each year incidence of PEs is 2 of every 100 people, and persists each year in 31% of cases, this risk is highest in adolescents.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Felim Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Jonah Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Jennifer Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Ian Kelleher
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH10 5HF, UK
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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Steenkamp LR, de Neve-Enthoven NGM, João AM, Bouter DC, Hillegers MHJ, Hoogendijk WJG, Blanken LME, Kushner SA, Tiemeier H, Grootendorst-van Mil NH, Bolhuis K. Psychotic experiences, suicidality and non-suicidal self-injury in adolescents: Independent findings from two cohorts. Schizophr Res 2023; 257:50-57. [PMID: 37285715 DOI: 10.1016/j.schres.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/10/2023] [Accepted: 05/06/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prior studies have shown that psychotic experiences are prospectively associated with an increased risk of suicidality. However, it is unclear whether this association is causal or arises from shared risk factors. Furthermore, little is known about the association between psychotic experiences and non-suicidal self-injury (NSSI). METHODS We used data from two independent samples of young adolescents, which we analyzed separately. In a population-based cohort, data on hallucinatory experiences and suicidality were collected at ages 10 and 14 years (N = 3435). In a cross-sectional study of a population oversampled for elevated psychopathology levels, psychotic experiences, suicidality, and NSSI were assessed at age 15 years (N = 910). Analyses were adjusted for sociodemographic covariates, maternal psychopathology, intelligence, childhood adversity, and mental health problems. RESULTS Psychotic experiences were prospectively associated with an increased risk of suicidality, even when considering self-harm ideation at baseline. Furthermore, persistent and incident, but not remittent, patterns of psychotic experiences were related to an increased burden of suicidality. Self-harm ideation was also prospectively associated with the risk for psychotic experiences, although of smaller magnitude and only by self-report. Among at-risk adolescents, psychotic experiences were cross-sectionally associated with a greater burden of suicidality and a higher frequency of NSSI events, with more extensive tissue damage. CONCLUSION Psychotic experiences are longitudinally associated with suicidality beyond the effects of shared risk factors. We also found modest support for reverse temporality, which warrants further investigation. Overall, our findings highlight the importance of assessing psychotic experiences as an index of risk for suicidality and NSSI.
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Affiliation(s)
- Lisa R Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | - Amanda Moreira João
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Diandra C Bouter
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Laura M E Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
| | | | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
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Rep C, Dubertret C, Pignon B, Sleurs D, Tebeka S, Le Strat Y. Psychotic-like experiences in general population: Psychiatric comorbidity and impact on quality of life across lifespan. Schizophr Res 2023; 256:52-62. [PMID: 37150148 DOI: 10.1016/j.schres.2023.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/23/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND AND HYPOTHESIS In this study, we aimed to determine the prevalence of Psychotics-Like Experiences according to age group and their association with psychiatric disorders through these different age-group, as well as their impact on quality of life. STUDY DESIGN Using data from the second wave of the NESARC, a large general population study, we considered 6 mutually exclusive groups according to the age at the interview: 20-29 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; 70+ years. We determined the frequency of PLEs defined as positive, negative, depressive, mania and disorganization symptoms with reference to the PANSS, and the association between the presence of PLEs in the previous year and the presence of lifetime psychiatric disorders and quality of life across different age groups. STUDY RESULTS The prevalence of PLEs decreased across age from a 34.7 % in the 20-29 years age group, to 19.7 % in the 70+ years age group. Across all age groups, individuals who reported PLEs in the previous year had higher risk of having any psychiatric disorder, (i.e any mood disorder, any anxiety disorder any substance abuse and any personality disorder) compared to individuals not reporting PLEs. All dimensions of quality of life on the SF12 scale were negatively associated with the presence of a PLE regardless of age group. CONCLUSION We found that the frequency of PLEs decreased with age and that the presence of PLE is associated with psychiatric disorders and with impaired quality of life in all age groups.
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Affiliation(s)
- Cécile Rep
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France.
| | - Caroline Dubertret
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France
| | - Baptiste Pignon
- Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique, Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie, Créteil, France Fondation FondaMental, fondation de cooperation scientifique, Créteil, France
| | - David Sleurs
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France
| | - Sarah Tebeka
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France
| | - Yann Le Strat
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, France
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YÜCE Z, ŞİMŞEK N. Psychosocial Support Programs and Telepsychiatry Services Implemented in the World and Türkiye during the Pandemic. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1079919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
In this study, which addresses the psychosocial dimension of the COVID-19 pandemic, it is seen that the pandemic has increased the frequency of anxiety, anxiety, fear, and depression in the society. In this process in the world and in Türkiye, the majority of psychosocial support programs and mental health services are provided on online platforms and the frequency of use of telepsychiatry services has increased. In this study, Google Scholar and Pub Med were scanned and relevant domestic and international studies were examined. The aim of this article was to draw attention to the innovations brought about by the epidemic in the provision of mental health services to people and suggestions were made in order to contribute to the relevant literature.
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Ho CSH, Chua J, Tay GWN. The diagnostic and predictive potential of personality traits and coping styles in major depressive disorder. BMC Psychiatry 2022; 22:301. [PMID: 35484526 PMCID: PMC9047339 DOI: 10.1186/s12888-022-03942-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/11/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals. METHODS Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals. RESULTS Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD. CONCLUSIONS Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.
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Affiliation(s)
- Cyrus S. H. Ho
- grid.410759.e0000 0004 0451 6143Department of Psychological Medicine, National University Health System, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J. Chua
- grid.4280.e0000 0001 2180 6431Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore, Singapore
| | - Gabrielle W. N. Tay
- grid.410759.e0000 0004 0451 6143Department of Psychological Medicine, National University Health System, Singapore, Singapore
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Yates K, Lång U, Peters EM, Wigman JTW, McNicholas F, Cannon M, DeVylder J, Ramsay H, Oh H, Kelleher I. Hallucinations in the general population across the adult lifespan: prevalence and psychopathologic significance. Br J Psychiatry 2021; 219:652-658. [PMID: 35048871 DOI: 10.1192/bjp.2021.100] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Community studies have found a relatively high prevalence of hallucinations, which are associated with a range of (psychotic and non-psychotic) mental disorders, as well as with suicidal ideation and behaviour. The literature on hallucinations in the general population has largely focused on adolescents and young adults. AIMS We aimed to explore the prevalence and psychopathologic significance of hallucinations across the adult lifespan. METHOD Using the 1993, 2000, 2007 and 2014 cross-sectional Adult Psychiatric Morbidity Survey series (N = 33 637), we calculated the prevalence of past-year hallucinations in the general population ages 16 to ≥90 years. We used logistic regression to examine the relationship between hallucinations and a range of mental disorders, suicidal ideation and suicide attempts. RESULTS The prevalence of past-year hallucinations varied across the adult lifespan, from a high of 7% in individuals aged 16-19 years, to a low of 3% in individuals aged ≥70 years. In all age groups, hallucinations were associated with increased risk for mental disorders, suicidal ideation and suicide attempts, but there was also evidence of significant age-related variation. In particular, hallucinations in older adults were less likely to be associated with a cooccurring mental disorder, suicidal ideation or suicide attempt compared with early adulthood and middle age. CONCLUSIONS Our findings highlight important life-course developmental features of hallucinations from early adulthood to old age.
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Affiliation(s)
- Kathryn Yates
- Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland
| | - Ulla Lång
- Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland
| | - Evyn M Peters
- Department of Psychiatry, University of Saskatchewan, Canada
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, The Netherlands
| | - Fiona McNicholas
- School of Medicine and Medical Sciences, University College Dublin, Ireland; Lucena Clinic Services, Child and Adolescent Mental Health Service of St. John of God Community Services, Ireland; and Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, USA
| | - Hugh Ramsay
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Finland; and Department of Psychiatry, Trinity College, Ireland
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, California, USA
| | - Ian Kelleher
- School of Medicine and Medical Sciences, University College Dublin, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland, Ireland; and Lucena Clinic Services, Child and Adolescent Mental Health Service of St. John of God Community Services, Ireland
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Carey E, Gillan D, Healy C, Dooley N, Campbell D, McGrane J, O'Neill A, Coughlan H, Clarke M, Kelleher I, Cannon M. Early adult mental health, functional and neuropsychological outcomes of young people who have reported psychotic experiences: a 10-year longitudinal study. Psychol Med 2021; 51:1861-1869. [PMID: 32216843 DOI: 10.1017/s0033291720000616] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Psychotic experiences (PE) are highly prevalent in childhood and are known to be associated with co-morbid mental health disorders and functional difficulties in adolescence. However, little is known about the long-term outcomes of young people who report PE. METHODS As part of the Adolescent Brain Development Study, 211 young people were recruited in childhood (mean age 11.7 years) and underwent detailed clinical interviews, with 25% reporting PE. A 10 year follow-up study was completed and 103 participants returned (mean age 20.9 years). Structured clinical interviews for DSM-5 (SCID-5) and interviewer-rated assessments of functioning were conducted. A detailed neuropsychological battery was also administered. Analyses investigated group differences between those who had ever reported PE and controls in early adulthood. RESULTS The PE group was at a significantly higher risk of meeting DSM-5 criteria for a current (OR 4.08, CI 1.16-14.29, p = 0.03) and lifetime psychiatric disorder (OR 3.27, CI 1.43-7.47, p = 0.005). They were also at a significantly higher risk of multi-morbid lifetime psychiatric disorders. Significantly lower scores on current social and global functioning measures were observed for the PE group. Overall, there were no differences in neuropsychological performance between groups apart from significantly lower scores on the Stroop Word task and the Purdue Pegboard task for the PE group. CONCLUSIONS Our findings suggest that reports of PE are associated with poorer mental health and functional outcomes in early adulthood, with some persisting cognitive and motor deficits. Young people who report such symptoms could be considered a target group for interventions to aid functional outcomes.
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Affiliation(s)
- Eleanor Carey
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Diane Gillan
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
| | - Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Dónal Campbell
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Josen McGrane
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
| | - Aisling O'Neill
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
- Trinity College Institute of Neuroscience, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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15
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Affiliation(s)
- Ian Kelleher
- School of Medicine, University College Dublin, Dublin, Ireland
- Lucena Clinic, Rathgar, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Beaumont Hospital, Dublin, Ireland
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McMahon EM, Corcoran P, Keeley H, Clarke M, Coughlan H, Wasserman D, Hoven CW, Carli V, Sarchiapone M, Healy C, Cannon M. Risk and protective factors for psychotic experiences in adolescence: a population-based study. Psychol Med 2021; 51:1220-1228. [PMID: 32026792 DOI: 10.1017/s0033291719004136] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) are reported by a significant minority of adolescents and are associated with the development of psychiatric disorders. The aims of this study were to examine associations between PEs and a range of factors including psychopathology, adversity and lifestyle, and to investigate mediating effects of coping style and parental support on associations between adversity and PEs in a general population adolescent sample. METHOD Cross-sectional data were drawn from the Irish centre of the Saving and Empowering Young Lives in Europe study. Students completed a self-report questionnaire and 973 adolescents, of whom 522 (53.6%) were boys, participated. PEs were assessed using the 7-item Adolescent Psychotic Symptom Screener. RESULTS Of the total sample, 81 (8.7%) of the sample were found to be at risk of PEs. In multivariate analysis, associations were found between PEs and number of adverse events reported (OR 4.48, CI 1.41-14.25; p < 0.011), maladaptive/pathological internet use (OR 2.70, CI 1.30-5.58; p = 0.007), alcohol intoxication (OR 2.12, CI 1.10-4.12; p = 0.025) and anxiety symptoms (OR 4.03, CI 1.57-10.33; p = 0.004). There were small mediating effects of parental supervision, parental support and maladaptive coping on associations between adversity and PEs. CONCLUSION We have identified potential risk factors for PEs from multiple domains including adversity, mental health and lifestyle factors. The mediating effect of parental support on associations between adversity and PEs suggests that poor family relationships may account for some of this mechanism. These findings can inform the development of interventions for adolescents at risk.
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Affiliation(s)
- Elaine M McMahon
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University CollegeCork, Ireland
| | - Paul Corcoran
- National Suicide Research Foundation, Cork, Ireland
- School of Public Health, University CollegeCork, Ireland
| | - Helen Keeley
- Child and Adolescent Mental Health Services North Cork, Health Service Executive, Ireland
| | - Mary Clarke
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Dept of Child and Adolescent Psychiatry, New York State Psychiatric Institute; Dept of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental lll-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Marco Sarchiapone
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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Fekih-Romdhane F, Dissem N, Cheour M. How did Tunisian university students cope with fear of COVID-19? A comparison across schizotypy features. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 178:110872. [PMID: 33814659 PMCID: PMC8009054 DOI: 10.1016/j.paid.2021.110872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 11/23/2022]
Abstract
Background Little consideration has been given to the impact of COVID-19 on people at risk of psychosis despite their particular preexisting vulnerability. We aimed to examine the role of coping strategies in determining the levels of fear in nonclinical students with high levels of self-reported schizotypal personality traits as compared to low-schizotypy controls. Method This was a cross-sectional survey. The Schizotypal Personality Questionnaire, the Fear of COVID-19 Scale and The Brief-Coping Orientation to Problems Experienced were used. Results High-schizotypy students had significantly higher maladaptive strategies scores and higher levels of fear of COVID-19 as compared to low-schizotypy students. Multivariate analyses have shown that high-schizotypy individuals were likely to rely on coping responses that are maladaptive (venting) and have potential exacerbating effects on fear of COVID-19, whereas low-schizotypy individuals were likely to use adaptive responses (acceptance) that seemed to be effective in reducing fear of COVID-19. Conclusion This study provided preliminary cross-sectional evidence for a differential impact of COVID-19 on individuals according to their schizotypy features. However, larger longitudinal population-based studies are necessary to confirm our findings.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia.,Razi Hospital, Mannouba, Tunisia
| | - Nouha Dissem
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia.,Razi Hospital, Mannouba, Tunisia
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Taylor JH, Calkins ME, Gur RE. Markers of Psychosis Risk in the General Population. Biol Psychiatry 2020; 88:337-348. [PMID: 32220500 DOI: 10.1016/j.biopsych.2020.02.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/17/2019] [Accepted: 02/05/2020] [Indexed: 12/17/2022]
Abstract
The categorical approach to defining schizophrenia spectrum disorders requires meeting established criteria. To advance early identification and intervention in young people, the field has progressed to studying help-seeking individuals who are at clinical high risk based on subthreshold psychosis spectrum symptoms, and criteria have been articulated for qualifying individuals as at risk. A broader dimensional examination of psychosis has been applied to population-based studies on non-help seekers. This review highlights the ascertainment and assessment approaches to such population-based studies. Most studies are cross-sectional and rely on questionnaires with limited overlap of tools. However, several consistent findings emerge on symptoms, neurocognitive deficits, and neuroimaging parameters and other biomarkers associated with emergence and persistence of psychotic features. The findings are consistent with the literature on abnormalities associated with schizophrenia, including the presence of neurocognitive deficits; abnormalities in brain structure, function, and connectivity that are related to distress; impairment; and functional outcome. These findings support the validity of studying psychosis experiences during development in a way that can chart the emergence of psychosis in the context of general psychopathology. Such studies are necessary for establishing developmental trajectories that characterize this emergence and for identifying risk and resilience biomarkers moderating or modulating the full range of schizophrenia-related manifestations. More community-based studies are needed, with better standardization and harmonization of measures and incorporating longitudinal follow-up, to establish mechanistic links between cellular-molecular aberrations and specific manifestations of psychosis as envisioned by the precision medicine agenda.
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Affiliation(s)
- Jerome H Taylor
- Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Monica E Calkins
- Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Lifespan Brain Institute, Penn Medicine and Children's Hospital of Philadelphia, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, and Department of Psychiatry, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
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Liu J, Lim MSM, Ng BT, Chong SA, Subramaniam M, Mahendran R. Global emotion dysregulation and maladaptive cognitive emotion regulation strategies mediate the effects of severe trauma on depressive and positive symptoms in early non-affective psychosis. Schizophr Res 2020; 222:251-257. [PMID: 32473932 DOI: 10.1016/j.schres.2020.05.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 02/06/2020] [Accepted: 05/16/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous research has shown that childhood trauma contributes to the onset and maintenance of psychosis. However, few studies have accounted for the effects of lifetime trauma and post-traumatic stress disorder (PTSD), and none have examined the mediating role of emotion dysregulation in symptom maintenance after severe trauma. The purpose of this study is to determine whether maladaptive cognitive emotion regulation strategies (CERS) and global emotion dysregulation mediate the effects of probable PTSD on depressive symptoms, and whether this pathway extends to influence positive symptoms in patients with early non-affective psychotic disorders. METHODS A total of 150 outpatients with early non-affective psychosis were assessed for trauma exposure, DSM-5 PTSD symptoms, CERS, global emotion dysregulation, and current depressive and positive symptoms. Parallel and serial mediation analyses based on ordinary least squares regressions were used to test the hypothesized models. RESULTS Mediation analyses controlling for gender, psychiatric comorbidities, antipsychotic medication dosage, duration of untreated psychosis (DUP), family history of mental illness, and cumulative trauma revealed that maladaptive CERS (rumination, catastrophic thinking, and self-blame) and global emotion dysregulation mediated the effects of probable PTSD on depressive symptoms (R2 = 41%), while maladaptive CERS, global emotion dysregulation, and depressive symptoms mediated the effects of probable PTSD on positive symptoms (R2 = 30%). CONCLUSIONS Our results demonstrate the indirect effects of maladaptive CERS and global emotion dysregulation on maintaining depressive and positive symptoms. Emotion dysregulation may be a potential transdiagnostic treatment target to alleviate depressive and positive symptoms in traumatized patients with early non-affective psychosis.
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Affiliation(s)
- Jianlin Liu
- Department of Psychological Medicine, National University of Singapore, Singapore; Research Division, Institute of Mental Health, Singapore.
| | | | - Boon Tat Ng
- Pharmacy Department, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | | | - Rathi Mahendran
- Department of Psychological Medicine, National University of Singapore, Singapore; Academic Development Department, Duke-NUS Medical School, Singapore
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Prevalence and psychiatric correlates of suicidal ideation in UK university students. J Affect Disord 2020; 272:191-197. [PMID: 32379615 DOI: 10.1016/j.jad.2020.03.185] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/16/2020] [Accepted: 03/30/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Evidence highlights increased susceptibility to thoughts and behaviors related to suicide (i.e. suicidal ideation) in the student population, often in co-occurrence with mental health difficulties. Typically, studies focus on specific symptoms, with few providing comprehensive examination of risk factors. In this study we examined the prevalence of suicidal ideation among UK university students and assessed the association with multiple psychiatric risk factors. METHODS A total of N = 1273 students completed online measures of suicidal ideation, anxiety, depression, insomnia, mania, psychosis, and perceived stress. RESULTS 37.3% students were classified as high-risk for suicidal behaviour. Moreover, 42.2% of students contemplated suicide at least once within the past twelve months, and 25.1% reported telling someone about these thoughts at least once. Logistic regression analysis showed that suicidal ideation was significantly associated with symptoms of depression, mania, psychosis, and stress. LIMITATIONS The cross-sectional nature of ours study does not allow us to infer causality in the observed associations. CONCLUSIONS Our results indicate the prevalence of suicidal ideation in a large sample of university students in the UK, and highlight associated mental health risk factors associated with it. Our findings have implications for mental health practitioners working with University students.
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Riera-López de Aguileta I, Vila-Badia R, Usall J, Butjosa A, Ochoa S. Coping strategies in first-episode psychosis: A systematic review. Early Interv Psychiatry 2020; 14:252-262. [PMID: 31318154 DOI: 10.1111/eip.12847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 06/09/2019] [Indexed: 12/12/2022]
Abstract
AIMS This paper reviews and discusses the published information on coping strategies in people with a first-episode psychosis (FEP). The objective is to update knowledge about coping strategies used by people with a FEP, to compare these strategies with those used by other mental disorders, and to examine the relationship between coping strategies and other variables in FEP. METHOD A search was conducted using PsycINFO, MEDLINE and PSICODOC between 1995 and 2018 using the following terms: coping strategies or Adaptation, Psychological and FEP. RESULTS A total of 167 studies were found, of which 14 were selected for review. The results suggest the need for a multiple and integrated approach, since there are several factors that are involved in the coping strategies (eg, socio-demographic, clinical and psychological variables) used in the different profiles of psychotic spectrum, specifically in FEP. CONCLUSIONS The role of coping skills is an important issue in psychopathological research in addition to clinical outcome, especially from the point of view of the patients, their social context and their recovery. Moreover, personalized therapies addressed to personal recovery should be considered to develop better coping specifically addressed to patients' needs.
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Affiliation(s)
| | | | - Judith Usall
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Anna Butjosa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Susana Ochoa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
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Prochwicz K, Kłosowska J, Dembińska A. The Mediating Role of Stress in the Relationship Between Attention to Threat Bias and Psychotic-Like Experiences Depends on Coping Strategies. Front Psychiatry 2020; 11:307. [PMID: 32411023 PMCID: PMC7200982 DOI: 10.3389/fpsyt.2020.00307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/27/2020] [Indexed: 11/16/2022] Open
Abstract
AIM Recent studies have provided evidence that enhanced stress level is associated with the increase of psychotic symptoms in both clinical and non-clinical populations. It has also been demonstrated that cognitive biases contribute to psychotic experiences. However, it remains unclear whether the effect of cognitive biases and perceived stress on psychotic-like experiences (PLEs) is influenced by coping methods. In the present study we examined whether the relationship linking cognitive biases with PLEs is mediated by the level of stress and whether particular coping methods modify the relationship between stress and PLEs. METHODS The study sample consisted of 290 non-clinical subjects; study variables were assessed by questionnaires. Moderated mediation analyses were conducted. RESULTS Perceived stress was found to serve as a partial mediator in the relationship linking attention to threat (ATB) and external attribution biases (ETB) with psychotic-like experiences. Also, moderated mediation analysis revealed that the indirect effect of attention to threat bias on positive and depressive symptoms of psychotic-like experiences via perceived stress was stronger at higher levels of distraction seeking coping. Moreover, the indirect effect of ATB on depressive symptoms was moderated by task-oriented coping and emotion-oriented coping. Task-oriented coping also moderated the indirect effect of ETB on depression. CONCLUSION The findings imply that both perceived stress and coping styles are important factors affecting the association between cognitive biases and psychotic-like experiences.
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Affiliation(s)
| | - Joanna Kłosowska
- Institute of Psychology, Jagiellonian University, Krakow, Poland
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23
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Yates K, Lång U, Cederlöf M, Boland F, Taylor P, Cannon M, McNicholas F, DeVylder J, Kelleher I. Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths: A Systematic Review and Meta-analysis of Longitudinal Population Studies. JAMA Psychiatry 2019; 76:180-189. [PMID: 30484818 PMCID: PMC6439738 DOI: 10.1001/jamapsychiatry.2018.3514] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
IMPORTANCE Recent research has highlighted that psychotic experiences are far more prevalent than psychotic disorders and associated with the full range of mental disorders. A particularly strong association between psychotic experiences and suicidal behavior has recently been noted. OBJECTIVE To provide a quantitative synthesis of the literature examining the longitudinal association between psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide deaths in the general population. DATA SOURCES We searched PubMed, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO from their inception until September 2017 for longitudinal population studies on psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death. STUDY SELECTION Two authors searched for original articles that reported a prospective assessment of psychotic experiences and suicidal ideation, suicide attempts, or suicide death in general population samples, with at least 1 follow-up point. DATA EXTRACTION AND SYNTHESIS Two authors conducted independent data extraction. Authors of included studies were contacted for information where necessary. We assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. We calculated pooled odds ratios using a random-effects model. A secondary analysis assessed the mediating role of co-occurring psychopathology. MAIN OUTCOMES AND MEASURES Psychotic experiences and subsequent suicidal ideation, suicide attempts, and suicide death. RESULTS Of a total of 2540 studies retrieved, 10 met inclusion criteria. These 10 studies reported on 84 285 participants from 12 different samples and 23 countries. Follow-up periods ranged from 1 month to 27 years. Individuals who reported psychotic experiences had an increase in the odds of future suicidal ideation (5 articles; n = 56 191; odds ratio [OR], 2.39 [95% CI,1.62-3.51]), future suicide attempt (8 articles; n = 66 967; OR, 3.15 [95% CI, 2.23-4.45]), and future suicide death (1 article; n = 15 049; OR, 4.39 [95% CI, 1.63-11.78]). Risk was increased in excess of that explained by co-occurring psychopathology: suicidal ideation (adjusted OR, 1.59 [95% CI, 1.09-2.32]) and suicide attempt (adjusted OR, 2.68 [95% CI, 1.71-4.21]). CONCLUSIONS AND RELEVANCE Individuals with psychotic experiences are at increased risk of suicidal ideation, suicide attempts, and suicide death. Psychotic experiences are important clinical markers of risk for future suicidal behavior.
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Affiliation(s)
- Kathryn Yates
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ulla Lång
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fiona Boland
- Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland,Data Science Centre and Department of General Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Peter Taylor
- Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiona McNicholas
- School of Medicine and Medical Sciences, University College Dublin, Belfield, Dublin, Ireland,Lucena Clinic St. John of God, Dublin, Ireland ,Department of Child Psychiatry, Our Lady’s Hospital for Sick Children, Dublin, Ireland
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, New York
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
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24
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Lee JY, Ban D, Kim SY, Kim JM, Shin IS, Yoon JS, Kim SW. Negative Life Events and Problematic Internet Use as Factors Associated With Psychotic-Like Experiences in Adolescents. Front Psychiatry 2019; 10:369. [PMID: 31191372 PMCID: PMC6549193 DOI: 10.3389/fpsyt.2019.00369] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/13/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: Psychotic-like experiences (PLEs) and problematic internet use (PIU) are common in adolescents. However, little is known about the association between PLEs and PIU among adolescents. The present study examined the associations between PLEs and PIU and negative life events among adolescents. Methods: In total, 1,678 adolescents attending high school were recruited for a cross-sectional survey. They completed self-reported assessments of PLEs using the Prodromal Questionnaire-16 (PQ-16) and measures of depression, anxiety, self-esteem, internet use, and negative life events using the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), the Rosenberg Self-Esteem Scale (RSES), the Korean Scale for Internet Addiction (K-scale), and the Lifetime Incidence of Traumatic Events for Children (LITE-C), including cybersexual harassment and school violence. Results: A total of 1,239 subjects (73.8%) scored at least 1 on the PQ-16. The mean total and distress PQ-16 scores were significantly higher in students who used mental health services. The total and distress prodromal questionnaire-16 (PQ-16) scores were positively correlated with the CES-D, STAI-S, STAI-T, LITE-C, and K-scale scores but negatively correlated with the RSES score. Hierarchical linear regression analysis revealed that PLEs were significantly associated with a high K-scale score and the incidence of negative life events, such as LITE-C, cybersexual harassment, and bully-victims. Conclusion: Our results demonstrate that PIU and negative life experiences were significantly associated with PLEs in adolescents. Assessment and therapeutic intervention with regard to internet use as a coping strategy for stress are needed to prevent the development of clinical psychotic symptoms.
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Affiliation(s)
- Ju-Yeon Lee
- Chonnam National University Medical School, Gwangju, South Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
| | - Dahye Ban
- Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
| | - Seon-Young Kim
- Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Chonnam National University Medical School, Gwangju, South Korea
| | - Il-Seon Shin
- Chonnam National University Medical School, Gwangju, South Korea
| | - Jin-Sang Yoon
- Chonnam National University Medical School, Gwangju, South Korea
| | - Sung-Wan Kim
- Chonnam National University Medical School, Gwangju, South Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
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25
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Abstract
Paranoid ideation is a core feature of psychosis, and models of paranoia have long proposed that it arises in the context of disturbances in the perception of the self. However, to develop targeted interventions, there is a benefit in clarifying further, which aspects of self-perception are implicated. Interpersonal sensitivity is a personality trait which has been associated with the risk of paranoid thinking in the general population. However, not all studies have found this link. We aimed to review the empirical literature assessing the association between interpersonal sensitivity and paranoia in both general population and clinical samples; and to explore if associations found differed depending on whether state or trait paranoia was assessed. The review followed PRISMA guidelines. Articles were identified through a literature search in OVID (PsychINFO, MEDLINE) and Web of Science up to December 2016. Fourteen studies with a total of 12 138 participants were included. All studies were of 'fair' or 'good' quality. A robust association was found between interpersonal sensitivity and paranoia in clinical and general population samples alike, regardless of the method of assessment of both paranoia and interpersonal sensitivity. Although this finding was more pronounced in studies of trait paranoia, it is likely that differences in study purpose, measurement, and power explain these differences. Findings from this review support the hypothesis that feelings of personal vulnerability and exaggerated socially evaluative concerns are central for both onset and maintenance of paranoid symptoms, suggesting avenues for future research in targeted interventions.
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Affiliation(s)
- Susanne F Meisel
- Department of Psychology,Institute of Psychology,Psychiatry and Neuroscience,King's College London,London,UK
| | - Philippa A Garety
- Department of Psychology,Institute of Psychology,Psychiatry and Neuroscience,King's College London,London,UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics,Institute of Psychology,Psychiatry and Neuroscience,King's College London,London,UK
| | - Lucia R Valmaggia
- Department of Psychology,Institute of Psychology,Psychiatry and Neuroscience,King's College London,London,UK
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26
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Hielscher E, Connell M, Lawrence D, Zubrick SR, Hafekost J, Scott JG. Prevalence and correlates of psychotic experiences in a nationally representative sample of Australian adolescents. Aust N Z J Psychiatry 2018; 52:768-781. [PMID: 29992826 DOI: 10.1177/0004867418785036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Despite growing literature on psychotic experiences, no nationally representative study has reported on the prevalence of both hallucinatory experiences and delusional experiences in Australian adolescents. Also, while many studies have examined the association between psychotic experiences and certain demographic and clinical correlates, there are more variables of interest to be investigated, including disordered eating behaviour and hours of sleep. The aims of this study were to examine (1) the prevalence of hallucinatory experiences and delusional experiences in Australian adolescents, and (2) the associations between different types of psychotic experiences with a broad range of demographic, clinical, and psychosocial variables. METHODS A random sample of Australian adolescents aged 14- to 17-year-olds were recruited in 2013-2014 as part of the Young Minds Matter Survey. Participants completed self-report questions regarding five different psychotic experience types (auditory and visual hallucinatory experiences, and thoughts read, special messages, spied upon) experienced in the past 12 months. Using logistic regression analyses, we investigated associations between psychotic experiences and demographic, clinical, and psychosocial factors. RESULTS The 12-month prevalence ranged from 3.3% (95% confidence interval = [2.6, 4.3]) for special messages to 14.0% (95% confidence interval = [12.3, 15.8]) for auditory hallucinatory experiences. At the bivariate level, each psychotic experience subtype was associated with increased likelihood of major depression, being bullied, psychological distress, low self-esteem, mental health service use and insufficient sleep (<8 hours per night). Multivariate analyses revealed both auditory and visual hallucinatory experiences were associated with an increased likelihood of four of these variables (depression, being bullied, service use, insufficient sleep), whereas associations with delusional experiences were inconsistent. CONCLUSION Hallucinatory and delusional experiences are common in Australian adolescents. Hallucinatory experiences, rather than delusional experiences, may be more clinically relevant in this demographic. When psychotic experiences are endorsed by adolescents, further assessment is indicated so as to ascertain more detail on the phenomenology of the experiences to better understand their clinical relevance.
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Affiliation(s)
- Emily Hielscher
- 1 Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,2 Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,3 School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Melissa Connell
- 1 Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,4 Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - David Lawrence
- 5 Graduate School of Education, The University of Western Australia, Perth, WA, Australia
| | - Stephen R Zubrick
- 6 Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.,7 Centre for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | - Jennifer Hafekost
- 5 Graduate School of Education, The University of Western Australia, Perth, WA, Australia
| | - James G Scott
- 1 Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,2 Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,4 Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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27
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Tsujino N, Tagata H, Baba Y, Kojima A, Yamaguchi T, Katagiri N, Nemoto T, Mizuno M. Survey of recognition and treatment of at-risk mental state by Japanese psychiatrists. Psychiatry Clin Neurosci 2018; 72:391-398. [PMID: 29485233 DOI: 10.1111/pcn.12647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 02/16/2018] [Accepted: 02/20/2018] [Indexed: 11/27/2022]
Abstract
AIM The importance of early intervention in psychiatry is widely recognized among psychiatrists. However, it is unknown whether precise knowledge of at-risk mental state has been disseminated. With this survey, we aimed to reveal how Japanese psychiatrists diagnose patients with at-risk mental state and prescribe treatment strategies for them. METHODS Using fictional case vignettes, we conducted a questionnaire survey of psychiatrists (n = 1399) who worked in Tokyo. We mailed study documents to all eligible participants in November 2015 with a requested return date in December. RESULTS Two hundred and sixty (19.3%) psychiatrists responded to the survey. Their correct diagnosis rates for the patients in the at-risk mental state vignettes were low (14.6% for the vignette describing at-risk mental state with attenuated positive symptom syndrome; 13.1% for the vignette describing at-risk mental state with brief intermittent psychotic syndrome). Many psychiatrists selected pharmacotherapy and antipsychotics to treat patients in the at-risk mental state vignettes. The psychiatrists who correctly diagnosed patients in the at-risk mental state vignettes had significantly fewer years of clinical psychiatric experience than did those who diagnosed them as having a non-at-risk mental state (12.5 years vs 22.7 years for the vignette describing at-risk mental state with attenuated positive symptom syndrome, P < 0.01; 14.3 years vs 22.2 years for the vignette describing at-risk mental state with brief intermittent psychotic syndrome, P < 0.01). CONCLUSION This study suggests that precise knowledge of at-risk mental state has not been disseminated among Japanese psychiatrists.
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Affiliation(s)
- Naohisa Tsujino
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan.,Department of Psychiatry, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan
| | - Hiromi Tagata
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Yoko Baba
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Akiko Kojima
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University School of Medicine, Tokyo, Japan
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28
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Diametric effects of autism tendencies and psychosis proneness on attention control irrespective of task demands. Sci Rep 2018; 8:8478. [PMID: 29855492 PMCID: PMC5981437 DOI: 10.1038/s41598-018-26821-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 05/15/2018] [Indexed: 11/09/2022] Open
Abstract
Our capacity to attend a target while ignoring irrelevant distraction impacts our ability to successfully interact with our environment. Previous reports have sometimes identified excessive distractor interference in both autism and schizophrenia spectrum disorders and in neurotypical individuals with high subclinical expressions of these conditions. Independent of task, we show that the direction of the effect of autism or psychosis traits on the suppression or rejection of a non-target item is diametrical. In Study 1, in which the presence of a salient non-target item hindered performance, higher autism traits were associated with better performance, while higher psychosis traits were associated with worse performance. In Study 2, in which the presence of a salient non-target item facilitated performance, a complete reversal of effects was observed. Future clinical interventions may be informed by the context-specific advantages we observed for the autism and psychosis spectra, and by the need to consider the diametric effects they yield.
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29
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Jolley S, Kuipers E, Stewart C, Browning S, Bracegirdle K, Basit N, Gin K, Hirsch C, Corrigall R, Banerjea P, Turley G, Stahl D, Laurens KR. The Coping with Unusual Experiences for Children Study (CUES): A pilot randomized controlled evaluation of the acceptability and potential clinical utility of a cognitive behavioural intervention package for young people aged 8-14 years with unusual experiences and emotional symptoms. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018. [PMID: 29527754 DOI: 10.1111/bjc.12176] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Health care guidelines recommend psychological interventions for childhood unusual experiences that are associated with distress or adverse functional impact (UEDs), based on adult, rather than child-specific, evidence. We report the first randomized controlled evaluation of the acceptability and potential clinical utility of cognitive behavioural therapy for childhood UEDs (CBT-UED). DESIGN Pilot randomized controlled trial. METHODS Participants aged 8-14 years were recruited from referrals to community services for children with emotional/behavioural problems and screened for self-reported UEDs. RESULTS Of around 1,000 referrals over 36 months, 304 (30%) were identified to the research team, 174 (57%) were successfully contacted, 110 (63%) consented to screening, 96 (87%) attended a screening assessment, and 51 (53%) reported UEDs. Forty-nine (96%) consented to randomization to either CBT-UED (9-12 weekly sessions of 40-50 min, adjunctive to usual care, n = 24) or treatment-as-usual/waitlist control (TAU/WL, n = 25). Childhood internalizing emotional symptoms (e.g., feeling 'nervous'/'scared'/'tearful'/'worried'/'sick'; proposed primary outcome), UEDs, depression, anxiety, and childhood psychopathology (secondary outcomes) were measured at baseline, at 12 weeks, and, where therapy was ongoing but incomplete (<12 sessions) at 12 weeks, at end-of-treatment (EOT). Twenty-two CBT-UED participants (92%) attended ≥5 sessions. Forty-four participants (90%) completed 12-week assessments (CBT-UED, n = 21/24, 88%; TAU/WL, n = 23/25, 92%). Preliminary findings were encouraging for emotional symptoms and UEDs, but otherwise mixed. CONCLUSIONS Retention, screening, and consent rates were as anticipated; recruitment took longer than planned. Trial procedures were acceptable to young people, their families, and clinicians. Therapy exceeded 12 weeks, but was well-received, with no serious adverse events attributed to participation. Further evaluation is needed. PRACTITIONER POINTS Around half of 8- to 14-year-olds in Child and Adolescent Mental Health Services reported distressing unusual experiences. An age-adapted cognitive behavioural intervention appears feasible, and safe to deliver, with the potential to augment standard care. This is a pilot study, and further evaluation is needed. Longer term outcomes should be a focus of future evaluation.
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Affiliation(s)
- Suzanne Jolley
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK.,National Institute for Health Research Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Catherine Stewart
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK.,South London and Maudsley NHS Foundation Trust, UK
| | | | | | - Nedah Basit
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK
| | | | - Colette Hirsch
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK.,National Institute for Health Research Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | | | - Grainne Turley
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - Daniel Stahl
- National Institute for Health Research Mental Health Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Kristin R Laurens
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, Queensland, Australia.,Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Neuroscience Research Australia, Randwick, New South Wales, Australia
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30
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Jolley S, Browning S, Corrigall R, Laurens KR, Hirsch C, Bracegirdle K, Gin K, Muccio F, Stewart C, Banerjea P, Kuipers E, Garety P, Byrne M, Onwumere J, Achilla E, McCrone P, Emsley R. Coping with Unusual ExperienceS for 12-18 year olds (CUES+): a transdiagnostic randomised controlled trial of the effectiveness of cognitive therapy in reducing distress associated with unusual experiences in adolescent mental health services: study protocol for a randomised controlled trial. Trials 2017; 18:586. [PMID: 29202862 PMCID: PMC5716372 DOI: 10.1186/s13063-017-2326-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/13/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Childhood 'unusual experiences' (such as hearing voices that others cannot, or suspicions of being followed) are common, but can become more distressing during adolescence, especially for young people in contact with Child and Adolescent Mental Health Services (CAMHS). Unusual experiences that are distressing or have adverse life impact (UEDs) are associated with a range of current and future emotional, behavioural and mental health difficulties. Recommendations for psychological intervention are based on evidence from adult studies, with some support from small, pilot, child-specific evaluations. Research is needed to ensure that the recommendations suit children as well as adults. The CUES+ study (Coping with Unusual ExperienceS for 12-18 year olds) aims to find out whether cognitive behaviour therapy for UEDs (CBT-UED) is a helpful and cost-effective addition to usual community care for 12-18 year olds presenting to United Kingdom National Health Service Child and Adolescent Mental Health Services in four London boroughs. METHODS The CUES+ study is a randomised controlled trial comparing CBT-UED plus routine care to routine care alone. CBT-UED comprises up to 16 sessions, including up to 12 individual and up to four family support meetings, each lasting around 45-60 min, delivered weekly. The primary outcome is emotional distress. Secondary outcomes are change in UEDs, risk events (self-harm, attendance at emergency services, other adverse events) and health economic outcomes. Participants will be randomised in a 1:1 ratio after baseline assessment. Randomisation will be stratified by borough and by severity of mental health presentation: 'severe' (an identified psychotic or bipolar disorder) or any 'other' condition. Outcomes will be assessed by a trained assessor blind to treatment condition at 0, 16 and 24 weeks. Recruitment began in February, 2015 and is ongoing until the end of March, 2017. DISCUSSION The CUES+ study will contribute to the currently limited child-specific evidence base for psychological interventions for UEDs occurring in the context of psychosis or any other mental health presentation. TRIAL REGISTRATION International Standard Randomised Controlled Trials, ID: ISRCTN21802136 . Prospectively registered on 12 January 2015. Protocol V3 31 August 2015 with screening amended.
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Affiliation(s)
- Suzanne Jolley
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Sophie Browning
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | | | - Kristin R. Laurens
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Banyo, QLD 4014 Australia
- Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
- Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, NSW 2052 Australia
- Neuroscience Research Australia, Randwick, NSW 2031 Australia
| | - Colette Hirsch
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | | | - Kimberley Gin
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Francesca Muccio
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Catherine Stewart
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Partha Banerjea
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Elizabeth Kuipers
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | - Philippa Garety
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit (BRC/U) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, SE5 8AZ UK
| | - Majella Byrne
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ UK
| | - Juliana Onwumere
- Department of Psychology, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, 16, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Evanthia Achilla
- Department of Health Service and Population Research, King’s Health Economics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - Paul McCrone
- Department of Health Service and Population Research, King’s Health Economics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF UK
| | - Richard Emsley
- Centre for Biostatistics, School of Health Sciences, The University of Manchester, Manchester Academic Health Science Centre, Manchester, M13 9PL UK
- Manchester Academic Health Science Centre Clinical Trials Unit, Manchester, M13 9PL UK
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31
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Bromet EJ, Nock MK, Saha S, Lim CCW, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Borges G, Bruffaerts R, Degenhardt L, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, He Y, Hu C, Karam EG, Kovess-Masfety V, Lee S, Lepine JP, Mneimneh Z, Navarro-Mateu F, Ojagbemi A, Posada-Villa J, Sampson NA, Scott KM, Stagnaro JC, Viana MC, Xavier M, Kessler RC, McGrath JJ. Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors: A Cross-National Analysis From the World Health Organization World Mental Health Surveys. JAMA Psychiatry 2017; 74:1136-1144. [PMID: 28854302 PMCID: PMC5710219 DOI: 10.1001/jamapsychiatry.2017.2647] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
IMPORTANCE Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life course or if mental disorders contribute to these associations. OBJECTIVE To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations. DESIGN, SETTING, AND PARTICIPANTS A total of 33 370 adult respondents across 19 countries from the World Health Organization World Mental Health Surveys were assessed for PEs, STBs (ie, ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onset of STBs. MAIN OUTCOMES AND MEASURES Prevalence and frequency of STBs with PEs, and odds ratios and 95% CIs. RESULTS Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5% (1.3), 10.8% (0.7), and 10.2% (0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95% CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95% CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95% CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively. CONCLUSIONS AND RELEVANCE Psychotic experiences are associated with elevated odds of subsequent STBs across the life course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs.
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Affiliation(s)
- Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York
| | - Matthew K. Nock
- Psychology Department, Harvard University, Cambridge, Massachusetts
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Carmen C. W. Lim
- Queensland Centre for Mental Health Research, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities, University of California-Davis Health System, Sacramento
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwaniya Governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, Institut Hospital del Mar d’Investigacions Mèdiques, Barcelona, Spain,Pompeu Fabra University, Barcelona, Spain,Centros de Investigación Biomédica en Red en Epidemiología y Salud Pública, Barcelona, Spain
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven, Campus Gasthuisberg, Leuven, Belgium
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, Istituti di Ricovero e Cura a Carattere Scientifico–St John of God Clinical Research Centre, Brescia, Italy
| | - Peter de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, the Netherlands,Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - Silvia Florescu
- National School of Public Health, Management, and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep M. Haro
- Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red en Salud Mental, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - Yanling He
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chiyi Hu
- Shenzhen Institute of Mental Health, Shenzhen Kangning Hospital, Shenzhen, China
| | - Elie G. Karam
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon,Institute for Development, Research, Advocacy, and Applied Care, Beirut, Lebanon
| | | | - Sing Lee
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong
| | - Jean-Pierre Lepine
- Hôpital Lariboisière-Fernand Widal, Assistance Publique Hôpitaux de Paris, Universités Paris Descartes-Paris Diderot, INSERM UMR-S 1144, Paris, France
| | - Zeina Mneimneh
- Survey Research Center, University of Michigan, Ann Arbor
| | - Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Menta, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, Instituto Murciano de Investigación Biosanitaria–Arrixaca, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública–Murcia, Murcia, Spain
| | - Akin Ojagbemi
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - José Posada-Villa
- Faculty of Social Sciences, Colegio Mayor de Cundinamarca University, Bogota, Colombia
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Kate M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - Juan C. Stagnaro
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Maria C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - Miguel Xavier
- Chronic Diseases Research Center, Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisbon, Portugal
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - John J. McGrath
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia,Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia,National Centre for Register-Based Research, Aarhus School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
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Connecting the Dots between Schizotypal Symptoms and Social Anxiety in Youth with an Extra X Chromosome: A Mediating Role for Catastrophizing. Brain Sci 2017; 7:brainsci7090113. [PMID: 28878159 PMCID: PMC5615254 DOI: 10.3390/brainsci7090113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 08/30/2017] [Accepted: 09/02/2017] [Indexed: 12/30/2022] Open
Abstract
Youth with an extra X chromosome (47, XXY & 47, XXX) display higher levels of schizotypal symptoms and social anxiety as compared to typically developing youth. It is likely that the extra X chromosome group is at-risk for clinical levels of schizotypy and social anxiety. Hence, this study investigated how schizotypal and social anxiety symptoms are related and mechanisms that may explain their association in a group of 38 children and adolescents with an extra X chromosome and a comparison group of 109 typically developing peers (8–19 years). Three cognitive coping strategies were investigated as potential mediators, rumination, catastrophizing, and other-blame. Moderated mediation analyses revealed that the relationship between schizotypal symptoms and social anxiety was mediated by catastrophizing coping in the extra X chromosome group but not in the comparison group. The results suggest that youth with an extra X chromosome with schizotypal symptoms could benefit from an intervention to weaken the tendency to catastrophize life events as a way of reducing the likelihood of social anxiety symptoms.
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Ered A, Gibson LE, Maxwell SD, Cooper S, Ellman LM. Coping as a mediator of stress and psychotic-like experiences. Eur Psychiatry 2017; 43:9-13. [PMID: 28365470 PMCID: PMC5474127 DOI: 10.1016/j.eurpsy.2017.01.327] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/23/2017] [Accepted: 01/25/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND There is evidence that individuals along the whole psychosis continuum have increased responsiveness to stress; however, coping responses to stressors have not been extensively explored in subthreshold psychotic symptoms. METHODS In 454 undergraduates, psychotic-like experiences (PLEs) were evaluated using the positive items of the Prodromal Questionnaire. Perceived stress and traumatic life events were assessed using the Life Events Checklist and Perceived Stress Scale, and coping was measured using the Brief COPE. We also examined whether different coping styles mediated the relationship between perceived stress and PLEs, as well as whether different coping styles mediated the relationship between traumatic life events and PLEs. RESULTS Both number of traumatic life events and current level of perceived stress were significantly associated with PLEs. These relationships were both mediated by higher levels of maladaptive coping. CONCLUSIONS Results have the potential to inform treatment strategies, as well as inform targets for exploration in longitudinal studies of those at risk for psychosis.
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Affiliation(s)
- A Ered
- Department of Psychology, Temple University, 1710N, 13th Street, 19122 Philadelphia, PA, USA
| | - L E Gibson
- Department of Psychology, Temple University, 1710N, 13th Street, 19122 Philadelphia, PA, USA
| | - S D Maxwell
- Department of Psychology, Temple University, 1710N, 13th Street, 19122 Philadelphia, PA, USA
| | - S Cooper
- Department of Psychology, Temple University, 1710N, 13th Street, 19122 Philadelphia, PA, USA
| | - L M Ellman
- Department of Psychology, Temple University, 1710N, 13th Street, 19122 Philadelphia, PA, USA.
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Ribolsi M, Lin A, Wardenaar KJ, Pontillo M, Mazzone L, Vicari S, Armando M. Clinical presentation of Attenuated Psychosis Syndrome in children and adolescents: Is there an age effect? Psychiatry Res 2017; 252:169-174. [PMID: 28282534 DOI: 10.1016/j.psychres.2017.02.050] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 01/04/2017] [Accepted: 02/15/2017] [Indexed: 01/11/2023]
Abstract
There is limited research on clinical features related to age of presentation of the Attenuated Psychosis Syndrome in children and adolescents (CAD). Based on findings in CAD with psychosis, we hypothesized that an older age at presentation of Attenuated Psychosis Syndrome would be associated with less severe symptoms and better psychosocial functioning than presentation in childhood or younger adolescence. Ninety-four CAD (age 9-18) meeting Attenuated Psychosis Syndrome criteria participated in the study. The sample was divided and compared according to the age of presentation of Attenuated Psychosis Syndrome (9-14 vs 15-18 years). The predictive value of age of Attenuated Psychosis Syndrome presentation was investigated using receiver operating characteristic (ROC)-curve calculations. The two Attenuated Psychosis Syndrome groups were homogeneous in terms of gender distribution, IQ scores and comorbid diagnoses. Older Attenuated Psychosis Syndrome patients showed better functioning and lower depressive scores. ROC curves revealed that severity of functional impairment was best predicted using an age of presentation cut-off of 14.9 years for social functioning and 15.9 years for role functioning. This study partially confirmed our hypothesis; older age at presentation of Attenuated Psychosis Syndrome was associated with less functional impairment, but age was not associated with psychotic symptoms.
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Affiliation(s)
- Michele Ribolsi
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, 100 Roberts Road, Subiaco, 6008 Western Australia, Australia
| | - Klaas J Wardenaar
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, The Netherlands
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Luigi Mazzone
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy
| | - Marco Armando
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165 Rome, Italy; Developmental Imaging and Psychopathology Laboratory, University of Geneva School of Medicine, Geneva, Switzerland.
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Kelleher I, Ramsay H, DeVylder J. Psychotic experiences and suicide attempt risk in common mental disorders and borderline personality disorder. Acta Psychiatr Scand 2017; 135:212-218. [PMID: 28185269 DOI: 10.1111/acps.12693] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Recent research has demonstrated a strong relationship between psychotic experiences and suicidal behaviour. No research to date, however, has investigated the role of borderline personality disorder (BPD) in this relationship, despite the fact that BPD is highly comorbid with common mental disorders and is associated with both recurrent suicidal behaviour and psychotic experiences. This paper examined the relationship between psychotic experiences and suicide attempts, including interrelationships with BPD and common mental disorders. METHOD We used the 2007 Adult Psychiatric Morbidity Study, a stratified, multistage probability sample of households in England, which recruited a nationally representative sample aged 16 years and older. Participants were assessed for common mental disorders, BPD (clinical and subclinical), suicidal behaviour, and psychotic experiences. RESULTS Approximately 4% of the total sample (n = 323) reported psychotic experiences. Psychotic experiences were associated with increased odds of suicide attempts in individuals with BPD (OR = 2.23, 95% CI = 1.03-4.85), individuals with a common mental disorder (OR = 2.47, 95% CI = 1.37-4.43), individuals without a common mental disorder (OR = 3.99, 95% CI = 2.47-6.43), and individuals with neither a common mental disorder nor BPD (OR = 3.20, 95% CI = 1.71-5.98). CONCLUSION Psychotic experiences are associated with high odds of suicidal behaviour in individuals with and without psychopathology. This relationship is not explained by clinical or subclinical BPD.
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Affiliation(s)
- I Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - H Ramsay
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Psychiatry, University of Oulu, Oulu, Finland
| | - J DeVylder
- Department of Social Work, University of Maryland, Baltimore, MD, USA
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Honings S, Drukker M, van Nierop M, van Winkel R, Wittchen HU, Lieb R, Ten Have M, de Graaf R, van Dorsselaer S, van Os J. Psychotic experiences and incident suicidal ideation and behaviour: Disentangling the longitudinal associations from connected psychopathology. Psychiatry Res 2016; 245:267-275. [PMID: 27565698 DOI: 10.1016/j.psychres.2016.08.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 07/28/2016] [Accepted: 08/03/2016] [Indexed: 01/05/2023]
Abstract
This study examines the longitudinal associations between psychotic experiences (PE) and incident suicidal ideation and behaviour in the general population, and to what degree the association may be confounded by non-psychotic psychopathology. Data from three prospective, general population cohorts were combined into one dataset (n=15,837) and analysed using logistic regression, controlling for continuous measures of depression, anxiety and mania symptoms. Analyses were conducted in the entire sample, and in subsamples stratified by presence or absence of mental disorders. The presence of PE at baseline increased the risk of incident suicidal ideation and behaviour. However, adjustment for dimensional measures of psychopathology reduced effect sizes, although PE remained significantly associated with suicide attempts. Further examination of the associations revealed that PE were only associated with suicide attempts in individuals with at least one mental disorder. Similarly, in individuals without mental disorders, the risk of suicidal ideation increased as PE co-occurred with more symptom domains. The results of this study confirm that individuals with PE are at increased risk of suicidal ideation and behaviour. However, these associations are not specific, but reflect the increased risk of suicidal ideation in individuals with subthreshold multidimensional psychopathology and suicide attempts in individuals with co-occurring mental disorders.
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Affiliation(s)
- Steven Honings
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Martine van Nierop
- Katholieke Universiteit Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium
| | - Ruud van Winkel
- Katholieke Universiteit Leuven, Department of Neuroscience, Research Group Psychiatry, Centre for Contextual Psychiatry, Leuven, Belgium; University Psychiatric Center Katholieke Universiteit Leuven, Campus Kortenberg, Leuvensesteenweg, Kortenberg, Belgium
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Roselind Lieb
- Max Planck Institute of Psychiatry, Munich, Germany; Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Margreet Ten Have
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | | | - Jim van Os
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
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Abu-Akel AM, Apperly IA, Wood SJ, Hansen PC. Autism and psychosis expressions diametrically modulate the right temporoparietal junction. Soc Neurosci 2016; 12:506-518. [DOI: 10.1080/17470919.2016.1190786] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Ian A. Apperly
- School of Psychology, University of Birmingham, Birmingham, U.K
| | - Stephen J. Wood
- School of Psychology, University of Birmingham, Birmingham, U.K
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Peter C. Hansen
- School of Psychology, University of Birmingham, Birmingham, U.K
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Abu-Akel AM, Wood SJ, Hansen PC, Apperly IA. Perspective-taking abilities in the balance between autism tendencies and psychosis proneness. Proc Biol Sci 2016; 282:20150563. [PMID: 25972469 DOI: 10.1098/rspb.2015.0563] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Difficulties with the ability to appreciate the perspective of others (mentalizing) is central to both autism and schizophrenia spectrum disorders. While the disorders are diagnostically independent, they can co-occur in the same individual. The effect of such co-morbidity is hypothesized to worsen mentalizing abilities. The recent influential 'diametric brain theory', however, suggests that the disorders are etiologically and phenotypically diametrical, predicting opposing effects on one's mentalizing abilities. To test these contrasting hypotheses, we evaluated the effect of psychosis and autism tendencies on the perspective-taking (PT) abilities of 201 neurotypical adults, on the assumption that autism tendencies and psychosis proneness are heritable dimensions of normal variation. We show that while both autism tendencies and psychosis proneness induce PT errors, their interaction reduced these errors. Our study is, to our knowledge, the first to observe that co-occurring autistic and psychotic traits can exert opposing influences on performance, producing a normalizing effect possibly by way of their diametrical effects on socio-cognitive abilities. This advances the notion that some individuals may, to some extent, be buffered against developing either illness or present fewer symptoms owing to a balanced expression of autistic and psychosis liability.
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Affiliation(s)
- Ahmad M Abu-Akel
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Stephen J Wood
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Peter C Hansen
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
| | - Ian A Apperly
- School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK
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Variation in psychosocial influences according to the dimensions and content of children's unusual experiences: potential routes for the development of targeted interventions. Eur Child Adolesc Psychiatry 2016; 25:311-9. [PMID: 26149604 DOI: 10.1007/s00787-015-0739-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 06/23/2015] [Indexed: 10/23/2022]
Abstract
The psychosocial processes implicated in the development and maintenance of psychosis differ according to both the dimensional attributes (conviction, frequency, associated distress, adverse life impact) and the content or type (e.g. grandiosity, hallucinations, paranoia) of the psychotic symptoms experienced. This has informed the development of 'targeted' cognitive behavioural therapy for psychosis (CBTp): interventions focusing on specific psychological processes in the context of particular symptom presentations. In adults, larger effect sizes for change in primary outcomes are typically reported in trials of targeted interventions, compared to those for trials of generic CBTp approaches with multiple therapeutic foci. We set out to test the theoretical basis for developing targeted CBTp interventions for young people with distressing psychotic-like, or unusual, experiences (UEs). We investigated variations in the psychosocial processes previously associated with self-reported UE severity (reasoning, negative life events, emotional problems) according to UE dimensional attributes and content/type (using an established five-factor model) in a clinically referred sample of 72 young people aged 8-14 years. Regression analyses revealed associations of conviction and grandiosity with reasoning; of frequency, and hallucinations and paranoia, with negative life events; and of distress/adverse life impact, and paranoia and hallucinations, with emotional problems. We conclude that psychological targets for intervention differ according to particular characteristics of childhood UEs in much the same way as for psychotic symptoms in adults. The development of targeted interventions is therefore indicated, and tailoring therapy according to presentation should further improve clinical outcomes for these young people.
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Honings S, Drukker M, Groen R, van Os J. Psychotic experiences and risk of self-injurious behaviour in the general population: a systematic review and meta-analysis. Psychol Med 2016; 46:237-251. [PMID: 26419206 DOI: 10.1017/s0033291715001841] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Recent studies suggest that psychotic experiences (PE) in the general population are associated with an increased risk of self-injurious behaviour. Both the magnitude of this association and the level of adjustment for confounders vary among studies. A meta-analysis was performed to integrate the available evidence. The influence of possible confounders, including variably defined depression, was assessed. METHOD A systematic review and meta-analysis was conducted including general population studies reporting on the risk of self-injurious behaviour in individuals with PE. Studies were identified by a systematic search strategy in Pubmed, PsycINFO and Embase. Reported effect sizes were extracted and meta-analytically pooled. RESULTS The risk of self-injurious behaviour was 3.20 times higher in individuals with PE compared with those without. Subanalyses showed that PE were associated with self-harm, suicidal ideation as well as suicidal attempts. All studies had scope for considerable residual confounding; effect sizes adjusted for depression were significantly smaller than effect sizes unadjusted for depression. In the longitudinal studies, adjustment for psychopathology resulted in a 74% reduction in excess risk. CONCLUSIONS PE are associated with self-injurious behaviour, suggesting they have potential as passive markers of suicidality. However, the association is confounded and several methodological issues remain, particularly how to separate PE from the full range of connected psychopathology in determining any specific association with self-injurious behaviour. Given evidence that PE represent an indicator of severity of non-psychotic psychopathology, the association between PE and self-injurious behaviour probably reflects a greater likelihood of self-injurious behaviour in more severe states of mental distress.
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Affiliation(s)
- S Honings
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - M Drukker
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network,Maastricht University Medical Centre,Maastricht,The Netherlands
| | - R Groen
- Faculty of Psychology and Neuroscience,Maastricht University,Maastricht,The Netherlands
| | - J van Os
- Department of Psychiatry and Psychology,South Limburg Mental Health Research and Teaching Network,Maastricht University Medical Centre,Maastricht,The Netherlands
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Prevalence and correlates of psychotic like experiences in a nationally representative community sample of adolescents in Ireland. Schizophr Res 2015; 169:241-247. [PMID: 26416443 DOI: 10.1016/j.schres.2015.09.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 12/29/2022]
Abstract
Adolescent psychotic like experiences (PLEs) are an important area of research, yet only a small number of community surveys have investigated their psychosocial correlates. This study presents the prevalence and correlates of three types of PLEs in a nationally representative community sample of 12-19 year olds in Ireland (N=5910). Correlates are considered across five domains: demographic, stressful life experiences, emotional/behavioral problems, substance use, and personal resources. Auditory hallucinations were reported by 13.7% of participants, 10.4% reported visual hallucinations and 13.1% reported paranoid thoughts. Participants who had experienced two of the three PLEs were assigned "risk" status (10.4%; n=616). Using binary logistic regression, PLEs were associated with a range of correlates across the five domains. Key correlates of risk status include depression (OR 4.07; 95% CI 3.39-4.88), low self-esteem (OR 4.03 95% CI 3.34-4.86), low optimism (OR 3.56; 95% CI 2.96-4.28), school misconduct (OR 3.10 95%; CI 2.56-3.75), and high avoidance coping (OR 2.86 95% CI 2.34-3.49). These associations remained significant in a multivariate analysis. While correlates for each of the three PLEs were similar, there were some nuances in these patterns. Notably, demographic and substance use variables were the weakest groups of correlates. Personal resources (e.g. self-esteem, optimism and coping) have been poorly studied in the adolescent PLE literature and these findings provide important insights for future research and intervention design.
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Social defeat predicts paranoid appraisals in people at high risk for psychosis. Schizophr Res 2015; 168:16-22. [PMID: 26276306 DOI: 10.1016/j.schres.2015.07.050] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 07/28/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND The experience of social defeat may increase the risk of developing psychotic symptoms and psychotic disorders. We studied the relationship between social defeat and paranoid appraisal in people at high risk for psychosis in an experimental social environment created using Virtual Reality (VR). METHOD We recruited UHR (N=64) participants and healthy volunteers (N=43). Regression analysis was used to investigate which baseline measures predicted paranoid appraisals during the VR experience. RESULTS At baseline, UHR subjects reported significantly higher levels of social defeat than controls (OR=.957, (CI) .941-.973, p<.000). Following exposure to the VR social environment, the UHR group reported significantly more paranoid appraisals than the controls (p<.000). Within the UHR sample, paranoid appraisals were predicted by the level of social defeat at baseline, as well as by the severity of positive psychotic and disorganised symptoms. CONCLUSION In people who are at high risk of psychosis, a history of social defeat is associated with an increased likelihood of making paranoid appraisals of social interactions. This is consistent with the notion that social defeat increases the risk of developing psychosis.
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The impact of neuropsychological functioning and coping style on perceived stress in individuals with first-episode psychosis and healthy controls. Psychiatry Res 2015; 226:128-35. [PMID: 25618467 DOI: 10.1016/j.psychres.2014.12.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 08/22/2014] [Accepted: 12/21/2014] [Indexed: 11/22/2022]
Abstract
Stress is implicated in the development and course of psychotic illness, but the factors that influence stress levels are not well understood. The aim of this study was to examine the impact of neuropsychological functioning and coping styles on perceived stress in people with first-episode psychosis (FEP) and healthy controls (HC). Thirty-four minimally treated FEP patients from the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia, and 26 HC participants from a similar demographic area participated in the study. Participants completed a comprehensive neuropsychological test battery as well as the Coping Inventory for Stressful Situations (task-, emotion- and avoidance-focussed coping styles) and Perceived Stress Scale (PSS). Linear regressions were used to determine the contribution of neuropsychological functioning and coping style to perceived stress in the two groups. In the FEP group, higher levels of emotion-focussed and lower levels of task-focussed coping were associated with elevated stress. Higher premorbid IQ and working memory were also associated with higher subjective stress. In the HC group, higher levels of emotion-focussed coping, and contrary to the FEP group, lower premorbid IQ, working memory and executive functioning, were associated with increased stress. Lower intellectual functioning may provide some protection against perceived stress in FEP.
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A preliminary investigation of schematic beliefs and unusual experiences in children. Eur Psychiatry 2015; 30:569-75. [PMID: 25591496 DOI: 10.1016/j.eurpsy.2014.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Revised: 12/13/2014] [Accepted: 12/13/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In cognitive models of adult psychosis, schematic beliefs about the self and others are important vulnerability and maintaining factors, and are therefore targets for psychological interventions. Schematic beliefs have not previously been investigated in children with distressing unusual, or psychotic-like, experiences (UEDs). The aim of this study was firstly to investigate whether a measure of schematic beliefs, originally designed for adults with psychosis, was suitable for children; and secondly, to examine the association of childhood schematic beliefs with internalising and externalising problems and with UEDs. METHOD Sixty-seven children aged 8-14 years, with emotional and behavioural difficulties, completed measures of UEDs, internalising (depression and anxiety), and externalising (conduct and hyperactivity-inattention) problems, together with the Brief Core Schema Scales (BCSS). RESULTS The BCSS was readily completed by participants, and scale psychometric properties were good. Children tended to view themselves and others positively. Internalising and externalising problems and UEDs were all associated with negative schematic beliefs; effect sizes were small to medium. CONCLUSIONS Schematic beliefs in young people can be measured using the BCSS, and negative schematic beliefs are associated with childhood psychopathology and with UEDs. Schematic beliefs may therefore form a useful target in psychological interventions for young people with UEDs.
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Poulton R, Van Ryzin MJ, Harold GT, Chamberlain P, Fowler D, Cannon M, Arseneault L, Leve LD. Effects of multidimensional treatment foster care on psychotic symptoms in girls. J Am Acad Child Adolesc Psychiatry 2014; 53:1279-87. [PMID: 25457926 PMCID: PMC4254696 DOI: 10.1016/j.jaac.2014.08.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/25/2014] [Accepted: 09/11/2014] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Neurodevelopmental theories of psychosis highlight the potential benefits of early intervention, prevention, and/or preemption. How early intervention should take place has not been established, nor whether interventions based on social learning principles can have preemptive effects. The objective was to test whether a comprehensive psychosocial intervention can significantly alter psychotic symptom trajectories during adolescence-a period of heightened risk for a wide range of psychopathology. METHOD This study was a randomized controlled trial (RCT) of Multidimensional Treatment Foster Care (MTFC) for delinquent adolescent girls. Assessment of psychotic symptoms took place at baseline and then 6, 12, 18, and 24 months post-baseline using a standardized self-report instrument (Brief Symptom Inventory). A second source of information about psychotic symptoms was obtained at baseline or 12 months, and again at 24 months using a structured diagnostic interview (the Diagnostic Interview Schedule for Children [DISC]). RESULTS Significant benefits for MTFC over treatment as usual for psychosis symptoms were observed over a 24-month period. Findings were replicated across both measures. Effects were independent of substance use and initial symptom severity and persisted beyond the initial intervention period. CONCLUSION Ameliorating nonclinical psychotic symptoms trajectories beginning in mid-adolescence via a multifaceted psychosocial intervention is possible. Developmental research on nonclinical psychotic symptoms and their prognostic value should be complemented by more psychosocial intervention research aimed at modifying these symptom trajectories early in their natural history. Clinical trial registration information-Juvenile Justice Girls Randomized Control Trial: Young Adult Follow-up; http://clinicaltrials.gov; NCT01341626.
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Affiliation(s)
- Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Dunedin School of Medicine, University of Otago, New Zealand
| | | | - Gordon T. Harold
- School of Psychology, University of Sussex, UK, Tomsk State University, Tomsk, Russia, and the MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, Wales
| | | | - David Fowler
- School of Psychology, University of Sussex, Brighton, UK
| | - Mary Cannon
- Royal College of Surgeons in Dublin and Beaumont Hospital, Dublin
| | | | - Leslie D. Leve
- University of Oregon and the Oregon Social Learning Center
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Kelleher I, Devlin N, Wigman JTW, Kehoe A, Murtagh A, Fitzpatrick C, Cannon M. Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning. Psychol Med 2014; 44:1615-1624. [PMID: 24025687 DOI: 10.1017/s0033291713002122] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Recent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functioning, and (iv) suicidal behaviour. METHOD The investigation was a clinical case-clinical control study using semi-structured research diagnostic psychiatric assessments in 108 patients newly referred to state adolescent mental health services. RESULTS Psychotic experiences were prevalent in a wide range of (non-psychotic) disorders but were strong markers of risk in particular for multimorbid psychopathology (Z = 3.44, p = 0.001). Young people with psychopathology who reported psychotic experiences demonstrated significantly poorer socio-occupational functioning than young people with psychopathology who did not report psychotic experiences, which was not explained by multimorbidity. Psychotic experiences were strong markers of risk for suicidal behaviour. Stratified analyses showed that there was a greatly increased odds of suicide attempts in patients with a major depressive disorder [odds ratio (OR) 8.89, 95% confidence interval (CI) 1.59-49.83], anxiety disorder (OR 15.4, 95% CI 1.85-127.94) or behavioural disorder (OR 3.13, 95% CI 1.11-8.79) who also had psychotic experiences compared with patients who did not report psychotic experiences. CONCLUSIONS Psychotic experiences (attenuated or frank) are an important but under-recognized marker of risk for severe psychopathology, including multimorbidity, poor functioning and suicidal behaviour in young people who present to mental health services.
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Affiliation(s)
- I Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - N Devlin
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - J T W Wigman
- Maastricht University, Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Kehoe
- University College Dublin, Catherine McAuley Research Centre, Dublin, Ireland
| | - A Murtagh
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - C Fitzpatrick
- University College Dublin, Catherine McAuley Research Centre, Dublin, Ireland
| | - M Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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Kelleher I, Cederlöf M, Lichtenstein P. Psychotic experiences as a predictor of the natural course of suicidal ideation: a Swedish cohort study. World Psychiatry 2014; 13:184-8. [PMID: 24890071 PMCID: PMC4102291 DOI: 10.1002/wps.20131] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Psychotic experiences are far more prevalent in the population than psychotic disorders and are associated with a wide range of depressive, anxiety and behavioral disorders, as well as increased risk for psychotic disorder. Recently, psychotic experiences have been highlighted as a potentially valuable clinical marker of risk for suicidal behavior. There have been few studies to date, however, to assess psychotic experiences as a predictor of suicidality over time. We wished to assess whether young persons with suicidal ideation at baseline assessment who reported psychotic experiences were at higher risk for persistence of suicidal ideation at follow-up than young persons who also reported suicidal ideation at baseline but who did not report co-occurring psychotic experiences. A total of 2,263 adolescents were assessed at age 13 to 14 years for psychotic experiences, suicidal ideation and internalizing and externalizing psychopathology. Participants were re-assessed at ages 16 to 17 years and 19 to 20 years. Among 13- to 14-year olds with suicidal ideation, co-occurring psychotic experiences did not predict an increased odds of persistence of suicidal ideation to age 16 to 17 years (OR=0.94, 95% CI: 0.19-4.78). Among 16- to 17-year olds with suicidal ideation, however, co-occurring psychotic experiences predicted a 6-fold increased odds of persistence of suicidal ideation to age 19 to 20 years (OR=5.53, 95% CI: 1.33-23.00). Psychotic experiences are an important but under-recognized marker of risk for persistence of suicidal ideation, in particular from mid-adolescence. An increased emphasis on the clinical assessment of psychotic experiences in mental health services should be a priority.
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Affiliation(s)
- Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont HospitalDublin 9, Ireland,Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetNobels vag 12A, 17177, Stockholm, Sweden
| | - Martin Cederlöf
- Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetNobels vag 12A, 17177, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetNobels vag 12A, 17177, Stockholm, Sweden
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Wigman JTW, Devlin N, Kelleher I, Murtagh A, Harley M, Kehoe A, Fitzpatrick C, Cannon M. Psychotic symptoms, functioning and coping in adolescents with mental illness. BMC Psychiatry 2014; 14:97. [PMID: 24690447 PMCID: PMC3976538 DOI: 10.1186/1471-244x-14-97] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 03/13/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Psychotic symptoms in the context of psychiatric disorders are associated with poor functional outcomes. Environmental stressors are important in the development of psychosis; however, distress may only be pathogenic when it exceeds an individual's ability to cope with it. Therefore, one interesting factor regarding poor functional outcomes in patients with psychotic symptoms may be poor coping. This paper aimed to address the question whether 1) psychotic symptoms are associated with poorer functioning and 2) whether poor coping moderated the association. METHODS In a clinical case-clinical control study of 106 newly-referred adolescent patients with non-psychotic psychiatric disorders, coping was investigated using the Adolescents Coping Scale. Severity of impairment in socio-occupational functioning was assessed with the Children's Global Assessment Scale. RESULTS Patients with non-psychotic psychiatric disorders and additional psychotic symptoms (N = 50) had poorer functioning and were more likely to use avoidance-oriented coping compared to patients with non-psychotic psychiatric disorders without psychotic symptoms (N = 56). No differences were found with respect to approach-oriented coping. When stratifying for poor/good coping, only those adolescent patients with psychotic symptoms who applied poor coping (i.e. less use of approach-oriented coping styles [OR 0.24, p < 0.015] and more use of avoidance-oriented coping [OR 0.23, p < 0.034]) had poorer functioning. However, these interactions were not significant. CONCLUSIONS Non-adaptive coping and poorer functioning were more often present in adolescents with non-psychotic psychiatric disorders and additional psychotic symptoms. Due to small subgroups, our analyses could not give definitive conclusions about the question whether coping moderated the association between psychotic symptoms and functioning. Improvement of coping skills may form an important target for intervention that may contribute to better clinical and functional outcomes in patients with psychotic symptoms.
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Affiliation(s)
- Johanna TW Wigman
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre Maastricht, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands
| | - Nina Devlin
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
| | - Aileen Murtagh
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
| | - Michelle Harley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
- St Joseph’s Adolescent Unit, St Vincent’s Hospital Fairview Dublin, Dublin, Ireland
| | - Anne Kehoe
- Department of Clinical Psychology, Queen’s University, Belfast, Northern Ireland
| | - Carol Fitzpatrick
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre Dublin, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital Dublin, Dublin, Ireland
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Jang JH, Lee YJ, Cho SJ, Cho IH, Shin NY, Kim SJ. Psychotic-like experiences and their relationship to suicidal ideation in adolescents. Psychiatry Res 2014; 215:641-5. [PMID: 24495577 DOI: 10.1016/j.psychres.2013.12.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 12/25/2013] [Accepted: 12/29/2013] [Indexed: 10/25/2022]
Abstract
Studies have suggested that psychotic-like experiences (PLEs) are associated with behavioral problems in adolescents. The aim of this study was to investigate relationships between domains of PLEs, suicidal ideation, and depression in a large community sample of adolescents. The sample consisted of 8096 Korean subjects (3184 boys and 4912 girls) aged 14 to 19 years. The level of PLEs, depression, and suicidal ideation were assessed by the Eppendorf schizophrenia inventory (ESI), Beck's depression inventory, and Beck's scale for suicidal ideation, respectively. Both the level of depression and suicidal ideation were significantly associated with PLEs. Among the four domains of the ESI, the deviant perception, ideas of reference, and auditory uncertainty were associated with the suicidal ideation. Additionally, subjects with more PLEs had significantly more suicidal ideation and depressive symptoms. PLEs in adolescents are associated with potential risk of suicide and depressive symptoms significantly mediated the association between suicidal ideation and PLEs. The presence of perceptual disturbances, ideas of reference, and depression may be regarded as warning signs for suicide-related behaviors.
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Affiliation(s)
- Joon Hwan Jang
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University of Medicine and Science, Incheon, Republic of Korea
| | - In Hee Cho
- Imom Neuropsychiatric Clinic, Seongnam, Republic of Korea
| | - Na Young Shin
- Clinical Cognitive Neuroscience Center, Neuroscience Institute, SNU-MRC, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Medicine, Seoul National University College of Medicine, 28, Yeongeon-dong, Jongno-gu, Seoul, Republic of Korea.
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Jalbrzikowski M, Sugar CA, Zinberg J, Bachman P, Cannon TD, Bearden CE. Coping styles of individuals at clinical high risk for developing psychosis. Early Interv Psychiatry 2014; 8:68-76. [PMID: 23164368 PMCID: PMC3582773 DOI: 10.1111/eip.12005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 07/31/2012] [Indexed: 11/28/2022]
Abstract
AIM There is a wealth of evidence suggesting that patients with schizophrenia tend to respond to life stressors using less effective coping skills, which are in turn related to poor outcome. However, the contribution of coping strategies to outcome in youth at clinical high risk (CHR) for developing psychosis has not been investigated. METHODS This longitudinal study followed CHR youth over a 12-month period, using the Brief COPE questionnaire. CHR subjects (n = 88) were compared at baseline with a healthy control sample (n = 53), and then mixed models were used to explore the relationship of coping strategies to clinical and psychosocial outcomes in CHR subjects over time (n = 102). RESULTS Cross-sectional analyses revealed that, in comparison with healthy controls, CHR youth reported using more maladaptive coping strategies (P < 0.001) and fewer adaptive coping strategies (P < 0.01). Longitudinal analyses within the CHR group showed significant decreases in maladaptive coping and symptom severity over time, with corresponding improvements in social and role functioning. Adaptive coping was associated with better concurrent social functioning and less severe symptomatology (both P < 0.001). Over time, more maladaptive coping was associated with more severe positive and negative symptoms (both P < 0.005). CONCLUSIONS Youth at risk for psychosis report using fewer adaptive and more maladaptive coping strategies relative to healthy controls. Over 1-year follow-up, more adaptive coping styles are associated with less severe clinical symptomatology and better social functioning. These findings suggest that teaching adaptive coping styles may be an important target for intervention in youth at high risk for psychosis.
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Affiliation(s)
- Maria Jalbrzikowski
- Department of Psychology, University of California, Los Angeles, California, USA
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