Abstract
Objective: TürkSch is a prospective, longitudinal study in a representative community sample (İzmir, Turkey), consisting of several data collection stages, to screen and follow-up mental health outcomes, with a special focus on the extended and transdiagnostic psychosis phenotype. The aim of the present paper is to describe the research methodology, data collection results, and associations with noncontact and refusal in the longitudinal arm. Methods: Households were contacted in a multistage clustered probability sampling frame, covering 11 districts and 302 neighborhoods at baseline (n = 4,011) and at 6-year follow-up (n = 2,185). Both at baseline and at follow-up, participants were interviewed with the Composite International Diagnostic Interview. Participants with probable psychotic disorder were reinterviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID)-I either at the hospital or at the participant’s residence. Relevant neighborhood-level measures were assessed in a separate sample (n = 5,124) in addition to individual-level measures. Candidate gene-by-environment interactions were investigated using two nested case-control studies. Results: Individuals with a mental health problem had lower refusal rates. Older and lower educated individuals had a lower probability of noncontact. Discussion: The TürkSch study has an advanced design to meet the challenges of evaluating the multidimensional etiological and phenomenological nature of the extended and transdiagnostic psychosis phenotype.
Highlights
After nearly two decades of epidemiological studies, there is evidence suggesting that psychosis is distributed as a spectrum [1]
The spectrum of psychosis extends from the clinical psychotic syndrome to nonpsychotic diagnoses with a degree of psychosis admixture and, to nonclinical populations with subthreshold psychotic experiences [2,3,4]
The extended psychosis phenotype is the range from psychotic experiences (PEs) gradually blending into psychotic disorders (PDs) [2]
Summary
After nearly two decades of epidemiological studies, there is evidence suggesting that psychosis is distributed as a spectrum [1]. The spectrum of psychosis extends from the clinical psychotic syndrome to nonpsychotic diagnoses with a degree of psychosis admixture and, to nonclinical populations with subthreshold psychotic experiences [2,3,4]. The extended psychosis phenotype is the range from psychotic experiences (PEs) gradually blending into psychotic disorders (PDs) [2]. The majority of individuals with PEs have a diagnosis of nonpsychotic disorder. A high prevalence of PEs has been demonstrated in individuals with nonpsychotic disorders where they can be considered markers of clinical severity [5]. PEs and nonpsychotic disorders have been shown to predict subsequent occurrences of each other, bidirectionally [6]. It has been suggested that these findings point to a transdiagnostic psychosis phenotype in the general population [7]
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