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Kisiang'ani IB, Aden M, Mwangi HR, Akena D, Alemayehu M, Barasa J, Gelaye B, Gichuru S, Kariuki SM, Kwobah EK, Kyebuzibwa J, Mwema RM, Newton CRJC, Ongeri L, Pretorius A, Stein DJ, Stevenson A, Stroud RE, Teferra S, Zingela Z, Atwoli L. Exploring psychotic symptoms among substance-naïve individuals and recent abstainers without a psychosis diagnosis: A cross-country study across Kenya, Uganda, Ethiopia, and South Africa. Psychiatry Res 2024; 342:116253. [PMID: 39514937 DOI: 10.1016/j.psychres.2024.116253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 09/23/2024] [Accepted: 10/27/2024] [Indexed: 11/16/2024]
Abstract
Psychotic symptoms are of increasing interest in mental health due to their predictive value for future psychotic disorders. While these symptoms are prevalent in the general population, their occurrence varies globally. This study aimed to explore the prevalence and factors associated with psychotic symptoms among individuals identified as substance-naïve and recent abstainers without a history of psychosis. A cross-sectional analysis was conducted on 11,686 participants who reported no lifetime substance use, no substance use in the previous three months, and did not have a diagnosis of psychosis. The study utilized the Psychosis Screening Questionnaire to estimate the one-year prevalence of psychotic symptoms and their associations with demographic and clinical attributes. Results revealed a 3.5 % overall prevalence of psychotic symptoms with 2.9 % prevalence among substance naïve and 4.3 % among recent abstainers. Factors associated with psychotic symptoms were age, being female, having chronic medical conditions, encountering traumatic life events being divorced or separated and lower education levels which positively correlated with symptom scores. There is a need for future investigations and longitudinal studies to uncover the underlying mechanisms and impacts of psychotic symptoms.
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Affiliation(s)
- Isaac Babu Kisiang'ani
- Department of Mental Health, Bungoma County Referral Hospital, Kenya; Department of Mental Health and Behavioural Sciences Moi University, Eldoret, Kenya.
| | - Mohammed Aden
- Department of Mental Health and Behavioural Sciences Moi University, Eldoret, Kenya; Department of Mental Health, Wajir County Referral Hospital, Garissa, Kenya
| | - Henry R Mwangi
- Department of Health Information Management, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Dickens Akena
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Melkam Alemayehu
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Julius Barasa
- Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Psychiatry, Harvard Medical School and The Chester M. Pierce MD, Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Stella Gichuru
- Department of Medicine, Medical College East Africa, The Aga Khan University, Nairobi, Kenya; Academic Model Providing Access to Health Care, Eldoret, Kenya
| | - Symon M Kariuki
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Edith Kamaru Kwobah
- Department of Mental Health, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Joseph Kyebuzibwa
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rehema M Mwema
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya
| | - Charles R J C Newton
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Research Programme-Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, Oxford, UK
| | - Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Adele Pretorius
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; SA MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town and Neuroscience Institute, Cape Town, South Africa
| | - Anne Stevenson
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA; Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rocky E Stroud
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zukiswa Zingela
- Executive Dean's Office, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Sciences Moi University, Eldoret, Kenya; Brain and Mind Institute, The Aga Khan University, Nairobi, Kenya; Department of Medicine, Medical College East Africa, The Aga Khan University, Nairobi, Kenya
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Bolhuis K, Espinosa Dice AL, Jansen PW, Tiemeier H, Denckla CA. Neurocognition and academic achievement among bereaved children in the Generation R Cohort. Sci Rep 2024; 14:21187. [PMID: 39261571 PMCID: PMC11391039 DOI: 10.1038/s41598-024-72178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 09/04/2024] [Indexed: 09/13/2024] Open
Abstract
Childhood bereavement is an adverse event, yet children demonstrate considerable variability in health outcomes. Bereaved children are at risk of lower lifelong educational attainment, though the contribution of neurocognitive performance is yet to be investigated. Using data from the population-based Generation R Study wherein nearly 10,000 pregnant mothers were recruited between 2002 and 2006, we estimated the association of bereavement by age 10 years with four subtests of cognitive function and academic achievement at 13 years. Bereavement by 10 years of age was experienced by n = 796 (37.3%) of youth and was associated with a 1.12-point (SD = 0.55; p-value = 0.04) lower full-scale IQ at 13 years, which was mainly driven by lower matrix reasoning scores (βadjusted = -0.27, SE = 0.11, p < 0.02). There were no differences in academic achievement or other subtests of neurocognitive function between bereaved and non-bereaved children. Secondary analyses adjusting for pre-bereavement nonverbal cognitive ability and mental health problems revealed an overall association between bereavement and subsequent full-scale IQ and matrix reasoning, but only among those youth whose caregivers reported that the loss had an emotional influence on the child. These novel findings leveraging prospective assessments in a population-based birth cohort highlight risk and resilience mechanisms warranting further research.
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Affiliation(s)
- K Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - A L Espinosa Dice
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - P W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - C A Denckla
- Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
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Hughes DE, Kunitoki K, Elyounssi S, Luo M, Bazer OM, Hopkinson CE, Dowling KF, Doyle AE, Dunn EC, Eryilmaz H, Gilman JM, Holt DJ, Valera EM, Smoller JW, Cecil CAM, Tiemeier H, Lee PH, Roffman JL. Genetic patterning for child psychopathology is distinct from that for adults and implicates fetal cerebellar development. Nat Neurosci 2023; 26:959-969. [PMID: 37202553 PMCID: PMC7614744 DOI: 10.1038/s41593-023-01321-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/29/2023] [Indexed: 05/20/2023]
Abstract
Childhood psychiatric symptoms are often diffuse but can coalesce into discrete mental illnesses during late adolescence. We leveraged polygenic scores (PGSs) to parse genomic risk for childhood symptoms and to uncover related neurodevelopmental mechanisms with transcriptomic and neuroimaging data. In independent samples (Adolescent Brain Cognitive Development, Generation R) a narrow cross-disorder neurodevelopmental PGS, reflecting risk for attention deficit hyperactivity disorder, autism, depression and Tourette syndrome, predicted psychiatric symptoms through early adolescence with greater sensitivity than broad cross-disorder PGSs reflecting shared risk across eight psychiatric disorders, the disorder-specific PGS individually or two other narrow cross-disorder (Compulsive, Mood-Psychotic) scores. Neurodevelopmental PGS-associated genes were preferentially expressed in the cerebellum, where their expression peaked prenatally. Further, lower gray matter volumes in cerebellum and functionally coupled cortical regions associated with psychiatric symptoms in mid-childhood. These findings demonstrate that the genetic underpinnings of pediatric psychiatric symptoms differ from those of adult illness, and implicate fetal cerebellar developmental processes that endure through childhood.
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Affiliation(s)
- Dylan E Hughes
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Keiko Kunitoki
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Safia Elyounssi
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Mannan Luo
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
- Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Oren M Bazer
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Casey E Hopkinson
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kevin F Dowling
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Translational Neuroscience Program, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA, USA
| | - Alysa E Doyle
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Erin C Dunn
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Center on the Developing Child at Harvard University, Cambridge, MA, USA
| | - Hamdi Eryilmaz
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jodi M Gilman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Daphne J Holt
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Eve M Valera
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
- Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Rotterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Rotterdam, the Netherlands
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Phil H Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, The Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
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Thakrar V, Bardhan M, Chakraborty N. Early intervention in psychosis: An analysis of the characteristics and service needs of patients over the age of 35. Early Interv Psychiatry 2023; 17:177-182. [PMID: 35739609 DOI: 10.1111/eip.13318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 11/27/2022]
Abstract
AIM In 2016 NICE updated its guidance, extending the age to which early intervention in psychosis (EIP) services treat patients following their first episode of psychosis, to 65 years, from the previous cut-off of 35 years. The aim of this service evaluation was to identify differences in the demographic details, diagnoses, and treatments between patients below and above 35 years to identify any unmet needs in the latter age category. METHODS A total of 100 patients from the caseload were randomly selected, with 50 from each age group, to analyse in further detail. Descriptive statistics was predominantly used due to the relatively small sample size. RESULTS The over 35 s were predominantly female (62%), whilst the under 35 s were predominantly male (66%). There was a statistically significantly higher rate of substance misuse in the under 35 s. Whilst schizophrenia was the most common diagnosis in both groups, higher rates of delusional disorders and psychosis NOS were observed in the over 35 s. In both age groups, a median of two different medications was used per patient. However, amongst the over 35 s there is less use of psychological therapy and of support, time and recovery workers (STR workers). CONCLUSION There are distinct differences between the two age groups including demographic and diagnostic features. Being historically youth based, EIP services needs to ensure that treatments offered are tailored to meet the need of the older age demographic who have different needs.
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Affiliation(s)
- Vedas Thakrar
- Psychosis Intervention & Early Recovery (PIER) Team, Leicestershire Partnership NHS Trust, Leicester, UK
- Department of Acute Medicine, Peterborough City Hospital, North West Anglia NHS Foundation Trust, Peterborough, UK
| | - Mainak Bardhan
- National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Nandini Chakraborty
- Psychosis Intervention & Early Recovery (PIER) Team, Leicestershire Partnership NHS Trust, Leicester, UK
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Gutteridge TP, Kelly AB, Laurens KR. Increased likelihood of distressing and functionally impairing psychotic-like experiences among children with co-occurring internalising and externalising problems. Schizophr Res 2023; 252:225-230. [PMID: 36681045 DOI: 10.1016/j.schres.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/01/2023] [Accepted: 01/07/2023] [Indexed: 01/20/2023]
Abstract
Among children with psychotic-like experiences (PLEs), the presence of co-occurring psychopathology may distinguish children's self-report of clinically significant experiences (i.e., PLEs that are distressing and/or impairing of daily functioning) from reports of more benign experiences. The aim of this study was to examine whether the likelihood of distressing or impairing PLEs differed according to type of co-occurring psychopathology symptoms. A community sample of 5268 children aged 9-12 years were recruited from Greater London, UK. Participants completed the Psychotic-Like Experiences Questionnaire for Children, and the Strengths and Difficulties Questionnaire to measure internalising and externalising problems. Multinomial logistic regressions were used to determine the likelihood of PLEs being distressing and/or impairing (vs. not) among children with different co-occurring symptom profiles (PLEs only; PLEs with internalising problems only - PLE-I; PLEs with externalising problems only - PLE-E; and PLEs with both internalising and externalising problems - PLE-IE). Children with co-occurring internalising and/or externalising problems had greater odds of distressing and/or impairing PLEs compared to children without co-occurring psychopathology (PLEs only). These associations were moderate for PLE-E and strong for PLE-I and PLE-IE, with the greatest odds of distressing and impairing PLEs evident in the presence of internalising plus externalising comorbidities (odds ratios [with 99 % confidence intervals] for PLE-IE relative to PLE-I = 2.00 [1.34-2.99]; PLE-IE relative to PLE-E = 5.46 [3.78-7.90]). These results affirm the importance of screening for the presence and type of co-occurring psychopathology among children with PLEs to demarcate potentially different treatment needs.
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Affiliation(s)
- Tiffany P Gutteridge
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, QLD, Australia
| | - Adrian B Kelly
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, QLD, Australia; Queensland University of Technology (QUT), Centre for Child Health and Well-being, Brisbane, QLD, Australia; Queensland University of Technology (QUT), Centre for Inclusive Education (C4IE), Brisbane, QLD, Australia
| | - Kristin R Laurens
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, QLD, Australia; Queensland University of Technology (QUT), Centre for Child Health and Well-being, Brisbane, QLD, Australia; Queensland University of Technology (QUT), Centre for Inclusive Education (C4IE), Brisbane, QLD, Australia; King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, London, UK.
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Owan VJ, Duruamaku-Dim JU, Okon AE, Akah LU, Agurokpon DC, Ubi IO, Abanyam VA. Interlinking alcohol intake, mental stress, psychotic experiences and job performance of higher institutions' graduates: A structural equation modelling. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:312. [PMID: 36439016 PMCID: PMC9683444 DOI: 10.4103/jehp.jehp_417_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Graduates' job performance has become a matter that needs urgent attention. This is because many stakeholders are increasingly becoming interested in understanding the extent schools are able to produce output that meets the yearnings of society. Along these lines, we examined the contributions of alcohol intake to the job performance of higher education graduates while treating mental stress and psychotic experiences as mediators in the nexus. MATERIALS AND METHODS The study's population comprised all the graduates of higher education institutions in Nigeria between 2015 and 2020. Data were collected from a virtual cross-section of 3,862 graduates who self-reported to have taken alcohol in the past. These participants responded to an electronic questionnaire that was mailed to them. The scale content validity for clarity and relevance were 0.90 and 0.88, respectively, while the Cronbach alpha reliability estimate of the instrument is 0.86. RESULTS Amongst many others, key findings indicate that alcohol intake, mental stress and psychotic experiences jointly made a significant negative contribution to the overall job performance of graduates (R 2 = 0.256, 95% confidence interval (CI) [0.23, 0.28], P = 0.00). Mental stress (B = -0.09, β = -0.14, z = -4.45, 95%CI [-0.24, -0.05], P = 0.00) and psychotic experiences (B = -0.26, β = -0.43, z = -8.07, 95%CI [-0.68, -0.16], P = 0.01) have significant negative contributions to graduates' job performance, respectively. Alcohol intake and mental stress jointly predict the psychotic experiences of graduates (B = -0.26, β = -0.43, z = -8.07, 95%CI [-0.68, -0.16], P = 0.01). Alcohol intake has a positive contribution to the mental stress of graduates (R 2 = 0.797, 95%CI [0.77, 0.825], P = 0.01). Mental stress and psychotic experiences jointly mediated the relationship between alcohol intake and graduates' job performance. CONCLUSION It was concluded that high intake of alcohol and high levels of mental stress and psychotic experiences significantly reduce graduates' job performance generally and in specific aspects. Alcohol intake can increase graduates' job performance to a small extent depending on the amount consumed.
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Affiliation(s)
| | | | - Abigail Edem Okon
- Department of Educational Foundations, University of Calabar, Nigeria
| | - Levi Udochukwu Akah
- Department of Human Kinetics and Health Education, University of Calabar, Nigeria
| | | | - Isaac Ofem Ubi
- Department of Educational Foundations, University of Calabar, Nigeria
| | - Victor Atah Abanyam
- Department of Vocational and Technical Education, University of Calabar, Nigeria
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Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D, Cannon M. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med 2022; 52:1-12. [PMID: 36004805 PMCID: PMC9772919 DOI: 10.1017/s0033291722002550] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/31/2022]
Abstract
Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.
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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
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College, Dublin 4, Ireland
- Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin 6, Ireland
| | - 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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8
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The educational burden of disease: a cohort study. THE LANCET PUBLIC HEALTH 2022; 7:e549-e556. [DOI: 10.1016/s2468-2667(22)00059-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 01/05/2023] Open
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Barnes GL, Stewart C, Browning S, Bracegirdle K, Laurens KR, Gin K, Hirsch C, Abbott C, Onwumere J, Banerjea P, Kuipers E, Jolley S. Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8-18 years. Soc Psychiatry Psychiatr Epidemiol 2022; 57:461-472. [PMID: 34480219 PMCID: PMC8934329 DOI: 10.1007/s00127-021-02168-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/26/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Neurocognitive difficulties and early childhood speech/motor delays are well documented amongst older adolescents and young adults considered at risk for psychosis-spectrum diagnoses. We aimed to test associations between unusual or psychotic-like experiences (PLEs), co-occurring distress/emotional symptoms, current cognitive functioning and developmental delays/difficulties in young people (aged 8-18 years) referred to Child and Adolescent Mental Health Services in South London, UK. METHODS Study 1 examined receptive language, verbal learning and caregiver-reported speech and motor delays/difficulties in a sample of 101 clinically-referred children aged 8-14 years, comparing those reporting no PLEs (n = 19), PLEs without distress (n = 16), and PLEs with distress (n = 66). Study 2 tested associations of severity of distressing PLEs with vocabulary, perceptual reasoning, word reading and developmental delays/difficulties in a second sample of 122 adolescents aged 12-18 years with distressing PLEs. RESULTS In Study 1, children with distressing PLEs had lower receptive language and delayed recall and higher rates of developmental delays/difficulties than the no-PLE and non-distressing PLE groups (F values: 2.3-2.8; p values: < 0.005). Receptive language (β = 0.24, p = 0.03) and delayed recall (β = - 0.17, p = 0.02) predicted PLE distress severity. In Study 2, the cognitive-developmental variables did not significantly predict PLE distress severity (β values = 0.01-0.22, p values: > 0.05). CONCLUSION Findings may be consistent with a cognitive-developmental model relating distressing PLEs in youth with difficulties in cognitive functioning. This highlights the potential utility of adjunctive cognitive strategies which target mechanisms associated with PLE distress. These could be included in cognitive-behavioural interventions offered prior to the development of an at-risk mental state in mental health, educational or public health settings.
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Affiliation(s)
- G L Barnes
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK.
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK.
| | - C Stewart
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - S Browning
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - K Bracegirdle
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - K R Laurens
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- Queensland University of Technology (QUT), School of Psychology and Counselling, Brisbane, QLD, 4059, Australia
- University of New South Wales, School of Psychiatry, Sydney, NSW, 2052, Australia
| | - K Gin
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - C Hirsch
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - C Abbott
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - J Onwumere
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - P Banerjea
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - E Kuipers
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
- NIHR Biomedical Research Centre (BRC) at the South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AZ, UK
| | - S Jolley
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
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10
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Schuurmans IK, Luik AI, de Maat DA, Hillegers MHJ, Ikram MA, Cecil CAM. The association of early life stress with IQ-achievement discrepancy in children: A population-based study. Child Dev 2022; 93:1837-1847. [PMID: 35822555 PMCID: PMC9796500 DOI: 10.1111/cdev.13825] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 01/01/2023]
Abstract
Early life stress (ELS) is associated with lower IQ and academic achievement; however, it remains unclear whether it additionally explains their discrepancy. In 2,401 children (54% girls, 30.2% migration background) from the population-based study Generation R Study, latent factors of prenatal and postnatal (age 0-10) ELS were estimated, and IQ-achievement discrepancy (age 12) was quantified as variance in academic achievement not explained by IQ. ELS was prospectively associated with larger IQ-achievement discrepancy (βprenatal = -0.24; βpostnatal = -0.28), lower IQ (βprenatal = -0.20; βpostnatal = -0.22), and lower academic achievement (βprenatal = -0.31; βpostnatal = -0.36). Associations were stronger for latent ELS than for specific ELS domains. Results point to ELS as a potential prevention target to improve academic potential.
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Affiliation(s)
- Isabel K. Schuurmans
- Department of EpidemiologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,The Generation R Study GroupErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Annemarie I. Luik
- Department of EpidemiologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Department of Child and Adolescent Psychiatry/PsychologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Donna A. de Maat
- The Generation R Study GroupErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Department of Psychology, Education, and Child StudiesErasmus School of Social and Behavioural Sciences, Erasmus University RotterdamRotterdamThe Netherlands
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - M. Arfan Ikram
- Department of EpidemiologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Charlotte A. M. Cecil
- Department of EpidemiologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Department of Child and Adolescent Psychiatry/PsychologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands,Department of Biomedical Data SciencesMolecular Epidemiology, Leiden University Medical CenterLeidenThe Netherlands
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11
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Steenkamp LR, Tiemeier H, Blanken LME, Hillegers MHJ, Kushner SA, Bolhuis K. Predicting persistence of hallucinations from childhood to adolescence. Br J Psychiatry 2021; 219:670-677. [PMID: 35048879 PMCID: PMC8674728 DOI: 10.1192/bjp.2021.115] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Psychotic experiences predict adverse health outcomes, particularly if they are persistent. However, it is unclear what distinguishes persistent from transient psychotic experiences. AIMS In a large population-based cohort, we aimed to (a) describe the course of hallucinatory experiences from childhood to adolescence, (b) compare characteristics of youth with persistent and remittent hallucinatory experiences, and (c) examine prediction models for persistence. METHOD Youth were assessed longitudinally for hallucinatory experiences at mean ages of 10 and 14 years (n = 3473). Multi-informant-rated mental health problems, stressful life events, self-esteem, non-verbal IQ and parental psychopathology were examined in relation to absent, persistent, remittent and incident hallucinatory experiences. We evaluated two prediction models for persistence with logistic regression and assessed discrimination using the area under the curve (AUC). RESULTS The persistence rate of hallucinatory experiences was 20.5%. Adolescents with persistent hallucinatory experiences had higher baseline levels of hallucinatory experiences, emotional and behavioural problems, as well as lower self-esteem and non-verbal IQ scores than youth with remittent hallucinatory experiences. Although the prediction model for persistence versus absence of hallucinatory experiences demonstrated excellent discriminatory power (AUC-corrected = 0.80), the prediction model for persistence versus remittance demonstrated poor accuracy (AUC-corrected = 0.61). CONCLUSIONS This study provides support for the dynamic expression of childhood hallucinatory experiences and suggests increased neurodevelopmental vulnerability in youth with persistent hallucinatory experiences. Despite the inclusion of a wide array of psychosocial parameters, a prediction model discriminated poorly between youth with persistent versus remittent hallucinatory experiences, confirming that persistent hallucinatory experiences are a complex multifactorial trait.
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Affiliation(s)
- Lisa R. Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, the Netherlands and Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, USA
| | - Laura M. E. Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, the Netherlands
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, the Netherlands
| | - Steven A. Kushner
- Department of Psychiatry, Erasmus University Medical Centre, the Netherlands
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, the Netherlands,Correspondence: Koen Bolhuis.
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12
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Steenkamp LR, Tiemeier H, Bolhuis K, Hillegers MHJ, Kushner SA, Blanken LME. Peer-reported bullying, rejection and hallucinatory experiences in childhood. Acta Psychiatr Scand 2021; 143:503-512. [PMID: 33524175 PMCID: PMC8248258 DOI: 10.1111/acps.13282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/07/2021] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Psychotic experiences, such as hallucinations, occur commonly in children and have been related to bullying victimization. However, whether bullying perpetration, peer rejection, or peer acceptance are related to hallucinatory experiences has remained under-examined. We used a novel peer nomination method to examine whether (i) bullying perpetration and (ii) social positions within peer networks were associated with future hallucinatory experiences. METHODS This prospective study was embedded in the population-based Generation R Study. Bullying perpetration, peer rejection, and peer acceptance were assessed using peer nominations at age 7 years (N = 925). Using a social network analysis, we estimated social positions within peer rejection and acceptance networks. Bullying victimization was assessed using self-reports. Self-reported hallucinatory experiences were assessed at age 10 years. Analyses were adjusted for sociodemographic covariates. RESULTS Higher levels of bullying perpetration were prospectively associated with an increased burden of hallucinatory experiences (OR = 1.22, 95% CI 1.05-1.43, p = 0.011). Bullies had a 50% higher, and bully-victims had a 89% higher odds, of endorsing hallucinatory experiences three years later than children who were not involved in bullying (ORbully = 1.50, 95% CI 1.01-2.24, p = 0.045; ORbully-victim = 1.89, 95% CI 1.15-3.10, p = 0.012). Unfavorable positions within peer rejection networks, but not peer acceptance networks, were associated with an increased risk for hallucinatory experiences (ORpeer rejection = 1.24, 95% CI 1.07-1.44, pFDR-corrected = 0.024). CONCLUSION Using peer reports, we observed that bullies and socially rejected children have a higher likelihood to report hallucinatory experiences in pre-adolescence. Children who are both a bully and a victim of bullying (ie, bully-victims) may be particularly vulnerable for psychotic experiences.
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Affiliation(s)
- Lisa R. Steenkamp
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands,Department of Social and Behavioral SciencesHarvard TH. Chan School of Public HealthBostonMAUSA
| | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Manon H. J. Hillegers
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
| | - Steven A. Kushner
- Department of PsychiatryErasmus University Medical CenterRotterdamThe Netherlands
| | - Laura M. E. Blanken
- Department of Child and Adolescent Psychiatry/PsychologyErasmus Medical CenterSophia Children's HospitalRotterdamThe Netherlands
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