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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: 28] [Impact Index Per Article: 14.0] [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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2
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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: 2.0] [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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Gin K, Stewart C, Abbott C, Banerjea P, Bracegirdle K, Browning S, Byrne M, Emsley R, Ginestet C, Hirsch C, Kuipers E, Laurens KR, Onwumere J, Plant D, Valmaggia L, Jolley S. Psychosocial predictors of distressing unusual experiences in adolescence: Testing the fit of an adult cognitive model of psychosis. Schizophr Res 2021; 237:1-8. [PMID: 34461373 DOI: 10.1016/j.schres.2021.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 08/09/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND For adults with psychosis, international guidelines recommend individual and family based cognitive behavioural therapy interventions. Recommendations are extended to children and adolescents, based on adult research. It is also recommended that psychological interventions are offered for childhood presentations of psychotic-like or Unusual Experiences (UE), in the absence of a formal diagnosis, when these are Distressing (UEDs). Cognitive models underpinning these interventions require testing in adolescent populations, to further refine therapies. We address this need, by testing for the first time, the application of the adult cognitive model of psychosis to adolescent UEDs. METHODS We used baseline data from the Coping with Unusual ExperienceS (CUES+) randomised controlled trial for 122 clinically referred adolescents (12-18 years) with self-reported UEDs. Known psychological mechanisms of adult cognitive models of psychosis; negative life events, affect (anxiety and depression), reasoning (jumping to conclusions bias), and schemas were investigated using multiple linear regression models, alongside variables particularly associated with the development and severity of adolescent UEDs and UE type (dissociation, externalising/behavioural problems, managing emotions). RESULTS The psychological mechanisms of adult cognitive models of psychosis explained 89% of the total variance of adolescent UED severity, F (10, 106) = 99.34, p < .0005, r2 = 0.89, with schemas as the principal significant contributor. Variance explained 40 - 72% across each of the UE types (paranoia, hallucinations, delusions, paranormal thinking and grandiosity). CONCLUSIONS Findings suggest that the psychological components of adult cognitive models of psychosis, particularly schemas, are also implicated in adolescent UEDs.
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Affiliation(s)
- Kimberley Gin
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
| | | | - Chris Abbott
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Partha Banerjea
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | | | - Sophie Browning
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Majella Byrne
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Richard Emsley
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Cedric Ginestet
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Colette Hirsch
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Kristin R Laurens
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK; Queensland University of Technology (QUT), School of Psychology and Counselling, Victoria Park Road, Kelvin Grove, QLD 4059, Australia
| | - Juliana Onwumere
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Deborah Plant
- South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Lucia Valmaggia
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Suzanne Jolley
- King's College London, Department of Psychology, Institute of Psychiatry Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
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Webb R, Bartl G, James B, Skan R, Peters E, Jones AM, Garety P, Kuipers E, Hayward M, Greenwood K. Exploring the Development, Validity, and Utility of the Short-Form Version of the CHoice of Outcome In Cbt for PsychosEs: A Patient-Reported Outcome Measure of Psychological Recovery. Schizophr Bull 2020; 47:653-661. [PMID: 33215190 PMCID: PMC8084424 DOI: 10.1093/schbul/sbaa173] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The original CHoice of Outcome In Cbt for psychosEs (CHOICE) measure was designed in collaboration with experts by experience as a patient-reported "Psychological Recovery" outcome measure for cognitive-behavioral therapy for psychosis (CBTp). A short version (CHOICE-SF) was developed to use as a brief outcome measure, with a focus on sensitivity to change, for use in future research and practice. CHOICE-SF was developed and validated using 3 separate samples, comprising 640 service users attending 1 of 2 transdiagnostic clinics for (1) CBTp or (2) therapies for voice hearing or (3) who took part in the treatment as usual arm of a trial. In the initial subsample of 69 participants, items from the original CHOICE measure with medium to large effect sizes for change pre- to post-CBTp were retained to form the CHOICE-SF. Internal consistency, construct validity, and sensitivity to change were confirmed, and the factor structure was examined in 242 participants. Specificity was confirmed by comparison with 44 participants who completed CHOICE at 2 time points but did not receive therapy. Validation of CHOICE-SF was carried out by confirming factor structure and sensitivity to change in a new sample of 354 and a subsample of 51 participants, respectively. The CHOICE-SF comprised 11 items and 1 additional personal goal item. A single-factor structure was confirmed, with high internal consistency, construct validity, and sensitivity to change. The CHOICE-SF is a brief, psychometrically robust measure to assess change following psychological therapies in research and clinical practice for people with psychosis and severe mental illness.
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Affiliation(s)
- Rebecca Webb
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Gergely Bartl
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Bryony James
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Rosie Skan
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK
| | - Emmanuelle Peters
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,Psychological Interventions Clinic for Outpatients With Psychosis, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK
| | - Anna-Marie Jones
- R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Philippa Garety
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Elizabeth Kuipers
- Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King’s College London, London, UK,Psychological Interventions Clinic for Outpatients With Psychosis, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK,National Institute for Health Research Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | - Mark Hayward
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK,R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Kathryn Greenwood
- School of Psychology, University of Sussex, Pevensey, Falmer, Brighton, UK,R&D Department, Sussex Partnership NHS Foundation Trust, Brighton, UK,To whom correspondence should be addressed; tel: +44 1273 678409, fax: +44 1273 678058, e-mail:
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Storebø OJ, Stoffers-Winterling JM, Völlm BA, Kongerslev MT, Mattivi JT, Jørgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev 2020; 5:CD012955. [PMID: 32368793 PMCID: PMC7199382 DOI: 10.1002/14651858.cd012955.pub2] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Over the decades, a variety of psychological interventions for borderline personality disorder (BPD) have been developed. This review updates and replaces an earlier review (Stoffers-Winterling 2012). OBJECTIVES To assess the beneficial and harmful effects of psychological therapies for people with BPD. SEARCH METHODS In March 2019, we searched CENTRAL, MEDLINE, Embase, 14 other databases and four trials registers. We contacted researchers working in the field to ask for additional data from published and unpublished trials, and handsearched relevant journals. We did not restrict the search by year of publication, language or type of publication. SELECTION CRITERIA Randomised controlled trials comparing different psychotherapeutic interventions with treatment-as-usual (TAU; which included various kinds of psychotherapy), waiting list, no treatment or active treatments in samples of all ages, in any setting, with a formal diagnosis of BPD. The primary outcomes were BPD symptom severity, self-harm, suicide-related outcomes, and psychosocial functioning. There were 11 secondary outcomes, including individual BPD symptoms, as well as attrition and adverse effects. DATA COLLECTION AND ANALYSIS At least two review authors independently selected trials, extracted data, assessed risk of bias using Cochrane's 'Risk of bias' tool and assessed the certainty of the evidence using the GRADE approach. We performed data analysis using Review Manager 5 and quantified the statistical reliability of the data using Trial Sequential Analysis. MAIN RESULTS We included 75 randomised controlled trials (4507 participants), predominantly involving females with mean ages ranging from 14.8 to 45.7 years. More than 16 different kinds of psychotherapy were included, mostly dialectical behaviour therapy (DBT) and mentalisation-based treatment (MBT). The comparator interventions included treatment-as-usual (TAU), waiting list, and other active treatments. Treatment duration ranged from one to 36 months. Psychotherapy versus TAU Psychotherapy reduced BPD symptom severity, compared to TAU; standardised mean difference (SMD) -0.52, 95% confidence interval (CI) -0.70 to -0.33; 22 trials, 1244 participants; moderate-quality evidence. This corresponds to a mean difference (MD) of -3.6 (95% CI -4.4 to -2.08) on the Zanarini Rating Scale for BPD (range 0 to 36), a clinically relevant reduction in BPD symptom severity (minimal clinical relevant difference (MIREDIF) on this scale is -3.0 points). Psychotherapy may be more effective at reducing self-harm compared to TAU (SMD -0.32, 95% CI -0.49 to -0.14; 13 trials, 616 participants; low-quality evidence), corresponding to a MD of -0.82 (95% CI -1.25 to 0.35) on the Deliberate Self-Harm Inventory Scale (range 0 to 34). The MIREDIF of -1.25 points was not reached. Suicide-related outcomes improved compared to TAU (SMD -0.34, 95% CI -0.57 to -0.11; 13 trials, 666 participants; low-quality evidence), corresponding to a MD of -0.11 (95% CI -0.19 to -0.034) on the Suicidal Attempt Self Injury Interview. The MIREDIF of -0.17 points was not reached. Compared to TAU, psychotherapy may result in an improvement in psychosocial functioning (SMD -0.45, 95% CI -0.68 to -0.22; 22 trials, 1314 participants; low-quality evidence), corresponding to a MD of -2.8 (95% CI -4.25 to -1.38), on the Global Assessment of Functioning Scale (range 0 to 100). The MIREDIF of -4.0 points was not reached. Our additional Trial Sequential Analysis on all primary outcomes reaching significance found that the required information size was reached in all cases. A subgroup analysis comparing the different types of psychotherapy compared to TAU showed no clear evidence of a difference for BPD severity and psychosocial functioning. Psychotherapy may reduce depressive symptoms compared to TAU but the evidence is very uncertain (SMD -0.39, 95% CI -0.61 to -0.17; 22 trials, 1568 participants; very low-quality evidence), corresponding to a MD of -2.45 points on the Hamilton Depression Scale (range 0 to 50). The MIREDIF of -3.0 points was not reached. BPD-specific psychotherapy did not reduce attrition compared with TAU. Adverse effects were unclear due to too few data. Psychotherapy versus waiting list or no treatment Greater improvements in BPD symptom severity (SMD -0.49, 95% CI -0.93 to -0.05; 3 trials, 161 participants), psychosocial functioning (SMD -0.56, 95% CI -1.01 to -0.11; 5 trials, 219 participants), and depression (SMD -1.28, 95% CI -2.21 to -0.34, 6 trials, 239 participants) were observed in participants receiving psychotherapy versus waiting list or no treatment (all low-quality evidence). No evidence of a difference was found for self-harm and suicide-related outcomes. Individual treatment approaches DBT and MBT have the highest numbers of primary trials, with DBT as subject of one-third of all included trials, followed by MBT with seven RCTs. Compared to TAU, DBT was more effective at reducing BPD severity (SMD -0.60, 95% CI -1.05 to -0.14; 3 trials, 149 participants), self-harm (SMD -0.28, 95% CI -0.48 to -0.07; 7 trials, 376 participants) and improving psychosocial functioning (SMD -0.36, 95% CI -0.69 to -0.03; 6 trials, 225 participants). MBT appears to be more effective than TAU at reducing self-harm (RR 0.62, 95% CI 0.49 to 0.80; 3 trials, 252 participants), suicidality (RR 0.10, 95% CI 0.04, 0.30, 3 trials, 218 participants) and depression (SMD -0.58, 95% CI -1.22 to 0.05, 4 trials, 333 participants). All findings are based on low-quality evidence. For secondary outcomes see review text. AUTHORS' CONCLUSIONS Our assessments showed beneficial effects on all primary outcomes in favour of BPD-tailored psychotherapy compared with TAU. However, only the outcome of BPD severity reached the MIREDIF-defined cut-off for a clinically meaningful improvement. Subgroup analyses found no evidence of a difference in effect estimates between the different types of therapies (compared to TAU) . The pooled analysis of psychotherapy versus waiting list or no treatment found significant improvement on BPD severity, psychosocial functioning and depression at end of treatment, but these findings were based on low-quality evidence, and the true magnitude of these effects is uncertain. No clear evidence of difference was found for self-harm and suicide-related outcomes. However, compared to TAU, we observed effects in favour of DBT for BPD severity, self-harm and psychosocial functioning and, for MBT, on self-harm and suicidality at end of treatment, but these were all based on low-quality evidence. Therefore, we are unsure whether these effects would alter with the addition of more data.
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Affiliation(s)
- Ole Jakob Storebø
- Child and Adolescent Psychiatric Department, Region Zealand, Roskilde, Denmark
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
- Department of Psychology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | | | - Birgit A Völlm
- Department of Forensic Psychiatry, Center for Neurology, University Rostock, Rostock, Germany
| | - Mickey T Kongerslev
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
- Department of Psychology, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Jessica T Mattivi
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Mie S Jørgensen
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
| | - Erlend Faltinsen
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
| | - Adnan Todorovac
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
| | - Christian P Sales
- Duncan MacMillan House, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- Institute of Mental Health, Department of Psychiatry & Applied Psychology, Nottingham, UK
| | | | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Erik Simonsen
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
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Maijer K, Staring T, Bartels-Velthuis AA, Palmen SJ, Sommer IE. Stronger than your voices: A cognitive behavioral therapy for youth suffering from auditory verbal hallucinations. Clin Child Psychol Psychiatry 2020; 25:386-400. [PMID: 31749371 DOI: 10.1177/1359104519888011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Auditory verbal hallucinations (AVHs) are a common feature in youth and mostly transient. Nevertheless, while present, AVH can cause considerable distress. Children and adolescents seeking help for distressing AVH represent a heterogeneous group in terms of underlying factors, yet they consistently suffer from their AVH. Until now, a youth-specific psychotherapeutic intervention for AVH was lacking. Experts in the field of treating AVH in both adults and youngsters collaborated with service users to develop the cognitive behavioral therapy (CBT) "Stronger Than Your Voices" (STYV). We investigated feasibility and clinical outcomes of the STYV therapy. METHODS Patients were derived from children and adolescents seeking help for AVH at the UMC Utrecht outpatient clinic with an indication for STYV therapy. Therapists preferably originated from referring health care facilities and were required to have sufficient general knowledge and experience with CBT. They received a short individual training to apply STYV. After, patients and their therapists could participate this naturalistic pilot study, assessing feasibility, tolerability, and clinical change when applying the STYV therapy. RESULTS Six participants (10-16 years old), all suffering from comorbid psychopathology, provided pre and post measures, all completing STYV therapy without experiencing an aggravation of symptoms. AVH total impact decreased 40% with Cohen's d within-group effect size (1.28) also suggesting clinically meaningful change. Therapists were positive about STYV therapy and manual. CONCLUSION The STYV therapy is feasible for youth with distressing AVH. First results indicate that STYV may be clinically effective. A trial to further test effectiveness in a larger sample is needed.
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Affiliation(s)
- Kim Maijer
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands.,De Bascule, The Netherlands
| | - Tonnie Staring
- Department for Transition Psychiatry and First Episode Psychosis, Altrecht Psychiatric Institute, The Netherlands
| | - Agna A Bartels-Velthuis
- Rob Giel Research Center, University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Saskia Jmc Palmen
- Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, The Netherlands
| | - Iris Ec Sommer
- Department of Neuroscience and Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands.,Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Norway
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7
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Laurens KR, Tzoumakis S, Dean K, Harris F, Carr VJ, Green MJ. Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:22-38. [PMID: 31328800 DOI: 10.1111/bjc.12230] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/17/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Kristin R. Laurens
- School of Psychology and Counselling, and Institute of Health and Biomedical Innovation Queensland University of Technology Brisbane Queensland Australia
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
| | - Stacy Tzoumakis
- School of Social Sciences University of New South Wales Sydney New South Wales Australia
| | - Kimberlie Dean
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- Justice Health & Forensic Mental Health Network Matraville New South Wales Australia
| | - Felicity Harris
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
| | - Vaughan J. Carr
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- School of Social Sciences University of New South Wales Sydney New South Wales Australia
- Department of Psychiatry Monash University Melbourne Victoria Australia
| | - Melissa J. Green
- School of Psychiatry University of New South Wales Sydney New South Wales Australia
- Neuroscience Research Australia Sydney New South Wales Australia
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8
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Kalman JL, Bresnahan M, Schulze TG, Susser E. Predictors of persisting psychotic like experiences in children and adolescents: A scoping review. Schizophr Res 2019; 209:32-39. [PMID: 31109737 DOI: 10.1016/j.schres.2019.05.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/22/2019] [Accepted: 05/05/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Subclinical psychotic experiences (PLEs) are among the frequently reported mental health problems in children/adolescents. PLEs identified in cross sectional studies of children/adolescents are associated with current and future mental health problems. These associations are stronger for PLEs that persist over time. Hence, it could be useful to examine which children/adolescents with PLEs at a first assessment (baseline) are more likely to have PLEs at subsequent assessments. METHODS We conducted a scoping review of studies that examined whether characteristics of children/adolescents (≤18 years) with PLEs at baseline predict whether PLEs are likely to be persistent or remittent at subsequent assessments. We included studies published between January 2002 and December 2017, conducted on general child/adolescent populations of ≥300 individuals, that provided data on PLEs for at least 2 time points, had available follow-up data for ≥50% of those assessed for PLEs at baseline and targeted for follow-up examination, and reported the differences between individuals with PLEs that persisted or remitted during the study period. RESULTS Six studies met our criteria. Each of them investigated a wide range of baseline characteristics but no predictor of persistence was replicated. CONCLUSIONS Our knowledge about which children/adolescents with PLEs at an initial assessment are likely to have persistent PLEs at subsequent assessments is sparse. A handful of predictors of persistent PLEs have been investigated so far, and none replicated. A better understanding of these predictors would be an important complement to investigations examining the evolution of PLEs and of mental health problems in children/adolescents.
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Affiliation(s)
- Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany.
| | - Michaeline Bresnahan
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, United States; Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University Göttingen, Göttingen, Germany; Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Ezra Susser
- Mailman School of Public Health, Columbia University, New York, NY, United States; New York State Psychiatric Institute, New York, New York, United States
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Maijer K, Hayward M, Fernyhough C, Calkins ME, Debbané M, Jardri R, Kelleher I, Raballo A, Rammou A, Scott JG, Shinn AK, Steenhuis LA, Wolf DH, Bartels-Velthuis AA. Hallucinations in Children and Adolescents: An Updated Review and Practical Recommendations for Clinicians. Schizophr Bull 2019; 45:S5-S23. [PMID: 30715540 PMCID: PMC6357982 DOI: 10.1093/schbul/sby119] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Hallucinations in children and adolescents are now known to occur on a continuum from healthy to psychopathology-related phenomena. Although hallucinations in young populations are mostly transient, they can cause substantial distress. Despite hallucinations being widely investigated, research so far has had limited implications for clinical practice. The present article has 3 main aims: (1) to review research findings since 2014 (when the last major review of the area was published); (2) to present assessment tools validated to measure hallucinations in children and adolescents; and (3) to discuss therapeutic strategies and clinical issues. We conclude by presenting a tailored care model for clinicians and outline future challenges for research.
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Affiliation(s)
- Kim Maijer
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands,Department of Psychiatry, University Medical Center Utrecht, Utrecht, the Netherlands,De Bascule, Amsterdam, the Netherlands,To whom correspondence should be addressed; University Medical Center Utrecht, Psychiatry department, HP A00.241, Heidelberglaan 100, 3485CX Utrecht, the Netherlands; tel: +31 88 7558180, fax: +31 88 755 54 43, e-mail:
| | - Mark Hayward
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Martin Debbané
- Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland,Developmental NeuroImaging and Psychopathology Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland,Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Renaud Jardri
- Univ Lille, CNRS UMR-9193, SCALab (PsyCHIC Team) & CHU Lille, CURE Platform, Fontan Hospital, Lille, France
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Andrea Raballo
- Division of Psychiatry, Clinical Psychology and Rehabilitation, Department of Medicine, University of Perugia, Perugia, Italy
| | - Aikaterini Rammou
- School of Psychology, University of Sussex, Brighton, UK,Research & Development Department, Sussex Partnership NHS Foundation Trust, Hove, UK
| | - James G Scott
- Centre for Clinical Research, Faculty of Medicine, University of Queensland, Herston, Australia,Metro North Mental Health, Herston, Australia,Queensland Centre for Mental Health Research, Wacol, Australia
| | - Ann K Shinn
- Psychotic Disorders Division, McLean Hospital, Belmont, MA,Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Laura A Steenhuis
- University of Groningen, Faculty of Behavioural and Social Sciences, Department of Clinical Psychology and Experimental Psychopathology, Groningen, the Netherlands
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research center, Groningen, the Netherlands
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