A twin study of genetic and environmental determinants of abnormal persistence of psychotic experiences in young adulthood

Abstract

Evidence suggests that subclinical psychotic experiences are more likely to cause transition to psychotic disorder if their expression becomes persistent. The study of longitudinal patterns of subclinical psychotic experiences may help to distinguish subgroups with transient and persistent psychotic symptoms, who may differ in risk of later psychosis. The current study investigated patterns of developmental course of subclinical psychotic experiences in a general population sample of 566 female twins, aged 18-45 years. The positive symptoms subscale of the Community Assessment of Psychic Experiences (CAPE), completed three times in 2 years, was analyzed with growth modeling. Using Latent Class Analysis, two developmental courses were distinguished: a Persistent and a Low (expression of subclinical psychotic experiences) group. The Persistent group reported significantly higher levels of depressive and negative symptoms and worse functioning in daily life. Childhood trauma (OR: 3.26, P < 0.0001) and stressful life events over the study period (OR: 3.15, P = 0.031) predicted membership of the Persistent group. Of the monozygotic (MZ) twins with their co-twin in the Persistent group, 49% also were in the Persistent group themselves (OR: 9.32, P < 0.0001), compared to only 14% in the dizygotic (DZ) co-twins (OR: 1.56, P = 0.42) (χ(2)(2) = 22.97; P < 0.001). The findings suggest that persistence of subclinical psychosis is influenced by both genetic and environmental factors, providing the possibility to study the (possibly modifiable) etiology underlying the longitudinal process of persistence of the early expression of psychosis liability.