Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome

Lotta-Katrin Pries, Sinan Guloksuz, Margreet Ten Have, Ron de Graaf, Saskia van Dorsselaer, N.C.H.F. Geurts - Gunther, Christian Rauschenberg, Ulrich Reininghaus, Rajiv Radhakrishnan, Maarten Bak, Bart Rutten, Jim van Os

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Abstract

Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration).

Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio.

Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other.

Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.

Original languageEnglish
Pages (from-to)710-719
Number of pages10
JournalSchizophrenia Bulletin
Volume44
Issue number4
DOIs
Publication statusPublished - 6 Jun 2018

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Psychotic Disorders
Logistic Models
Neurobehavioral Manifestations
Affective Symptoms
Sex Education
Cannabis
Health Surveys
Psychopathology
Mood Disorders
Hearing Loss
Netherlands
Mental Health
Cohort Studies

Keywords

  • Adolescent
  • Adult
  • Aged
  • Disease Susceptibility
  • Environment
  • Female
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Netherlands/epidemiology
  • Psychotic Disorders/epidemiology
  • Risk Factors
  • Young Adult
  • symptom dimensions
  • MENTAL-HEALTH SURVEY
  • GENERAL-POPULATION
  • AFFECTIVE PATHWAY
  • INCIDENCE STUDY-2
  • psychotic experiences
  • SUBCLINICAL PSYCHOSIS
  • risk factors
  • DELUSIONAL IDEATION
  • NETWORK APPROACH
  • ULTRA-HIGH RISK
  • BIPOLAR DISORDER
  • CHILDHOOD TRAUMA

Cite this

Pries, Lotta-Katrin ; Guloksuz, Sinan ; Ten Have, Margreet ; de Graaf, Ron ; van Dorsselaer, Saskia ; Geurts - Gunther, N.C.H.F. ; Rauschenberg, Christian ; Reininghaus, Ulrich ; Radhakrishnan, Rajiv ; Bak, Maarten ; Rutten, Bart ; van Os, Jim. / Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome. In: Schizophrenia Bulletin. 2018 ; Vol. 44, No. 4. pp. 710-719.
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abstract = "Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration).Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio.Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other.Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.",
keywords = "Adolescent, Adult, Aged, Disease Susceptibility, Environment, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Netherlands/epidemiology, Psychotic Disorders/epidemiology, Risk Factors, Young Adult, symptom dimensions, MENTAL-HEALTH SURVEY, GENERAL-POPULATION, AFFECTIVE PATHWAY, INCIDENCE STUDY-2, psychotic experiences, SUBCLINICAL PSYCHOSIS, risk factors, DELUSIONAL IDEATION, NETWORK APPROACH, ULTRA-HIGH RISK, BIPOLAR DISORDER, CHILDHOOD TRAUMA",
author = "Lotta-Katrin Pries and Sinan Guloksuz and {Ten Have}, Margreet and {de Graaf}, Ron and {van Dorsselaer}, Saskia and {Geurts - Gunther}, N.C.H.F. and Christian Rauschenberg and Ulrich Reininghaus and Rajiv Radhakrishnan and Maarten Bak and Bart Rutten and {van Os}, Jim",
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Pries, L-K, Guloksuz, S, Ten Have, M, de Graaf, R, van Dorsselaer, S, Geurts - Gunther, NCHF, Rauschenberg, C, Reininghaus, U, Radhakrishnan, R, Bak, M, Rutten, B & van Os, J 2018, 'Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome', Schizophrenia Bulletin, vol. 44, no. 4, pp. 710-719. https://doi.org/10.1093/schbul/sby051

Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome. / Pries, Lotta-Katrin; Guloksuz, Sinan; Ten Have, Margreet; de Graaf, Ron; van Dorsselaer, Saskia; Geurts - Gunther, N.C.H.F.; Rauschenberg, Christian; Reininghaus, Ulrich; Radhakrishnan, Rajiv; Bak, Maarten; Rutten, Bart; van Os, Jim.

In: Schizophrenia Bulletin, Vol. 44, No. 4, 06.06.2018, p. 710-719.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Evidence That Environmental and Familial Risks for Psychosis Additively Impact a Multidimensional Subthreshold Psychosis Syndrome

AU - Pries, Lotta-Katrin

AU - Guloksuz, Sinan

AU - Ten Have, Margreet

AU - de Graaf, Ron

AU - van Dorsselaer, Saskia

AU - Geurts - Gunther, N.C.H.F.

AU - Rauschenberg, Christian

AU - Reininghaus, Ulrich

AU - Radhakrishnan, Rajiv

AU - Bak, Maarten

AU - Rutten, Bart

AU - van Os, Jim

PY - 2018/6/6

Y1 - 2018/6/6

N2 - Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration).Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio.Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other.Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.

AB - Background: The observed link between positive psychotic experiences (PE) and psychosis spectrum disorder (PSD) may be stronger depending on concomitant presence of PE with other dimensions of psychopathology. We examined whether the effect of common risk factors for PSD on PE is additive and whether the impact of risk factors on the occurrence of PE depends on the co-occurrence of other symptom dimensions (affective dysregulation, negative symptoms, and cognitive alteration).Method: Data from the Netherlands Mental Health Survey and Incidence Study 2 were used. Risk factors included childhood adversity, cannabis use, urbanicity, foreign born, hearing impairment, and family history of affective disorders. Logistic regression models were applied to test (1) the additive effect of risk factors (4 levels) on PE and (2) the moderating effects of symptom dimensions on the association between risk factors (present/absent) and PE, using additive interaction, expressed as the interaction contrast ratio.Results: Risk factors were additive: the greater the number of risk factors, the greater the odds of PE. Furthermore, concomitant presence of the other symptom dimensions all increased the impact of risk factors on PE. After controlling for age, sex, and education, only affective dysregulation and negative symptoms remained significant moderators; only affective dysregulation remained a significant moderator if all dimensions were adjusted for each other.Conclusions: Risk factors may not be directly associated with PE but additively give rise to a multidimensional subthreshold state anticipating the multidimensional clinical syndrome. Early motivational and cognitive impairments in the context of PE may be reducible to affective dysregulation.

KW - Adolescent

KW - Adult

KW - Aged

KW - Disease Susceptibility

KW - Environment

KW - Female

KW - Health Surveys

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Netherlands/epidemiology

KW - Psychotic Disorders/epidemiology

KW - Risk Factors

KW - Young Adult

KW - symptom dimensions

KW - MENTAL-HEALTH SURVEY

KW - GENERAL-POPULATION

KW - AFFECTIVE PATHWAY

KW - INCIDENCE STUDY-2

KW - psychotic experiences

KW - SUBCLINICAL PSYCHOSIS

KW - risk factors

KW - DELUSIONAL IDEATION

KW - NETWORK APPROACH

KW - ULTRA-HIGH RISK

KW - BIPOLAR DISORDER

KW - CHILDHOOD TRAUMA

U2 - 10.1093/schbul/sby051

DO - 10.1093/schbul/sby051

M3 - Article

VL - 44

SP - 710

EP - 719

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

SN - 0586-7614

IS - 4

ER -