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Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: a 6-year longitudinal general population study

Published online by Cambridge University Press:  11 April 2011

J. T. W. Wigman ,
R. van Winkel ,
Q. A. W. Raaijmakers ,
J. Ormel ,
F. C. Verhulst ,
S. A. Reijneveld ,
J. van Os  and
W. A. M. Vollebergh
J. T. W. Wigman*
Affiliation:
Department of Interdisciplinary Social Science, University of Utrecht, The Netherlands
R. van Winkel
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands
Q. A. W. Raaijmakers
Affiliation:
Research Center for Adolescent Development, University of Utrecht, The Netherlands
J. Ormel
Affiliation:
Department of Psychiatry, University of Groningen, The Netherlands
F. C. Verhulst
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus University Medical Center of Rotterdam, The Netherlands
S. A. Reijneveld
Affiliation:
Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands
J. van Os
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Center, The Netherlands King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
W. A. M. Vollebergh
Affiliation:
Department of Interdisciplinary Social Science, University of Utrecht, The Netherlands
*
*Address for correspondence: J. T. W. Wigman, M.Sc., Department of Interdisciplinary Social Science, Faculty of Social and Behavioral Sciences, University of Utrecht, PO Box 80.140, Heidelberglaan 2, 3508 TC Utrecht, The Netherlands. (Email: J.T.W.Wigman@uu.nl)
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Abstract

Background

Research suggests that subclinical psychotic experiences during adolescence represent the behavioral expression of liability for psychosis. Little is known, however, about the longitudinal trajectory of liability in general population samples.

Method

Growth mixture modeling was used to examine longitudinal trajectories of self-reported positive psychotic experiences in the Youth Self Report (YSR), completed three times over a period of 6 years by a general population cohort of adolescents aged 10–11 years at baseline (n=2230).

Results

Four groups with distinct developmental trajectories of low, decreasing, increasing and persistent levels of mild positive psychotic experiences were revealed. The persistent trajectory was associated strongly with cannabis use, childhood trauma, developmental problems and ethnic minority status, and consistently displayed strong associations with factors known to predict transition from subclinical psychotic experience to clinical psychotic disorder (severity of and secondary distress due to psychotic experiences, social and attentional problems and affective dysregulation) and also with high levels of parental-reported psychotic experiences and use of mental health care at the end of the follow-up period. Progressively weaker associations were found for the increasing, decreasing and low trajectories respectively.

Conclusions

The results suggest that the outcome of early developmental deviation associated with later expression of psychotic experiences is contingent on the degree of later interaction with environmental risks inducing, first, persistence of psychotic experiences and, second, progression to onset of need for care and service use. Insight into the longitudinal dynamics of risk states in representative samples may contribute to the development of targeted early intervention in psychosis.

Keywords

Adolescencedevelopmentgeneral populationpsychosis
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 11 , November 2011 , pp. 2317 - 2329
Copyright
Copyright © Cambridge University Press 2011

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