Psychotic Experiences Research Articles

Response to psychotic experiences: Impact of personality traits on perceived levels of distress

BackgroundThis study examined the influence of personality traits on (subclinical) positive symptom distress in patients with a psychotic disorder, their unaffected siblings and healthy controls. MethodsData were obtained from the Genetic Risk and Outcome of Psychosis study (GROUP), a Dutch longitudinal multicenter cohort study. Data from 140 patients, 216 unaffected siblings and 102 healthy controls was available for baseline levels of Five Factor Model personality traits and frequency and distress due to psychotic experiences three years later, assessed with the Community Assessment of Psychic Experience questionnaire. Main effects of all five personality traits on symptom distress were investigated as well as moderating effects of Neuroticism, Extraversion and Openness on positive symptom frequency and positive symptom distress. Age, gender, symptom frequency and IQ were controlled for. ResultsIn both patients and siblings, the observed main effects of Neuroticism and Openness on (subclinical) positive symptom distress three years later either lost significance or had a very small effect size when controlling for covariates, mainly due to the correction for the effect of positive symptoms on personality traits at baseline. In both groups, levels of Openness at baseline moderated the association between positive symptom frequency and positive symptom distress three years later, in the direction that higher levels of Openness were associated with weaker associations between positive symptom frequency and - distress, even when covariates were controlled for. DiscussionThe level of Openness to Experiences influences the perceived distress from (subclinical) positive symptoms in both patients and siblings.

Psychotic experiences in university students: prevalence, correlates and association with non-specific psychological distress

Introduction Subclinical psychotic experiences (PEs) are far more prevalent than psychotic disorders, with an estimated prevalence of 7.2% (Linscott & Van Os. Psychol Med 2013;43(6) 1133-1149). PEs are particularly prevalent in late adolescence and young adulthood, when obtaining academic education is one of the main developmental tasks. University students are at the peak age of onset of mental disorders, and often experience high levels of social and academic stress that may contribute to the onset of psychopathology. Hence, estimating the prevalence and correlates of PEs among university students is particularly important.ObjectivesTo estimate the prevalence of PEs in a sample of Israeli students; assess whether rates of PEs differ by selected sociodemographic characteristics; and examine the association between PEs and non-specific psychological distress.Methods150 students from universities and colleges in Israel participated in a cross-sectional online survey. All students were over the age of 18 and were not diagnosed with psychotic disorders. Participants completed self-report questionnaires, including the Prodromal Questionnaire - Brief Version (PQ-B), Kessler Psychological Distress Scale (K10) and sociodemographic details. The PQ-B yields a score for the total number of items endorsed (range 0–21), and a total distress score (range 0–105). A cutoff of ≥8 distressing symptoms was used to identify participants at high-risk for psychosis.Results 21 participants (14.0%) reported 8 or more distressing PEs. PEs were more common in males and among those with a psychiatric illness (Table 1). PEs were not associated with marital status, religiosity, or immigrant status. While a greater number of PEs was positively associated with non-specific psychological distress (r=0.589, p<.001), there was no association between distress caused by PEs and non-specific psychological distress (r=0.145, NS). Table 1.Sociodemographic characteristics by groupPEs-PEs+X2, pSexM29.5%52.4%4.32, .038F70.5%47.6%Marital StatusMarried17.1%23.8%0.56, NSUnmarried82.9%76.2%ImmigrantNo89.9%85.7%0.34, NSYes10.1%14.3%ReligiositySecular74.4%57.1%2.67, NSOther25.6%42.9% PsychiatricillnessNo87.6%61.9%8.87, .003Yes12.4%38.1%ConclusionsThe findings confirm that self-reported PEs are much more prevalent than clinically diagnosed psychotic disorders, particularly among young adults. As PEs were found to be associated with non-specific psychological distress, and as they are known forerunners for severe mental disorders, it is important to address mental health issues in school settings and promote prevention and early intervention programs.Disclosure of InterestNone Declared

Aberrant Salience, Psychotic-Like Experiences, and Anxiety: a Case-Control Study

IntroductionIn this research, we investigate how Aberrant Salience (AS), Psychotic-Like Experiences (PLEs), and anxiety are interlinked in both healthy individuals and subjects with psychotic disorders. AS is a trait contributing to a susceptibility to psychosis and anxiety, while PLEs are subclinical states often leading to psychosis. We hypothesize that AS impacts the occurrence and severity of PLEs, which in turn influences anxiety.ObjectivesThe goal is to offer a more nuanced understanding of the risk factors leading to psychotic disorders and to shed light on anxiety psychopathogenesis in healthy and psychotic populations.MethodsWe used self-reported questionnaires like the Aberrant Salience Inventory (ASI), Community Assessment of Psychic Experiences (CAPE), and Symptom Check List-90-revised (SCL-90-R). Data analysis included descriptive statistics and mediation analysis, adjusting for age, gender, and education. Controls were sourced through convenience and snowball sampling, while out-patients diagnosed with Schizophrenia Spectrum Disorder, Bipolar Disorder with psychotic features, or Major Depression with psychotic features were recruited from Florence University Hospital.ResultsA total of 207 participants were included, with 163 controls and 44 patients. Descriptive statistics are shown in Table 1. Mediation analysis showed that PLEs frequency acted as a mediator between AS and anxiety only in the control group (Figure 1), not in patients (Figure 2).Table 1.Descriptive statistics - Mean ± Std. Deviation.Control Group (N=163)Psychotic Group (N=44)p-value ASI11.690 ± 6.09814.360 ± 7.1630.014CAPEposF1.391 ± 0.3401.617 ± 0.4880.001CAPEposD1.792 ± 0.6151.941 ± 0.6940.167SCL-90-R-ANX0.678 ± 0.6000.905 ± 0.6430.030Legend: ASI, Aberrant Salience Inventory; CAPEposF, Community Assessment of Psychic Experiences - positive dimension - Frequency; CAPEposD, Community Assessment of Psychic Experiences - positive dimension - Distress; SCL-90-R-ANX, Symptom Check List-90-revised, Anxiety.Image:Image 2:ConclusionsPLEs triggered by AS led to anxiety in the control group but not in psychotic patients. The discrepancy could be due to reduced novelty and awareness of experiences in the patient group. This may affect how bodily responses to PLEs are perceived and suggests the need for specialized treatment approaches for anxiety in these two groups.Disclosure of InterestNone Declared

Longitudinal Trajectories of Plasma Polyunsaturated Fatty Acids and Associations With Psychosis Spectrum Outcomes in Early Adulthood

BackgroundEvidence supports associations between polyunsaturated fatty acids such as docosahexaenoic acid (DHA) and psychosis. However, polyunsaturated fatty acid trajectories in the general population have not been characterized, and associations with psychosis spectrum outcomes in early adulthood are unknown. MethodsPlasma omega-6 to omega-3 ratio and DHA (expressed as percentage of total fatty acids) were measured by nuclear magnetic spectroscopy at 7, 15, 17, and 24 years of age in participants of ALSPAC (Avon Longitudinal Study of Parents and Children). Curvilinear growth mixture modeling evaluated body mass index–adjusted trajectories of both measures. Outcomes were assessed at 24 years. Psychotic experiences (PEs), at-risk mental state status, psychotic disorder, and number of PEs were assessed using the Psychosis-Like Symptoms interview (n = 3635; 2247 [61.8%] female). Negative symptoms score was measured using the Community Assessment of Psychic Experiences (n = 3484; 2161 [62.0%] female). Associations were adjusted for sex, ethnicity, parental social class, and cumulative smoking and alcohol use. ResultsRelative to stable average, the persistently high omega-6 to omega-3 ratio trajectory was associated with increased odds of PEs and psychotic disorder, but attenuated on adjustment for covariates (PEs adjusted odds ratio [aOR] = 1.63, 95% CI = 0.92-2.89; psychotic disorder aOR = 1.69, 95% CI = 0.71-4.07). This was also the case for persistently low DHA (PEs aOR = 1.42, 95% CI = 0.84-2.37; psychotic disorder aOR = 1.14, 95% CI = 0.49-2.67). Following adjustment, persistently high omega-6 to omega-3 ratio was associated with increased number of PEs (β = 0.41, 95% CI = 0.05-0.78) and negative symptoms score (β = 0.43, 95% CI = 0.14-0.72), as was persistently low DHA (number of PEs β = 0.45, 95% CI = 0.14-0.76; negative symptoms β = 0.35, 95% CI = 0.12-0.58). ConclusionsOptimization of polyunsaturated fatty acid status during development warrants further investigation in relation to psychotic symptoms in early adulthood.

Assessment of the relationship between psychotic-like experiences and traumatic life events: a cross-sectional study

IntroductionTraumatic life events (TLEs) have been associated with the entire spectrum of psychosis outcomes, including risk and severity of psychotic disorders and psychotic-like experiences (PLEs). In a non-clinical setting, understanding the relationship could help improve prevention services.ObjectivesThe aim of this study is to establish the relationship between TLEs and PLEs.Methods A cross-sectional study was conducted in a Tunisan business and engineering school from March 2022 to June 2022. Participants completed the Tunisian dialect version of the Prodromal Questionnaire-Brief (PQ-B), a validated self-report instrument designed to evaluate prodromal symptoms. TLEs such as physical, sexual, and emotional abuse, as well as neglect experiences, lived or witnessed have been assessed along with bullying experiences.Results The final sample size consisted of 358 participants, with a median age of 22 ± 2.22 years, with a sex ratio (M/F) of 1.41. More than half of the participants (58.6%) reported having experienced TLEs (49% in the preceding 6 months) while 31% had experienced bullying or abuse in school (27.9% in the preceding 6 months). The mean total score of the PQ-B for the study population was 7.27 ± 4.387, 36.3% reached the threshold and were defined as PQ-B-positive subjects. Those with a lifetime history of major life events were more likely to screen positive on the total score PQ-B (p = 0.000), as were those with a lifetime history of bullying or abuse (p = 0.000).Conclusions Understanding the factors that interact in the significant association between PLEs and TLEs may provide useful information for prevention programs and the improvement of mental health.Disclosure of InterestNone Declared

Association of early-life exposure to air and noise pollution with youth mental health: findings from the ALSPAC cohort

BackgroundIncreasing evidence suggests that air pollution exposure contributes to the development of mental health problems, including psychosis and depression. However, little is known about the importance of early-life exposure, nor the potential role of noise pollution, a correlate of air pollution. We examined the association of exposure to air and noise pollution from pregnancy to age 12 years with three mental health problems assessed at ages 12, 18, and 24 years. MethodsData were from the Avon Longitudinal Study of Parents and Children (ALSPAC), which tracks the development of about 14 000 babies who had expected delivery dates between April 1, 1991, and Dec 31, 1992, in Avon, UK. This was linked with novel data on nitrogen dioxide, PM2·5, and noise pollution in pregnancy, childhood (ages 1–9 years), and adolescence (ages 10–12 years). Psychotic experiences, depression, and anxiety were measured at ages 12, 18, and 24 years. Logistic regression models were controlled for individual-level, family-level, and area-level confounders, and e-values were calculated to estimate residual confounding. FindingsParticipants exposed to higher PM2.5, particularly during pregnancy, had greater odds for psychotic experiences (adjusted odds ratio 1·17 [95% CI 1·05–1·30]) and depression (1·11 [1·01–1·22]). There was little evidence associating nitrogen dioxide or noise pollution with psychotic experiences or depression. Conversely, higher nitrogen dioxide (but not PM2·5) exposure in pregnancy (1·16 [1·01–1·33]), and higher noise pollution in childhood (1·20 [1·06-1·37]) and adolescence (1·17 [1·02-1·35]), were associated with greater odds for anxiety. InterpretationOur study builds on evidence linking air pollution to psychosis and depression and provides rare longitudinal evidence linking noise pollution to anxiety. Our findings indicate that air pollution exposure earlier in development (eg, during pregnancy) might be particularly important, and suggest a degree of specificity in terms of pollutant-outcome associations. If causal, our findings suggest that interventions to reduce air pollution would improve global mental health. FundingWellcome Trust, UK Medical Research Council–Wellcome, and University of Bristol.

Exploring the Interplay Between Psychosis and Sleep Disruption: Insights into Course, Insomnia, Nightmares, and Treatment

IntroductionPsychosis and sleep disruption are complex phenomena that often intertwine, influencing each other in intricate ways. This abstract delves into the dynamic relationship between psychosis and sleep disturbances, shedding light on their course, the prevalence of insomnia, the role of nightmares and dreams, and the impact of psychotic symptoms on sleep patterns. Additionally, it discusses the treatment approaches for individuals with psychosis and sleep disturbances, as well as the consequences of these interventions on both conditions.ObjectivesTo investigate the longitudinal course of psychosis and sleep disruption, exploring their temporal connections; to assess the prevalence and characteristics of insomnia among individuals experiencing psychosis; to examine the relationship between nightmares, dreams, and psychotic experiences; to analyze the impact of psychotic symptoms on the pattern and architecture of sleep; to review current treatment modalities for individuals with co-occurring psychosis and sleep disturbances and their effects on both conditions.MethodsSystematic reviewResults Preliminary findings indicate a bidirectional relationship between psychosis and sleep disruption, with each exacerbating the other over time. Insomnia is prevalent among individuals with psychosis, contributing to the severity of psychotic symptoms. Nightmares and disturbing dreams are common experiences, often mirroring the content of psychotic hallucinations and delusions. Psychotic symptoms disrupt sleep patterns, leading to decreased sleep efficiency and altered sleep architecture. Various treatment approaches show promise in addressing both psychosis and sleep disturbances, but further research is needed to determine their long-term effects.Conclusions The intricate interplay between psychosis and sleep disruption, emphasizing the need for a holistic approach to assessment and intervention. Understanding the course of these conditions, the high prevalence of insomnia, and the role of nightmares and dreams in the psychotic experience is crucial for developing targeted interventions. Additionally, recognizing the impact of psychotic symptoms on sleep patterns is vital for improving overall well-being. Effective treatment strategies that address both psychosis and sleep disturbances offer hope for enhanced outcomes, but ongoing research is essential to fully elucidate their potential benefits and long-term consequences.Disclosure of InterestNone Declared

Age-related differences in the impact of resilience on mental health outcomes during the COVID-19 pandemic in Hong Kong.

This study investigated changes in mental health in Hong Kong over two years and examined the role of resilience and age in mitigating the negative effects of public health emergencies, particularly the COVID-19 pandemic. Complete data of interest from two telephone surveys conducted in 2020 (n=1182) and 2021 (n=1108) were analysed. Participants self-reported depressive and anxiety symptoms using the Patient Health Questionnaire 4-item version (PHQ), psychotic-like experiences (PLEs) using three items from the Prodromal Questionnaire Brief (PQB), and resilience using the Connor-Davidson Resilience Scale 2-item version (CD-RISC-2). We observed an increase in the percentage of participants with high depressive and anxiety symptoms and PLEs from 1.6% to 6.5% between 2020 and 2021. The likelihood of having high depressive and anxiety symptoms or PLEs depended on resilience and age, with no significant between-year differences. Resilience and age interaction effects were significant when comparing the high PHQ-high PQB group to the low PHQ-low PQB group only in 2021 but not in 2020. This study provides valuable insights into the impact of the COVID-19 pandemic on mental health in Hong Kong, emphasising the age-dependent nature of resilience in mitigating negative effects. Future research should explore the mechanisms by which resilience promotes mental health and well-being and identify ways to enhance resilience among older individuals during public health crises.

Body image as a mediator in the relationship between psychotic experiences and later disordered eating: A 12-month longitudinal study in high school adolescents

IntroductionPsychotic experiences (PE) and disordered eating (DE) are frequently observed among the general population, especially in childhood and adolescence. However, the relationship between the two groups of disorders is still unclear.ObjectivesTo explore the hypothesis that the pathways from PEs to DE are mediated by body-image disturbances in a sample of adolescentsMethodsWe conducted a 12-month longitudinal study on high school students from four different high schools from the Ariana governorate, from April 2022 to April 2023.Participants were evaluated at baseline then every 6 months with a target length of follow-up of 1 year.The questionnaire containedQuestions about socio demographic variablesThe Eating Attitude Test (EAT-26)The Multidimensionnal Body Self-Relations Questionnaire Appearance Scale (MBSRQ-AS)The Community Assesment of Psychic Experiences (CAPE-42)Results1) Sample characteristicsSample was constituted of 510 individuals. Of those, 312 (61.2%) were females. Mean age was of 16.05 (SD=1.01) years.The majority of the students resided in urban areas, accounting for 97.8% of the total.When it comes to family income, 4.1% of the students’ families had an income of less than 1000 Tunisian Dinars (TD), 25.9% had an income between 1000 and 2000 TD, 32.2% had an income ranging from 2000 to 3000 TD, and the remaining 37.8% had a family income of over 3000 TD.The EAT-26, MBSRQ-AS and CAPE-42 scores are shown in table 1. Table 1.The longitudinal evolution of study variables Baseline T 6 months T 12 months pPartial Eta Squared η2Disordered eating (EAT-26)11.9 ± 9.411.9 ± 9.712.6 ± 10.2.080.006Self-classified weight (Body image)6.0 ± 1.75.9 ± 1.66.0 ± 1.6.946.001Body areas satisfaction30.9 ± 6.431.8 ± 6.431.4 ± 6.8.025.010Overweight preoccupation9.3 ± 3.69.2 ± 3.79.2 ± 3.7.545.001Appearance Orientation41.0 ± 5.441.6 ± 5.441.6 ± 5.5.007.014CAPE positive dimension (total)39.6 ± 8.739.1 ± 9.139.7 ± 9.5.756.001Body Mass index21.6 ± 3.421.5 ± 3.221.7 ± 3.2.034.0092) Findings of the mediating analysisDisordered Eating scores had no significant effect in subjects across time. However, the effect of the interaction between baseline Overweight Preoccupation with Disordered Eating across time was statistically significant (p=0.036). Overweight Preoccupation (Z=85.095, p<0.001), Body Area Satisfaction (Z=25.053, p<0.001), and CAPE positive dimension (Z=59.931, p<0.001) scores had significant main effects between subjects. (figure 1 and figure 2)Image:Image 2:ConclusionsFindings showed that body image disturbances mediated the prospective association between PEs and DE. Adolescents with increased PEs were more likely to experience body image disturbances and, in turn, DE symptoms. These findings offer promising new avenues for prevention and early intervention.Disclosure of InterestNone Declared

Can Ecological Momentary assessments be used to investigate the person-environment interactions in people with psychosis?

Abstract Psychotic experiences show a dynamic pattern over time, often in interaction with the environment. In my talk, I will discuss how Ecological Momentary Assessment (EMA) or Experience Sampling Methodology can be used to assess psychotic symptoms in the flow of daily life. I will focus on the assessment of both positive and negative symptoms, where I will discuss both how we can measure such symptoms as well as what the dynamic patterns look like in everyday life. Furthermore, I will also focus on how ESM can be used to transfer psychological treatment to daily life using an app. I will discuss the INTERACT trial, a trial in people at the early stages of psychosis, where we investigated the effect of Acceptance And Commitment Therapy in Daily Life, compared to Treatment As Usual.Disclosure of InterestNone Declared

Peer Support in Psychosis Care: A Valuable Resource for Recovery

IntroductionA variety of peer support workers have been integrated in the mental health workforce in several countries. The effectiveness of this approach is still inconclusive. However, some data reveals promising results. Some projects have integrated peer support intervention in the treatment of psychosis. In fact, UK clinical guidelines for psychosis advise the inclusion of peer support within Early Intervention in Psychosis services.ObjectivesThe current study aims to evaluate how peer support may assist the intervention in psychosis and highlight challenges ahead in this field.MethodsNarrative review of the available scientific literature.Results Research suggests that consistent and frequent peer support enhances social support and boosts self-confidence and the overall quality of life for people going through psychosis. Individuals diagnosed with severe mental illnesses who receive peer support reportedly experience an increased sense of control, hopefulness, and empowerment, enabling them to initiate positive changes in their lives. People going through psychosis experience internalized stigma. Destigmatization of psychotic experiences is a central theme of intervention in psychosis. Participants viewed peer support as a valuable form of assistance that could offer advantages to both peers (service users) and peer support workers.ConclusionsPeer support makes a strong contribution to destigmatising psychosis. The available date is promising and supports the effectiveness of peer support in such instances. As projects of peer support in psychosis continue to be implemented, further research should provide additional insight into the effectiveness and inherent challenges of this type of intervention.Disclosure of InterestNone Declared

Psychotic Experiences Questionnaire. Part 1

BACKGROUND: The rationale for the concept of psychotic and psychotic-like experiences, delusions and auditory hallucinations, on the basis of which the Psychotic Experiences Questionnaire was developed.
 AIM: The purpose of this study is to present the results of testing and validating of a questionnaire that assesses the severity of psychotic experiences. The study aims to determine the content of the experience at different phases of manifestation, including the phase of psychotic-like experiences, as well as metacognitive appraisals of the experience and its relationship to social anxiety.
 MATERIAL AND METHODS: The sample of 122 respondents includes non-clinical and two clinical groups — with symptoms of the affective spectrum and with symptoms of the psychotic spectrum. To assess the convergent validity of the Questionnaire, the Russian-language Symptom Check List-90-Revised was used. Metacognitive appraisals of psychotic experience and the overall severity of social anxiety (“Social Anxiety and Social Anxiety Disorder Questionnaire”) were measured.
 RESULTS: The structure of the Questionnaire obtained by cluster analysis was verified by confirmatory factor analysis, and optimal agreement between theoretical and empirical models was demonstrated (CFI=0.998; TLI=0.998; SRMR=0.102; RMSEA=0.02; RMSEA p-value=0.986). Three scales and corresponding subscales (six categories) defining the phases of unfolding of psychotic experience were identified. The high reliability and item consistency of the Questionnaire was determined using Cronbach's alpha coefficient. Convergent validity was assessed using Pearson correlation analysis of the questionnaire scales with the SCL scales — psychoticism, paranoid ideation and obsessive-compulsive symptoms; reliable and adequate statistical relationships were obtained. The role of social anxiety and metacognitive appraisals of psychotic experiences in their actualisation and maintenance is shown. The conceptualisation of thought the emergence of intrusions, “voices” as a dialogical embodiment of the internalised experience of social defeat in re-expanded inner speech is presented.
 CONCLUSION: The results of approbation and validation of the questionnaire are presented, and the relationships of the psychotic experiences component with its metacognitive appraisals and social anxiety are described. The concept of psychotic experiences is considered a continuum in which disruptions in the usual controllability of mental processes vary range from mild (objectification of thinking) — to moderate (disturbance of self-perception, intrusive phenomena, including “voices”) — to severe (disturbance of the sense of agency, including command “voices”).

Plasma complement and coagulation proteins as prognostic factors of negative symptoms: An analysis of the NAPLS 2 and 3 studies

IntroductionNegative symptoms impact the quality of life of individuals with psychosis and current treatment options for negative symptoms have limited effectiveness. Previous studies have demonstrated that complement and coagulation pathway protein levels are related to later psychotic experiences, psychotic disorder, and functioning. However, the prognostic relationship between complement and coagulation proteins and negative symptoms is poorly characterised. MethodsIn the North American Prodrome Longitudinal Studies 2 and 3, negative symptoms in 431 individuals at clinical high-risk for psychosis (mean age: 18.2, SD 3.6; 42.5 % female) were measured at multiple visits over 2 years using the Scale of Psychosis-Risk Symptoms. Plasma proteins were quantified at baseline using mass spectrometry. Four factors were derived to represent levels of proteins involved in the activation or regulation of the complement or coagulation systems. The relationships between standardised protein group factors and serial measurements of negative symptoms over time were modelled using generalised least squares regression. Analyses were adjusted for baseline candidate prognostic factors: negative symptoms, positive symptoms, functioning, depressive symptoms, suicidal ideation, cannabis use, tobacco use, antipsychotic use, antidepressant use, age, and sex. ResultsClinical and demographic prognostic factors of follow-up negative symptoms included negative, positive, and depressive symptoms, functioning, and age. Adjusting for all candidate prognostic factors, the complement regulators group and the coagulation regulators group were identified as prognostic factors of follow-up negative symptoms (β: 0.501, 95 % CI: 0.160, 0.842; β: 0.430, 95 % CI: 0.080, 0.780 respectively. The relationship between complement regulator levels and negative symptoms was also observed in NAPLS2 alone (β: 0.501, 95 % CI: −0.037, 1.039) and NAPLS3 alone, additionally adjusting for BMI (β: 0.442, 95 % CI: 0.127, 0.757). ConclusionThe results indicate that plasma complement and coagulation regulator levels are prognostic factors of negative symptoms, independent of clinical and demographic prognostic factors. These results suggest complement and coagulation regulator levels could have potential utility in informing treatment decisions for negative symptoms in individuals at risk.

Neurocognition and brain functional connectivity in a non-clinical population-based sample with psychotic experiences

We characterized the neurocognitive profile of communed-based individuals and unaffected siblings of patients with psychosis from Brazil reporting psychotic experiences (PEs). We also analyzed associations between PEs and the intra and inter-functional connectivity (FC) in the Default Mode Network (DMN), the Fronto-Parietal Network (FPN) and the Salience Network (SN) measured by functional magnetic resonance imaging. The combined sample of communed-based individuals and unaffected siblings of patients with psychosis comprised 417 (neurocognition) and 85 (FC) volunteers who were divided as having low (<75th percentile) and high (≥75th percentile) PEs (positive, negative, and depressive dimensions) assessed by the Community Assessment of Psychic Experiences. The neurocognitive profile and the estimated current brief intellectual quotient (IQ) were assessed using the digit symbol (processing speed), arithmetic (working memory), block design (visual learning) and information (verbal learning) subtests of Wechsler Adult Intelligence Scale-third edition. Logistic regression models were performed for neurocognitive analysis. For neuroimaging, we used the CONN toolbox to assess FC between the specified regions, and ROI-to-ROI analysis. In the combined sample, high PEs (all dimensions) were related to lower processing speed performance. High negative PEs were related to poor visual learning performance and lower IQ, while high depressive PEs were associated with poor working memory performance. Those with high negative PEs presented FPN hypoconnectivity between the right and left lateral prefrontal cortex. There were no associations between PEs and the DMN and SN FC. Brazilian individuals with high PEs showed neurocognitive impairments like those living in wealthier countries. Hypoconnectivity in the FPN in a community sample with high PEs is coherent with the hypothesis of functional dysconnectivity in schizophrenia.

Association between discrimination and subsequent psychotic experiences in patients with COVID-19: A cohort study

Although cross-sectional studies have suggested that discrimination has a negative impact on the mental health of patients with COVID-19, no cohort studies with longitudinal data have established a causal relationship. Therefore, this study aimed to investigate the association between COVID-19-related discrimination and subsequent psychotic experiences in individuals who had contracted the disease. Secondary outcomes were PTSD symptoms, psychological distress, and suicidal ideation. We utilized inverse probability weighting and marginal structural models with robust standard errors to analyze the association, accounting for confounders and loss to follow-up. In a sensitivity analysis, we evaluated the robustness of the estimates to potential unmeasured confounding by analyzing E-values. Of 7760 participants who had contracted COVID-19, 5971 were included after excluding those with missing sociodemographic data. Of these, 1736 (29.1 %) reported experiencing COVID-19-related discrimination. Of the 2559 participants who completed the study, 253 (9.9 %) reported having at least one psychotic experience. Participants who reported experiencing any COVID-19-related discrimination showed a higher risk of subsequent psychotic experiences compared with participants without such discrimination (risk difference 6.6 %, 95 % CI 4.0 %–9.9 %; risk ratio 1.82, 95 % CI 1.42–2.47). A negative impact was also found in suicidal ideation, PTSD symptoms, and psychological distress. E-values demonstrated the robustness of some of the observed associations to unmeasured confounding. The study found that COVID-19-related discrimination was associated with subsequent psychotic experiences and other mental health outcomes in individuals who had contracted the disease. A study focusing on prevention strategies, such as an anti-discrimination campaign, is warranted.

Towards a scalable approach to assess speech organization across the psychosis-spectrum -online assessment in conjunction with automated transcription and extraction of speech measures

Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of psychosis-onset. The potential of speech markers is, however, hampered by (i) lengthy assessments in laboratory settings and (ii) manual transcriptions. We investigated whether a short, scalable data collection (online) and processing (automated transcription) procedure would provide data of sufficient quality to extract previously validated speech measures. To evaluate the fit of our approach for purpose, we assessed speech in relation to psychotic-like experiences in the general population. Participants completed an 8-minute-long speech task online. Sample 1 included measures of psychometric schizotypy and delusional ideation (N = 446). Sample 2 included a low and high psychometric schizotypy group (N = 144). Recordings were transcribed both automatically and manually, and connectivity, semantic, and syntactic speech measures were extracted for both types of transcripts. 73%/86% participants in sample 1/2 completed the experiment. Nineteen out of 25 speech measures were strongly (r > 0.7) and significantly correlated between automated and manual transcripts in both samples. Amongst the 14 connectivity measures, 11 showed a significant relationship with delusional ideation. For the semantic and syntactic measures, On Topic score and the Frequency of personal pronouns were negatively correlated with both schizotypy and delusional ideation. Combined with demographic information, the speech markers could explain 11–14% of the variation of delusional ideation and schizotypy in Sample 1 and could discriminate between high-low schizotypy with high accuracy (0.72−0.70, AUC = 0.78–0.79) in Sample 2. The moderate to high retention rate, strong correlation of speech measures across manual and automated transcripts and sensitivity to psychotic-like experiences provides initial evidence that online collected speech in combination with automatic transcription is a feasible approach to increase accessibility and scalability of speech-based assessment of psychosis.

Childhood adversity and psychopathology: the dimensions of timing, type and chronicity in a population-based sample of high-risk adolescents.

Research on childhood adversity and psychopathology has begun investigating the dimension of timing, however the results have been contradictory depending on the study population, outcome and how adverse life events (ALEs) were operationalized. Additionally, studies so far typically focus only on a narrow range of psychiatric diagnoses or symptoms. The current cross-sectional study aimed to examine the association between timing, type and chronicity of ALEs and adolescent mental health problems. Adolescents from a population-based cohort oversampled on emotional and behavioral problems (mean age 14.8; range 12-17, N = 861) were included in the current analysis. Primary caregivers were interviewed on what ALEs adolescents experienced. ALEs were defined in two ways: (1) broad operationalization, including school difficulties, parental divorce, and family sickness; and (2) physically threatening abuse only, including physical and sexual violence. After looking at lifetime ALEs, we turned to chronicity, timing and sex differences. We focused on overall psychiatric symptoms as well as specific domains of emotional and behavioral problems, assessed using the Youth Self Report (YSR) and psychotic experiences assessed using the Prodromal Questionnaire-16 (PQ-16). A series of linear models adjusted for sociodemographic and parental factors were used. Lifetime ALEs were associated with all types of psychopathology, with relatively bigger effect sizes for broad than for physical ALEs. The latter associations were found to be more robust to unmeasured confounding. The 9-12 age period of experiencing both broad and physical ALE's was most saliently associated with any psychopathology. Girls were more at risk after experiencing any ALEs, especially if the adversity was chronic or ALEs took place after the age of 12. Broad as well as physical ALEs are associated with psychopathology, especially ALEs experienced during the 9-12 age period. Physical ALEs may be more useful in investigating specific etiological factors than broad ALEs. Sex differences may not emerge in lifetime measures of ALEs, but can be important for chronic and later childhood adversity.

The effect of life events on NSSI: the chain mediating effect of sleep disturbances and PLEs among Chinese college students.

This study aimed to explore the relationship between life events and non-suicidal self-injury (NSSI) in college students, as well as the mediating effect of sleep disturbances and psychotic-like experiences (PLEs). After excluding invalid questionnaires, 5,754 were retained, and the valid efficiency was 75.94%. The subjects were aged 16 to 29 years (M = 19.166; SD = 1.392), with 1,969 males (34.22%) and 3,785 females (65.78%). Life events, sleep disturbances, PLEs, and NSSI were assessed using standard scales. Data were analyzed by Pearson Correlation Analysis and bias-correction percentile Bootstrap method. The results show that (1) life events were significant positive predictors of NSSI, sleep disturbances, and PLEs; (2) sleep disturbances, PLEs, and the chain mediation between the two, were mediators between life events and NSSI. Life events are thus shown to be an important external factor influencing NSSI in university students, and this process is mediated through sleep disturbances, PLEs, and the chain between the two. Interventions for NSSI can therefore be made by improving college students' sleep quality and reducing PLEs.

Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis.

Pre-diagnostic stages of psychotic illnesses, including 'clinical high risk' (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.

Carl Jung: a life on the edge of reality with hypnagogia, hyperphantasia, and hallucinations.

Whether the Swiss psychiatrist Carl Jung (1875-1961) became psychotic after his mid-thirties is much debated. His recently published Black Books, a seven-volume journal, reveal new insights into this debate. Based on a phenomenological analysis of his self-reports in these books and in other writings, we here identify several types of anomalous perceptual experiences: hypnagogic-hypnopompic experiences, hyperphantasia, hallucinations, personifications, and sensed presence. We argue that these experiences were not indicative of a psychotic disorder, but rather stemmed from extremely vivid mental imagery, or hyperphantasia, a condition Jung's contemporaries and later biographers were unable to take into account because it had not yet been conceptualised. Recently, the degree of vividness of mental imagery and its potential to become indistinguishable from regular sense perception has been the subject of extensive studies. Unknowingly, Jung may have foreshadowed this line of research with his psychoanalytic concept of reality equivalence, i.e., the substitution of an external world for an inner mental reality that he encountered in individuals diagnosed with schizophrenia. There is a need for future research to investigate the possible role of hyperphantasia in psychotic experiences, but to Jung, psychosis was 'a failure to contain and comprehend' the content of one's experiences in the context of one's own life, whereas he himself did manage to put the content of his perceptual experiences into context, to find meaning in them, and to share them with others - to great acknowledgement and acclaim.