Psychotic Experiences Research Articles

Cognitive functioning in people with psychotic experiences: a systematic review and meta-analysis study

Cognitive functioning in people with psychotic experiences: a systematic review and meta-analysis study

Psychotic Experiences and Risk of Suicidal Thoughts and Behaviors: A Systematic Review and Meta-Analysis of Longitudinal Population Studies.

Since a prior systematic review and meta-analysis reported an association between psychotic experiences (PEs) and suicidal thoughts and behaviors, a large number of new studies have been published on the topic, including several novel studies on the association between PEs and transition from suicidal ideation to attempt. Two authors independently searched PubMed, Embase, CINAHL, and PsycINFO databases from inception until July 2023, conducted data extraction, and assessed study quality using the Newcastle-Ottawa Quality Assessment Scale. Random-effects models were used to calculate pooled odds ratios (ORs) for the association of PEs and subsequent suicide ideation, suicide attempts, suicide death, and transition from suicidal ideation to attempt, first for the total population, and second stratified by age group. Secondary analyses assessed the mediating role of co-occurring psychopathology. Twenty studies from 18 different samples (n = 81,861) were identified. Individuals who reported PEs had increased odds of subsequent suicidal ideation (k = 12, OR = 1.90, 95% CI = 1.65-2.19), suicide attempt (k = 13, OR = 2.95, 95% CI = 2.21-3.94), transition from suicidal ideation to suicide attempt (k = 3, OR = 2.83, 95% CI = 1.60-4.99), and suicide death (k = 1, OR = 4.39, 95% CI = 1.63-11.80). This heightened risk was stable across childhood, adolescence, and adulthood. PEs predicted suicide attempts over and above co-occurring psychopathology (k = 8, OR = 2.85, 95% CI = 2.06-3.95). Individuals reporting PEs are at increased risk of all types of suicidal thoughts and behaviors. In addition, PEs are particularly important risk markers for future suicidal behaviors, including in individuals already reporting suicidal ideation. This risk is in excess of what is explained by co-occurring psychopathology.

Ruminative thinking mediates the effects of exposure to adverse life events on psychotic-like experiences

Introduction:A growing literature has shown that exposure to adverse life events during childhood or adolescence is associated with the presence of psychotic-like experiences (PLEs), which is in turn associated with the risk of psychotic outcomes. Ruminative thinking, i.e., the tendency to dwell on particular issues or ideas, may affect the perceived aversiveness and ability to cope with adverse life events. However, the role that rumination plays in the relationship between adverse life events and the presence of PLEs remains unclear. The purpose of this study is to assess the association between adverse life events and PLEs in a longitudinal sample of young adults and adolescents, and to investigate whether this relationship is mediated by ruminative thinking.MethodsWe used a longitudinal naturalistic sample of 706 volunteers assessed at ages 18 and 22 years, within the Imagen consortium. Lifetime occurrence of adverse life events (i.e., events perceived as strongly negative by participants) was investigated using the Life Events Questionnaire. The Community Assessment of Psychic Experience (CAPE-42) served to assess the presence of PLEs, while ruminative thinking was investigated through the Ruminative Response Scale.ResultsResults showed that both frequency of PLEs and their persistence over time were associated with greater adverse life events exposure (r = 0.32, p < 0.001 and F1 = 9.8; p < 0.001, respectively) and greater ruminative response (r = 0.66, p < 0.001 and F1 = 94.9; p < 0.001, respectively). Mediation analyses showed that relationship between adverse life events and PLEs frequency was partially mediated by rumination (direct effect Z: 5.4, p < 0.001; indirect effect Z: 6.9, p < 0.001; total effect Z: 5.9, p < 0.001). Considering changes between the two assessment timepoints, relationship between PLEs variation between 18 and 22 years and adverse life events occurred during the same period was partially mediated by changes in rumination (direct effect Z: 2.8, p < 0.005; indirect effect Z: 4.3, p < 0.001; total effect Z: 4.3; p < 0.001).DiscussionOverall, our findings confirm that the presence of adverse life events may increase the risk of experiencing PLEs in healthy individuals and suggest that dysfunctional coping strategies, such as ruminative thinking, may be related to psychosis proneness. Results do not disentangle whether individuals with greater risk for psychosis tend to ruminate more or whether rumination exacerbates psychosis risk.

Adaptation and validation of the Adolescent Psychotic-like Symptom Screener (APSS-6) in Spain: evidence from adult population.

Psychotic-like experiences are common in the general population and an important indicator of psychological vulnerability. One of the used instruments for their assessment is the Adolescent Psychotic-Like Symptom Screener (APSS). However, there are few studies on the APSS psychometric characteristics in different cultural contexts. The aim of this study is to adapt the instrument in the Spanish context and analyze its psychometric properties in an adult population. Upon the translation and adaptation of the APSS to Spanish, a sample of 287 participants (19-60 years) completed the questionnaire online together with the Symptom Assessment-45 Questionnaire (SA-45) and an ad-hoc survey on clinical and sociodemographic variables. The sample was then randomly split into two halves, the first being the calibration (n = 144) and the second the validation sample (n = 143). An exploratory factor analysis was performed with the former, and a confirmatory factor analysis was performed with the latter, together with internal consistency and convergent validity analyses. The APSS Spanish version presents a unifactorial structure comprising 6 out of the 7 original items with adequate fit and good internal consistency. This single factor structure is invariant across age, sex and history of self-reported psychopathology. The instrument also shows significant positive correlations with the SA-45 psychoticism and paranoid ideation subscales. To the best of our knowledge, this is the first study that has conducted a psychometric analysis of the APSS in adult population. The Spanish version of the APSS shows adequate reliability, construct and convergent validity in adults, therefore provides a handy tool to be used for the screening of psychotic-like experiences in the Spanish general population.

Imitative inhibitory control is associated with psychotic experiences in a sample from the general population

Psychotic experiences (PE) are prevalent and associated with several negative mental health outcomes in both clinical and general population, particularly in young people. A promising avenue to understand the mechanisms underlying PE is to investigate functions that may be related to specific neural systems. One of these key cognitive mechanisms is the ability to control our imitative responses, which is strongly linked to an adequate social functioning. Emergent evidence suggests that impairments in this function might be involved in the early expressions of psychosis, but few studies have investigated its association with PE in a sample from the general population. Using an imitation-inhibition paradigm we examined this relationship in a community sample of young healthy individuals (N=204) and found that increased levels of PE levels were associated with lower imitative inhibitory control. These effects seem to be specific to imitation-inhibition as no correlation was found for a more general cognitive control as addressed by a Stroop-like task. In addition, these effects seem to be more evident for paranoid ideations. Overall, our results suggest that imitative inhibitory control can serve as a proxy to detect abnormalities associated with psychotic experiences.

Arts and mental health: assessment of changes in self-reported wellbeing, psychotic-like experiences, mentalisation and self-efficacy for persons with schizophrenia spectrum disorders participating in the creative writing group intervention REWRITALIZE

Purpose Schizophrenia spectrum disorders (SSD) are associated with social difficulties that call for psychosocial interventions as supplement to standard treatment. The aim of the present study was to assess if there were changes in wellbeing, psychotic-like experiences, mentalisation and self-efficacy from pre- to post-intervention, in persons with SSD who took part in a creative writing group intervention in addition to their standard treatment. Materials and methods Participants (n = 73 with SSD) self-reported their level of wellbeing (Patient-reported outcome measures; PROMs), psychotic-like experiences (Inventory of psychotic-like anomalous self-experiences; IPASE), mentalisation (Reflective functioning questionnaire; RFQ and Toronto Alexithymia Scale; TAS), and self-efficacy (General self-efficacy scale; GSE) before and after REWRITALIZE, a creative writing group intervention led by a professional author in which participants were introduced to literary forms, wrote spontaneously on those forms, and engaged in literary conversation about their texts. Results There was a significant difference from pre- to post-intervention in psychotic-like experiences (IPASE), ability to understand one’s own reasons and feelings (TAS), and self-efficacy (GSE). Conclusion Although the study was uncontrolled, these results suggest that REWRITALIZE as supplement to standard treatment may be beneficial to persons with SSD.

Psychotic-like Experiences and Underlying Mechanisms: An Integrative Model of ADHD Symptoms, Rumination, Negative Affect, and Trauma Experience

Background: Psychotic-like experiences (PLEs) are low-intensity subclinical phenomena, often transient in nature. The etiology of PLEs primarily involves neurodevelopmental changes, trauma exposure, and maladaptive coping styles. Attention-Deficit/Hyperactivity Disorder (ADHD) is considered to be one of the factors that increase the risk of future psychosis. Furthermore, ADHD symptoms predict a heightened incidence of traumatic experiences, ruminative thoughts, and negative affect (NA). This present study examines whether rumination and NA mediate the relationship between ADHD symptoms and PLEs and whether trauma experiences moderate these pathways. Methods: A total of 188 participants (72% female) aged 18–35 completed questionnaires assessing ADHD symptoms and traumatic experiences and took part in a seven-day experience sampling method (ESM) procedure, completing ratings of PLEs experiences, the intensity of ruminations, and NA. Results: Correlation analysis showed significant relationships between all tested variables. Serial mediation analysis revealed a significant indirect effect of rumination and NA in the link between ADHD symptoms and PLEs. There was no significant impact of trauma experience in this relationship. Conclusions: Our study underscores the important role of rumination and NA in the co-development of ADHD symptoms and PLEs. Future research should consider investigating the intra-individual dynamics of ADHD and trauma using ecologically valid research methods in the context of PLEs to better understand these complex relationships.

An exploratory study of metabolomics in endogenous and cannabis-use-associated psychotic-like experiences in adolescence

In adolescence, psychotic-like experiences (PLE) may indicate potential prodromal symptoms preceding the onset of psychosis. Metabolomic studies have shown promise in providing valuable insights into predicting psychosis with enhanced precision compared to conventional clinical features. This study investigated metabolomic alterations associated with PLE in 76 depressed adolescents aged 14–20 years. Serum concentrations of 92 metabolites were analyzed with liquid chromatography–mass spectrometry. PLE were assessed using the Youth Experiences and Health (YEAH) questionnaire. The associations between PLE symptom dimensions (delusions, paranoia, hallucinations, negative symptoms, thought disorder, and dissociation) and metabolite concentrations were analyzed in linear regression models adjusted for different covariates. The symptom dimensions consistently correlated with the metabolome in different models, except those adjusted for cannabis use. Specifically, the hallucination dimension was associated with 13 metabolites (acetoacetic acid, allantoin, asparagine, decanoylcarnitine, D-glucuronic acid, guanidinoacetic acid, hexanoylcarnitine, homogentisic acid, leucine, NAD+, octanoylcarnitine, trimethylamine-N-oxide, and valine) in the various linear models. However, when adjusting for cannabis use, eight metabolites were associated with hallucinations (adenine, AMP, cAMP, chenodeoxycholic acid, cholic acid, L-kynurenine, neopterin, and D-ribose-5-phosphate). The results suggest diverse mechanisms underlying PLE in adolescence; hallucinatory experiences may be linked to inflammatory functions, while cannabis use may engage an alternative metabolic pathway related to increased energy demand and ketogenesis in inducing PLE. The limited sample of individuals with depression restricts the generalizability of these findings. Future research should explore whether various experiences and related metabolomic changes jointly predict the onset of psychoses and related disorders.

The impact of affective and negative symptoms on the development of psychosis in a six-year follow-up of a community-based population.

The Clinical High Risk (CHR) concept has a limited transition risk to psychotic disorders (PD). This study investigates the association between affective and negative symptoms, currently not included in the CHR concept, and the risk of transition to PD in a community-based population of 2185 participants in Turkey. Participants were assessed twice over six years using a multistage sampling technique. Two separate linear regression analyses were conducted on data from both assessments, investigating the relationship between affective and negative symptoms, subclinical and clinical psychotic experiences (PE) and progression to PD. The overall transition rate to PD was 1.3%. The analysis showed no increased risk of developing PD for the 'subclinical PE only' group at follow-up, compared to the 'no PE' group. However, being classified as having 'clinical PE only' (OR: 6.23; p = 0.010) and 'clinical PE + affective/negative symptoms' (OR: 8.48; p = 0.001) at baseline was associated with an increased risk of developing PD at follow-up. The presence of 'affective/negative symptoms' at baseline was associated with an increased risk of incident subclinical PE (RR: 1.98; p = 0.001), incident clinical PE (RR: 3.14; p = 0.001), and incident PD (RR: 4.21; p = 0.030) at follow-up. The results confirm the significance of the baseline severity of positive symptoms in predicting the transition to PD and suggest that both positive and affective/negative symptoms impact the transition risk to PD and incident psychotic symptoms. This highlights the potential utility of defining CHR groups based on a combination of positive, affective, and negative symptoms.

The association between aberrant salience and psychotic experiences in general population twins, and genetic vulnerability as a modifier

BackgroundPrevious studies assessing the hypothesis that the construct of ‘aberrant salience’ is associated with psychosis and psychotic symptoms showed conflicting results. For this reason, the association between measures to index aberrant salience and subclinical psychotic symptoms in a general population sample was analysed. In addition, genetic vulnerability was added to the analysis as a modifier to test the hypothesis that modification by genetic vulnerability may explain variability in the results.MethodsThe TwinssCan project obtained data from general population twins (N = 887). CAPE (Community Assessment of Psychic Experience) scores were used to index psychotic experiences. Aberrant salience was assessed with white noise task and ambiguous situations task.ResultsMeasures of aberrant salience were not associated with psychotic experiences, nor was there evidence for an interaction with genetic predisposition in this association (Z = 1.08, p = 0.282).ConclusionsVarious studies including the present could not replicate the association between aberrant salience and psychotic experiences in general population samples. The conflicting findings might be explained by moderation by genetic vulnerability, but results are inconsistent. If there was evidence for a main effect or interaction, this was in the positive symptom scale only. On the other hand, the association was more robust in so-called ‘ultra-high risk’ patients and first episode psychosis patients. Thus, this association may represent a state-dependent association, present only at the more severe end of the psychosis spectrum.

Associations between polygenic scores for cognitive and non-cognitive factors of educational attainment and measures of behavior, psychopathology, and neuroimaging in the adolescent brain cognitive development study.

Educational attainment (EduA) is correlated with life outcomes, and EduA itself is influenced by both cognitive and non-cognitive factors. A recent study performed a 'genome-wide association study (GWAS) by subtraction,' subtracting genetic effects for cognitive performance from an educational attainment GWAS to create orthogonal 'cognitive' and 'non-cognitive' factors. These cognitive and non-cognitive factors showed associations with behavioral health outcomes in adults; however, whether these correlations are present during childhood is unclear. Using data from up to 5517 youth (ages 9-11) of European ancestry from the ongoing Adolescent Brain Cognitive DevelopmentSM Study, we examined associations between polygenic scores (PGS) for cognitive and non-cognitive factors and cognition, risk tolerance, decision-making & personality, substance initiation, psychopathology, and brain structure (e.g. volume, fractional anisotropy [FA]). Within-sibling analyses estimated whether observed genetic associations may be consistent with direct genetic effects. Both PGSs were associated with greater cognition and lower impulsivity, drive, and severity of psychotic-like experiences. The cognitive PGS was also associated with greater risk tolerance, increased odds of choosing delayed reward, and decreased likelihood of ADHD and bipolar disorder; the non-cognitive PGS was associated with lack of perseverance and reward responsiveness. Cognitive PGS were more strongly associated with larger regional cortical volumes; non-cognitive PGS were more strongly associated with higher FA. All associations were characterized by small effects. While the small sizes of these associations suggest that they are not effective for prediction within individuals, cognitive and non-cognitive PGS show unique associations with phenotypes in childhood at the population level.

Sex Differences in Subclinical Psychotic Experiences: The Role of Daily-Life Social Interactions.

Sex differences in psychosis are reported across the psychosis spectrum, including in subclinical stages. An important factor in understanding these variations is the subjective experience of everyday social interactions (SI). We investigated whether the presence of psychotic experiences (PEs), as well as associated distress, differs between men and women. We focused on the role of daily-life SI quality and whether its association with PEs varies by sex. We included adolescents from SIGMA, a general youth population study in Flanders, Belgium (n = 344; mean age = 18.7; 63.4% female). Psychotic experiences were measured using the PQ-16. We used Experience Sampling Methodology to assess daily-life SI. A multilevel model and multiple linear regressions were used to assess, respectively, the relationship between sex and SI quality and whether PEs and their association with SI quality differ between young men and women. The results of the multilevel linear regression model indicate that the prevalence of and distress associated with PEs were higher in women. No significant difference was observed in the subjective quality of daily SI. Social interaction quality was strongly related to PEs. This association did not seem to vary for the prevalence of PEs, though women's distress about PEs appeared to be more affected by SI quality. Present findings highlight the role of the subjective quality of SI in subclinical psychosis. More research is needed to investigate the mechanisms through which SI quality relates to PEs, and whether these differ between young men and women.

Blunted Cortisol Awakening Response Is Associated with External Attribution Bias Among Individuals with Personality Disorders.

The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been associated with various mental disorders. One of the most commonly described parameters of HPA axis functioning is the cortisol awakening response (CAR). To date, few studies have been conducted on the relationship between personality disorders and CAR. The present study aimed to compare the CAR between individuals with personality disorders and healthy controls. Moreover, the study aimed to assess the association of CAR with cognitive biases and psychopathological symptoms in people with personality disorders. A total of 43 individuals with personality disorders and 45 healthy controls were enrolled. Participants completed questionnaires measuring the severity of depressive symptoms, anxiety, cognitive biases, and psychotic-like experiences. Cortisol levels were measured in four morning saliva samples: immediately after awakening, and after 15, 30, and 45 min. A significantly lower CAR was found among individuals with personality disorders, even after adjustment for age, sex, and the level of education. However, the receiver operating characteristic (ROC) curve analysis showed a relatively low area under the curve (AUC = 0.362). Furthermore, a significant negative correlation was observed between the CAR and the level of external attribution bias among individuals with personality disorders. No significant associations of the CAR with psychopathological symptoms and other cognitive biases were observed. Findings from this study indicate that the HPA axis activity might be altered in personality disorders. However, the clinical utility of this observation needs further studies in larger samples. External attribution might be related to the HPA axis alterations in this population.

Under the surface: paranoid and unusual thought content are associated with depressive symptoms and suicidal ideation in adolescents entering psychiatric care

ABSTRACT Background Psychotic Like Experiences (PLEs), suicidal ideation, and depressive symptoms are related and common symptoms in adolescents treated in psychiatric services. However, more granular analysis of the associations between the two types of symptoms is sparse. This study aims to investigate the associations between self-reported PLEs and depressive symptoms on a sub-scale and item level, among adolescents attending secondary level psychiatric care. Methods The sample included 328 adolescents (aged 13–18 years) attending adolescent psychiatry outpatient units of the Helsinki University Hospital. Depressive symptoms were assessed using the BDI-1A (total score and separate Suicidal Ideation item score). PLEs were assessed with the PQ-B and analysed as sum scores for the sub-scales Sensory Distortion, Grandiosity, Disorganised Speech, Paranoia, and Unusual Thoughts. Results High scores on PQ-B subscales Paranoia and Unusual Thoughts were both independently associated with more depression and suicidality. Item analysis showed that the associations between PLEs and depression were driven by two PQ-B Paranoia subscale items, and one Unusual Thoughts subscale item. Discussion The findings suggest that the association between PLEs and depressive symptoms is driven by paranoid experiences and unusual thought content. Professionals in psychiatric care should expect this type of co-occurrence.

Suicidal thinking and behavior in young people at Clinical High Risk for Psychosis: Psychopathological considerations and treatment response across a 2-year follow-up study.

Suicidal ideation has high rates among individuals at Clinical High Risk for Psychosis (CHR-P). CHR-P mental states are currently defined as attenuated psychotic symptoms, brief intermittent psychotic symptoms, or genetic risk and functioning deterioration syndrome. However, the relationship between psychotic experiences and suicidality in CHR-P subjects is still not fully understood. Research emphasizes the need to address suicidality in CHR-P individuals due to its incidence and severe socio-economic impact. This study aimed to assess the baseline prevalence and 2-year incidence rates of suicidal thinking and behaviors in an Italian CHR-P sample, investigate the stability of suicidal ideation over 2 years, and examine its associations with treatment outcomes, sociodemographic characteristics, and clinical factors. CHR-P participants were treated in an "Early Intervention in Psychosis" program and completed the PANSS and the GAF scale at baseline and every 12 months. 180 CHR-P individuals were enrolled (92 with suicidal ideation [SI+]). SI+ subjects had a higher baseline prevalence of past suicide attempts. Over 2 years, a decrease in suicidal ideation severity was observed in the total group. Longitudinal improvement in disorganized symptoms was a key predictor of the decrease in suicidal ideation. Participants with a history of suicide attempts were more likely to attempt again. Addressing disorganization is crucial for suicide prevention in the CHR-P population. Continuous risk monitoring and preventive actions are needed for those with past suicide attempts.

The moderating effect of insomnia severity in the association between noise annoyance and psychotic experiences in adolescents

ABSTRACT Adolescence has been identified as a particularly vulnerable age group with a high prevalence of insomnia and a heightened susceptibility to experiencing psychotic experiences, which in turn increases the risk of developing psychotic disorders. In particular, insomnia symptoms were found to be predominant among noise-sensitive adolescents exhibiting a higher level of noise annoyance. This study aimed to assess the moderating effect of insomnia severity between noise annoyance and psychotic disorders among Lebanese adolescents. A cross-sectional study was conducted among 527 Lebanese adolescents. Participants filled a self-administered online questionnaire. Insomnia moderated the association between noise annoyance and psychotic disorders. Noise annoyance was significantly associated with a higher risk of emergence of psychotic disorders. At low and moderate levels of insomnia severity, higher noise annoyance was significantly associated with higher psychotic experiences. Understanding how these variables interact provide valuable insights into the underlying mechanisms leading to psychotic disorders among adolescents.

Exploring associations between psychotic experiences and structural brain age: a population-based study in late adolescence.

Neuroimaging studies show advanced structural "brain age" in schizophrenia and related psychotic disorders, potentially reflecting aberrant brain ageing or maturation. The extent to which altered brain age is associated with subthreshold psychotic experiences (PE) in youth remains unclear. We investigated the association between PE and brain-predicted age difference (brain-PAD) in late adolescence using a population-based sample of 117 participants with PE and 115 without PE (aged 19-21 years) from the Avon Longitudinal Study of Parents and Children. Brain-PAD was estimated using a publicly available machine learning model previously trained on a combination of region-wise T1-weighted grey-matter measures. We found little evidence for an association between PEs and brain-PAD after adjusting for age and sex (Cohen's d = -0.21 [95% CI -0.47, 0.05], p = 0.11). While there was some evidence for lower brain-PAD in those with PEs relative to those without PEs after additionally adjusting for parental social class (Cohen's d = -0.31 [95% CI -0.58, -0.03], p = 0.031) or birth weight (Cohen's d = -0.29 [95% CI -0.55, -0.03], p = 0.038), adjusting for maternal education or childhood IQ did not alter the primary results. These findings do not support the notion of advanced brain age in older adolescents with PEs. However, they weakly suggest there might be a younger-looking brain in those individuals, indicative of subtle delays in structural brain maturation. Future studies with larger samples covering a wider age range and multimodal measures could further investigate brain age as a marker of psychotic experiences in youth.

Psychotic Experiences Questionnaire. Part 2

BACKGROUND: On the basis of the concept of psychotic and psychotic-like experiences, delusions and auditory hallucinations presented in Part 1 of this article, the structure of the links between psychotic experiences and social anxiety and its components and psychological parameters is analyzed. A mediator model of the relationship between social anxiety and the phase of psychotic alienation — "experiencing external control" — is discussed. AIM: To investigate the parameters and stages of development of psychotic and psychotic-like experiences registered with the Psychotic Experiences Questionnaire in the context of analyzing the structure of relationships with psychological variables (social anxiety, metacognitive and cognitive phenomena). Тo construct a mediator model of the indirect effect of social anxiety components on the “experience of being controlled externally” mediated by thought suppression (“polar bear effect”). MATERIALS AND METHODS: The sample — 122 respondents, includes non-clinical and two clinical groups — with symptoms of the affective spectrum and with symptoms of the psychotic spectrum. The author's ‘Psychotic Experiences Questionnaire’ was used to assess the severity of psychotic experiences, the scales of which represent the phases of the unfolding of the experiences. Social anxiety and its components (author's “Social Anxiety and Social Anxiety Disorder Questionnaire”), cognitive (“Cognitive Flexibility Questionnaire”, “Behavioural Self-Regulation Style — SSPM 2020” questionnaire) and metacognitive (Thought Suppression Scale, author's “Self-Focused Attention Questionnaire”) strategies were determined. RESULTS: Pearson correlation analysis showed significant ‘direct’ associations of early and moderate psychotic and psychotic-like experiences with social anxiety and its components, metacognitive (self-focused attention and thought suppression) parameters, and ‘inverse’ links with cognitive parameters (cognitive component of conscious self-regulation and cognitive flexibility). Correlations with psychological parameters become insignificant in intense psychotic experiences. Using mediator analysis, the full indirect effects of the social anxiety components influence on the enhancement of “experiencing being controlled externally” as a phase of psychotic experiences maximum intensity were measured (mediator — thought suppression). CONCLUSION: Metacognitive strategies, social anxiety, disturbed self-regulation and flexibility play an important role in the genesis and maintenance of psychotic experiences. Significant correlations of the parameters with psychotic experience are shown, but at the height of alienation the significant correlations weaken. At the height of psychotic experience in the absence of direct effects it is possible to explicate the indirect influence of the predictor — social anxiety on the experience of controllability from the outside, mediated by thought suppression. This article is a continuation of the article by Sagalakova OA, Truevtsev DV, Zhirnova OV. Psychotic Experiences Questionnaire. Part 1. Neurology Bulletin. 2024;56(1):23–36. DOI: https://doi.org/10.17816/nb623959

Prevalence of psychotic-like experiences and their association with depression symptoms among patients entering adolescent psychiatric care

Background Psychotic-like experiences (PLEs) are common in clinical adolescent samples and form a continuum based on their frequency and intensity. PLEs can have harmful effects on both behaviour and affect. Methods Prevalence and subjective distress due to PLEs were assessed with the Prodromal Questionnaire-Brief (PQ-B) and depressive symptoms with the Beck Depression Inventory (BDI-21A) among adolescents (N = 399; 71.7% female, mean age 14.9 years, range 13–18) entering specialized adolescent psychiatric services. Various PQ-B Distress scale cut-off points were tested for their ability to detect high and low BDI scores using the superiority index, the effect size for mean difference, and spline regressions. Results The mean number of endorsed PLEs assessed with the PQ-B was 3.27 (SD 3.64; males: M 1.75; SD 2.78; females: M 3.89; SD 3.78), while mean PQ-B Distress scores were 20.33 (SD 18.03; males: M 11.84; SD 13.90; females: M 23.74; SD 18.40). The most common PLE within both genders were experiences of paranoia and suspiciousness, with a prevalence of 59.9%. BDI scores and PQ-B distress scores were strongly associated (r = 0.534, p<.001). Superiority indices, effect sizes, and spline regressions indicated that a low PQ-B Distress cut-off of 2 or 3 was most informative both when using BDI as a continuous variable and when dichotomized as mild depression (≥10) or major depressive disorder (≥16). Conclusion PLEs are common among adolescent entering psychiatric care. Even a relatively small amount of distress due to PLEs indicates clinical levels of depressive symptoms.

Sex-specific association between schizophrenia polygenic risk and subclinical schizophrenia-related traits

BackgroundAccording to the dimensional view of psychiatric disorders, psychosis is expressed as a continuum in the general population. However, the investigation of the putative genetic aetiological continuity between its clinical and subclinical phenotypes has yielded mixed results. We aimed to replicate previous findings regarding the association of polygenic risk for schizophrenia with subclinical traits (i.e., schizotypy traits and psychotic-like experiences), and to examine the role of sex in this association in a large nonclinical sample. MethodsThe Multidimensional Schizotypy Scale and the Community Assessment of Psychic Experiences were assessed in 919 nonclinical participants. Polygenic Risk Scores for schizophrenia (SZ-PRSs) were computed using the PRS-CS method based on the latest genome-wide association study of schizophrenia. Summary statistics derived from the total GWAS sample and stratified by sex were used. Linear regression analyses tested the associations of the SZ-PRSs with the psychometric variables, both in the total sample and by sex. ResultsNo associations were found between the SZ-PRSs and the positive, negative or disorganized dimensions of schizotypy in the total sample. Likewise, no associations were found with psychotic-like experiences. However, the sex-stratified analyses revealed a male-specific association with positive schizotypy. Similar results were obtained with the PRSs derived from the sex-stratified summary statistics. DiscussionOur results are consistent with the lack of clear evidence of an association between SZ common genetic risk and its subclinical phenotypes. Nevertheless, the male-specific association found suggests that this PRS might explain better the male phenotype, as reported in previous studies. Future studies should put a focus on the role of sex in this association to unravel its sex specificities.