Differences Between Self-Reported Psychotic Experiences, Clinically Relevant Psychotic Experiences, and Attenuated Psychotic Symptoms in the General Population
Moriyama, Tais Silveira; van Os, Jim; Gadelha, Ary; Pan, Pedro Mario; Salum, Giovanni Abrahão; Manfro, Gisele Gus; Mari, Jair de Jesus; Miguel, Eurípedes Constantino; Rohde, Luis Augusto; Polanczyk, Guilherme Vanoni; McGuire, Philip; Bressan, Rodrigo Affonseca; Drukker, Marjan
(2019) Frontiers in Psychiatry, volume 10, issue OCT
(Article)
Abstract
Purpose: Psychotic experiences in childhood (such as hearing voices or being suspicious) represent an important phenotype for early intervention. However, these experiences can be defined in several ways: self-reported psychotic experiences (SRPE) rely exclusively on the child's report, clinically validated psychotic experiences (CRPE) are based on clinical assessment, and attenuated
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psychotic symptoms (APS) represents a categorization to do with clinical relevance in relation to severity. Very few studies have investigated how these distinctions impact clinical and other domains. The present study aims to compare SRPE, CRPE, and APS among children and adolescents. Methods: This study is part of the Brazilian High-Risk Cohort Study for Psychiatric Disorders, in which 2,241 individuals aged 6-14 years provided self-ratings of 20 psychotic experiences using the Community Assessment of Psychic Experiences (CAPE). A trained psychologist conducted an interview to validate or reject reported experiences and to rate the presence of APS and affective flattening. In parallel, parents provided information about child mental health to an independent interviewer. We tested the association of mutually exclusive categories of non-validated SRPE (nSRPE), clinically validated PE below the threshold for APS (nCRPE), and APS (nSRPE = 33%, nCRPE = 11%, APS = 6%), with parents' information about the child's positive attributes and levels of psychopathology and psychologist assessment of blunted affect. Results: Most associations were qualitatively similar, and there was a dose-response in the strength of associations across categories, such that APS > nCRPE > nSRPE. Experiences in all three categories were associated with female sex. nSRPE were associated with overall levels of psychopathology, but to a lesser degree than nCRPE and APS. APS and nCRPE were associated with less positive attributes, with APS more so than nCRPE. Only APS was associated with affective flattening. Conclusions: In children and adolescents, SRPE, CRPE, and APS all index liability for psychopathology, but as clinician rated relevance increases, associations get stronger and become evident across more domains.
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Keywords: Adolescents, Attenuated psychotic symptoms, Psychiatric epidemiology, Psychotic experiences, Schizophrenia, Psychiatry and Mental health
ISSN: 1664-0640
Publisher: Frontiers Research Foundation
Note: Funding Information: This work is supported by the National Institute of Developmental Psychiatry for Children and Adolescents, a science and technology institute funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; National Council for Scientific and Technological Development; grant number 573974/2008-0) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; Research Support Foundation of the State of São Paulo; grant number 2008/57896-8). It was also supported in part by the European Community's Seventh Framework Program (grant agreement No. HEALTH-F2-2009-241909, Project EU-GEI). The author’s scholarships are supported by the following Brazilian government institutions: CNPq, FAPESP, Coordenação de Aperfeiçoamentode Pessoal de Nível Superior (CAPES; Brazilian Federal Agency for Support and Evaluation of postgraduate education) and Fundação de Amparo a Pesquisa do Estado do Rio Grande do Sul (FAPERGS; Research Support Foundation from the State of Rio Grande do Sul). Tais Moriyama received a sandwich scholarship from CAPES (process number 10553/12-6) and a PhD scholarship from CAPES; Ary Gadelha received a CAPES PhD scholarship; Pedro Mario Pan received a CNPq/CAPES master’s degree scholarship; Giovanni Abrahão Salum received a CAPES/FAPERGS post-doctoral scholarship; Gisele Gus Manfro, Jair J. Mari, Eurípedes Constantino Miguel (302463/2011-9), Luis A. Rohde, Guilherme V. Polanczyk (310582/2017-2) and Rodrigo A. Bressan are in receipt of a senior research CNPq scholarship. Publisher Copyright: © 2019 Moriyama, van Os, Gadelha, Pan, Salum, Manfro, Mari, Miguel,,Rohde, Polanczyk, McGuire, Bressan and Drukker.
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