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Chalker SA, Sicotte R, Bornheimer LA, Parrish EM, Wastler H, Ehret B, DeVylder J, Depp CA. A call to action: informing research and practice in suicide prevention among individuals with psychosis. Front Psychiatry 2024; 15:1378600. [PMID: 38711871 PMCID: PMC11073495 DOI: 10.3389/fpsyt.2024.1378600] [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: 01/29/2024] [Accepted: 03/22/2024] [Indexed: 05/08/2024] Open
Abstract
Although it is well established that individuals living with psychosis are at increased risk for suicidal ideation, attempts, and death by suicide, several gaps in the literature need to be addressed to advance research and improve clinical practice. This Call-to-Action highlights three major gaps in our understanding of the intersection of psychosis and suicide as determined by expert consensus. The three gaps include research methods, suicide risk screening and assessment tools used with persons with psychosis, and psychosocial interventions and therapies. Specific action steps to address these gaps are outlined to inform research and practice, and thus, improve care and prognoses among persons with psychosis at risk for suicide.
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Affiliation(s)
- Samantha A. Chalker
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, CA, United States
| | - Roxanne Sicotte
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Research Center of the Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Lindsay A. Bornheimer
- University of Michigan, School of Social Work, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Emma M. Parrish
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Heather Wastler
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | | | - Jordan DeVylder
- Silver School of Social Work, New York University, New York, NY, United States
| | - Colin A. Depp
- Veterans Affairs San Diego Healthcare System, San Diego, CA, United States
- Department of Psychiatry, University of California, San Diego, CA, United States
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Fekih-Romdhane F, Pandi-Perumal SR, Conus P, Krebs MO, Cheour M, Seeman MV, Jahrami HA. Prevalence and risk factors of self-reported psychotic experiences among high school and college students: A systematic review, meta-analysis, and meta-regression. Acta Psychiatr Scand 2022; 146:492-514. [PMID: 36000793 DOI: 10.1111/acps.13494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Adolescents are at high risk of incident psychopathology. Fleeting psychotic experiences (PEs) that emerge in young people in response to stress may be warning signs that are missed by research that fails to study stressed populations, such as late high school and college/university students. Our aim in this systematic review was to conduct a meta-analysis that estimates prevalence rates of PEs in students, and to assess whether these rates differ by gender, age, culture, and COVID-19 exposure. METHOD We searched nine electronic databases, from their inception until January 31, 2022 for relevant studies. We pooled the estimates using the DerSimonian-Laird technique and random-effects meta-analysis. Our main outcome was the prevalence of self-reported PEs in high school and college/university students. We subsequently analyzed our data by age, gender, population, country, culture, evaluation tool, and COVID-19 exposure. RESULTS Out of 486 studies retrieved, a total of 59 independent studies met inclusion criteria reporting 210' 024 students from 21 different countries. Nearly one in four students (23.31%; 95% CI 18.41%-29.05%), reported having experienced PEs (heterogeneity [Q = 22,698.23 (62), p = 0.001] τ2 = 1.4418 [1.0415-2.1391], τ = 1.2007 [1.0205-1.4626], I2 = 99.7%, H = 19.13 [18.59-19.69]). The 95% prediction intervals were 04.01%-68.85%. Subgroup analyses showed that the pooled prevalence differed significantly by population, culture, and COVID-19 exposure. CONCLUSION This meta-analysis revealed high prevalence rates of self-reported PEs among teen and young adult students, which may have significance for mental health screening in school settings. An important realization is that PEs may have very different mental health meaning in different cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., Toronto, Canada.,Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Philippe Conus
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Odile Krebs
- Inserm, Laboratoire de Physiopathologie des maladies Psychiatriques, UMR_S1266 Institut de Psychiatrie et Neurosciences de Paris, Université Paris Descartes, Paris, France.,Institut de Psychiatrie (CNRS GDR 3557), Paris, France.,Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Paris, France
| | - Majda Cheour
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.,The Tunisian Center of Early Intervention is Psychiatry, Department of psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Mary V Seeman
- Department of Psychiatry, University of Toronto, Canada
| | - Haitham A Jahrami
- Psychiatric Hospital, Ministry of Health, Manama, Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Jaya ES, Wüsten C, Alizadeh BZ, van Amelsvoort T, Bartels-Velthuis AA, van Beveren NJ, Bruggeman R, Cahn W, de Haan L, Delespaul P, Luykx JJ, Myin-Germeys I, Kahn RS, Schirmbeck F, Simons CJP, van Haren NE, van Os J, van Winkel R, Fonseca-Pedrero E, Peters E, Verdoux H, Woodward TS, Ziermans TB, Lincoln TM. Comparing psychotic experiences in low-and-middle-income-countries and high-income-countries with a focus on measurement invariance. Psychol Med 2022; 52:1509-1516. [PMID: 33023691 DOI: 10.1017/s0033291720003323] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias. METHODS A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently used self-report measure of PEs, the Community Assessment of Psychic Experiences (CAPE), in LAMIC (n = 2472) and HIC (n = 4669). The CAPE measures positive (e.g. hallucinations), negative (e.g. avolition) and depressive symptoms. MI analyses were conducted with multiple-group confirmatory factor analyses. RESULTS MI analyses showed similarities in the structure and understanding of the CAPE factors between LAMIC and HIC. Partial scalar invariance was found, allowing for latent score comparisons. Residual invariance was not found, indicating that sum score comparisons are biased. A comparison of latent scores before and after MI adjustment showed both overestimation (e.g. avolition, d = 0.03 into d = -0.42) and underestimation (e.g. magical thinking, d = -0.03 into d = 0.33) of PE in LAMIC relative to HIC. After adjusting the CAPE for MI, participants from LAMIC reported significantly higher levels on most CAPE factors but a significantly lower level of avolition. CONCLUSION Previous studies using sum scores to compare differences across countries are likely to be biased. The direction of the bias involves both over- and underestimation of PEs in LAMIC compared to HIC. Nevertheless, the study confirms the basic finding that PEs are more frequent in LAMIC than in HIC.
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Affiliation(s)
- Edo S Jaya
- Psychosis Studies Research Group, Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Caroline Wüsten
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
| | - Behrooz Z Alizadeh
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Therese van Amelsvoort
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Agna A Bartels-Velthuis
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
| | - Nico J van Beveren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Antes Center for Mental Health Care, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
| | - Richard Bruggeman
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Wiepke Cahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Altrecht, General Mental Health Care, Utrecht, The Netherlands
| | - Lieuwe de Haan
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Philippe Delespaul
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Jurjen J Luykx
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, University Medical Center Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands
| | - Inez Myin-Germeys
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Rene S Kahn
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frederike Schirmbeck
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | - Claudia J P Simons
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- GGzE Institute for Mental Health Care, Eindhoven, The Netherlands
| | - Neeltje E van Haren
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Rotterdam, The Netherlands
| | - Jim van Os
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry, University Medical Center Utrecht, Brain Centre Rudolf Magnus, Utrecht University, Utrecht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK
| | - Ruud van Winkel
- Genetic Risk and Outcome of Psychosis (GROUP) Investigators
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, School for Mental Health and Neuroscience, Maastricht, The Netherlands
- Department of Neuroscience, Research Group Psychiatry, KU Leuven, Leuven, Belgium
| | - Eduardo Fonseca-Pedrero
- Department of Educational Sciences, University of La Rioja, La Rioja, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Spain
| | - Emmanuelle Peters
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Hélène Verdoux
- University Bordeaux, U1219 Bordeaux Population Health Research Center, Bordeaux, France
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Mental Health and Addictions Research Institute, Vancouver, BC, Canada
| | - Tim B Ziermans
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Universität Hamburg, Hamburg, Germany
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Sun M, Wang D, Jing L, Zhou L. Changes in psychotic-like experiences and related influential factors in technical secondary school and college students during COVID-19. Schizophr Res 2021; 231:3-9. [PMID: 33725647 PMCID: PMC9190274 DOI: 10.1016/j.schres.2021.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/12/2021] [Accepted: 02/27/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Although students have been found to be at high risk of distress during the COVID-19 pandemic, little is known about the pandemic's impact on psychotic-like experiences (PLEs). We conducted a study in technical secondary school and college students before and during the pandemic to explore changes in PLEs and relevant influential factors. METHODS A total of 938 students completed both waves of the survey through electronic questionnaires. PLEs were assessed using the 15-item Positive Subscale of the Community Assessment of Psychic Experiences (CAPE-P15). Childhood trauma, perceived stress, resilience, and demographic factors were evaluated at baseline, and psychological status was measured during the pandemic. RESULTS The overall CAPE-P15 scores significantly decreased during the pandemic. Students with persistent PLEs showed the most severe COVID-19 related psychological symptoms, followed by new-onset and remitted individuals; those without PLEs exhibited the mildest symptoms (all p < .001). A single parent family (OR = 4.707), more childhood trauma (OR = 1.056), and a higher family income (OR = 1.658) were predictive of new-onset PLEs during the pandemic, while better resilience was a protective factor, associated with remission of previous PLEs (OR = 0.932). CONCLUSIONS Despite a downward trend in the prevalence of PLEs during the pandemic, PLEs predict greater serious psychological impact due to COVID-19, especially for students with persistent PLEs. Interventions that cultivate students' resilience are urgently needed to reduce PLEs and improve mental health, especially for students from single parent households or those who have experienced childhood trauma.
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Affiliation(s)
- Meng Sun
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Dongfang Wang
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, 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, School of Psychology, South China Normal University, Guangzhou, Guangdong, China
| | - Ling Jing
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Liang Zhou
- Department of Social Psychiatry, the Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
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