Differences Between Self-Reported Psychotic Experiences, Clinically Relevant Psychotic Experiences, and Attenuated Psychotic Symptoms in the General Population

Author(s):Show less -

Moriyama, Tais Silveira ^{[1, 2, 3, 4]} ; van Os, Jim ^{[2, 5, 6]} ; Gadelha, Ary ^{[1, 3]} ; Pan, Pedro Mario ^{[1, 3]} ; Salum, Giovanni Abrahao ^{[7, 3]} ; Manfro, Gisela Gus ^{[7, 3]} ; Mari, Jair de Jesus ^{[1, 3]} ; Miguel, Euripedes Constantino ^{[3, 8]} ; Rohde, Luis Augusto ^{[7, 3]} ; Polanczyk, Guilherme Vanoni ^{[3, 8]} ; McGuire, Philip ^[5] ; Bressan, Rodrigo Affonseca ^{[1, 2, 3]} ; Drukker, Marian ^[2]

Affiliation

^[1] Univ Fed Sao Paulo, Dept Psychiat, Sao Paulo - Brazil

^[2] MUMC, Sch Mental Hlth & Neurosci MHeNS, Dept Psychiat & Psychol, Maastricht - Netherlands

^[3] CNPq, INCT, Natl Inst Dev Psychiat Children & Adolescents, Brazilian High Risk Cohort Study Psychiat Disorde, Sao Paulo - Brazil

^[4] Inst Bairral Psiquiatria, Ctr Atendimento Especializado, Itapira - Brazil

^[5] Kings Coll London, Kings Hlth Partners, Dept Psychosis Studies, London - England

^[6] Univ Utrecht, Med Ctr, UMC Utrecht Brain Ctr, Dept Psychiat, Utrecht - Netherlands

^[7] Univ Fed Rio Grande do Sul, Dept Psychiat, Porto Alegre, RS - Brazil

^[8] Univ Sao Paulo, Fac Med FMUSP, Dept Psiquiatria, Sao Paulo - Brazil

• Document type: Journal article
• Source: FRONTIERS IN PSYCHIATRY; v. 10, OCT 29 2019.
• Web of Science Citations: 0

Abstract

Purpose: Psychotic experiences in childhood (such as hearing voices or being suspicious) represent an important phenotype for early intervention. However, these experiences can be defined in several ways: self-reported psychotic experiences (SRPE) rely exclusively on the child's report, clinically validated psychotic experiences (CRPE) are based on clinical assessment, and attenuated psychotic symptoms (APS) represents a categorization to do with clinical relevance in relation to severity. Very few studies have investigated how these distinctions impact clinical and other domains. The present study aims to compare SRPE, CRPE, and APS among children and adolescents. Methods: This study is part of the Brazilian High-Risk Cohort Study for Psychiatric Disorders, in which 2,241 individuals aged 6-14 years provided self-ratings of 20 psychotic experiences using the Community Assessment of Psychic Experiences (CAPE). A trained psychologist conducted an interview to validate or reject reported experiences and to rate the presence of APS and affective flattening. In parallel, parents provided information about child mental health to an independent interviewer. We tested the association of mutually exclusive categories of non-validated SRPE (nSRPE), clinically validated PE below the threshold for APS (nCRPE), and APS (nSRPE = 33%, nCRPE = 11%, APS = 6%), with parents' information about the child's positive attributes and levels of psychopathology and psychologist assessment of blunted affect. Results: Most associations were qualitatively similar, and there was a dose-response in the strength of associations across categories, such that APS > nCRPE > nSRPE. Experiences in all three categories were associated with female sex. nSRPE were associated with overall levels of psychopathology, but to a lesser degree than nCRPE and APS. APS and nCRPE were associated with less positive attributes, with APS more so than nCRPE. Only APS was associated with affective flattening. Conclusions: In children and adolescents, SRPE, CRPE, and APS all index liability for psychopathology, but as clinician rated relevance increases, associations get stronger and become evident across more domains. (AU)

• FAPESP's process: 08/57896-8 - National Institute for Developmental Psychiatry
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants