Chapter 7 - Psychotic-like experiences in the general population

Abstract

Over the past twodecades, a growing body of literature has assisted in reshaping the perception of psychotic phenomena and their meaning within psychiatry. This shift in view is particularly owing to epidemiological research, which has steered the focus away from phenomena suffered by those with debilitating psychiatric conditions, to what is now seen as an extension of “normal” experience evident within the general population, namely psychotic-like experiences (PLEs). For most, PLEs are transient and relate to difficulties coping with current life adversity. For a minority (20%), PLEs will persist, and persistence appears to accentuate the “risk” of comorbid/subsequent psychiatric disorders and psychosocial dysfunction. PLEs seem to emerge from the interaction between genetic predisposition and certain environmental factors particularly exposure to trauma, a poor social environment, and cannabis use. While the prevalence and relevance of PLEs are increasingly understood, several questions remain: Which PLEs are pathological and/or persist? Do persistant PLEs require intervention? Finally, given the prevalence of PLEs, it is important to disseminate existing findings regarding their meaning? Guiding this narrative will hopefully cause shifts in public opinion regarding psychosis.