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Subclinical psychosis syndromes in the general population: results from a large-scale epidemiological survey among residents of the canton of Zurich, Switzerland

Published online by Cambridge University Press:  26 November 2013

W. Rössler ,
V. Ajdacic-Gross ,
H. Haker ,
S. Rodgers ,
M. Müller  and
M. P. Hengartner
W. Rössler*
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland University of Zurich and ETHZ, Collegium Helveticum Zurich, Zurich, Switzerland Laboratory of Neuroscience – LIM 27, Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
V. Ajdacic-Gross
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland Laboratory of Neuroscience – LIM 27, Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
H. Haker
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich & ETH Zurich, Zurich, Switzerland
S. Rodgers
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
M. Müller
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
M. P. Hengartner
Affiliation:
University Hospital of Psychiatry, Zurich Programme for Sustainable Development of Mental Health Services, Zurich, Switzerland
*
*Address for correspondence: Dr Wulf Rössler, Psychiatric University Hospital, University of Zurich, Militärstrasse 8, CH-8004 Zurich, Switzerland (Email: roessler@dgsp.uzh.ch)
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Abstract

Aims.

Prevalence and covariates of subclinical psychosis have gained increased interest in the context of early identification and treatment of persons at risk for psychosis.

Methods.

We analysed 9829 adults representative of the general population within the canton of Zurich, Switzerland. Two psychosis syndromes, derived from the SCL-90-R, were applied: ‘schizotypal signs’ and ‘schizophrenia nuclear symptoms’.

Results.

Only a few subjects (13.2%) reported no schizotypal signs. While 33.2% of subjects indicated mild signs, only a small proportion (3.7%) reported severe signs. A very common outcome was no ‘schizophrenia nuclear symptoms’ (70.6%). Although 13.5% of the participants reported mild symptoms, severe nuclear symptoms were very rare (0.5%). Because these two syndromes were only moderately correlated (r = 0.43), we were able to establish sufficiently distinct symptom clusters. Schizotypal signs were more closely connected to distress than was schizophrenia nuclear symptoms, even though their distribution types were similar. Both syndromes were associated with several covariates, such as alcohol and tobacco use, being unmarried, low education level, psychopathological distress and low subjective well-being.

Conclusions.

Subclinical psychosis symptoms are quite frequent in the general population but, for the most part, are not very pronounced. In particular, our data support the notion of a continuous Wald distribution of psychotic symptoms in the general population. Our findings have enabled us to confirm the usefulness of these syndromes as previously assessed in other independent community samples. Both can appropriately be associated with well-known risk factors of schizophrenia.

Keywords

Attenuated psychosis syndromeepidemiologyschizotypysubclinical psychosis
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 24 , Issue 1 , February 2015 , pp. 69 - 77
Copyright
Copyright © Cambridge University Press 2013 

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