Classes of Psychotic Experiences in Kenyan Children and Adolescents

Abstract

Psychotic-like experiences (PLEs) have been observed worldwide in both adults and children outside the context of a clinical disorder. In the current study, we investigate the prevalence and patterns of PLEs among children and adolescents in Kenya. Among 1,971 students from primary and secondary schools around Nairobi (aged 8–19), 22.1 % reported a lifetime history of a psychotic experience, and 16.3 % reported this unrelated to sleep or drugs. Psychotic experiences were more common in males compared to females. LCA resulted in a three-class model comprised of a normative class (83.3 %), a predominately hallucinatory class (Type 1 psychosis: 9.6 %), and a pan-psychotic class (Type 2 psychosis: 7.2 %). These results indicate that PLEs are prevalent in children and adolescents, and the distributions of symptom clusters are similar to that found in adulthood. The relationship of specific PLEs to the future development of psychotic disorder, functional impairment or distress will require further study.

The Brief 10‐Item Community Assessment of Psychic Experiences‐Positive Scale (Brief CAPE‐P10): Initial psychometric properties, gender measurement invariance and mean differences among Nigerian adolescents

“…In terms of mean differences, the male respondents had higher scores on the Brief CAPE-P10 and its subscales. Mamah et al (2013) reported a similar finding in a cross-sectional sample of 1971 Kenyan adolescents.…”

Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

“…Four of the five childhood PLE profiles ( None , Moderate , Hallucinatory , and Strong ) were previously also identified in studies employing LCA on lifetime symptoms from interviews of adolescent and adult samples. In those, 83–93% of individuals were classified into a ‘normal’ class (Gale et al ., ; Mamah et al ., ; Ndetei et al ., ; Pignon et al ., ; Shevlin et al ., ), whereas 57.1% of children were classified into two classes characterized by high probabilities of responding Not True to all items ( None; 27.4% of children) or all but three items ( Minor ; 29.7% ) . The differentiation of the None and Minor classes in our sample is unlikely to reflect over‐fitting of the LCA model, as Minor emerged already in the 4‐class solution with None , Moderate , and Strong (i.e., before Hallucinatory in the 5‐class model).…”

“…In contrast, the other three classes delineated profiles characterized by more prominent endorsement of PLEs and robust (medium‐to‐large) independent associations with each psychopathology. Greater proportions of children were classified in each of these three classes relative to adolescent and adult samples (Gale et al ., ; Mamah et al ., ; Ndetei et al ., ; Pignon et al ., ; Shevlin et al ., ), but the consistency of these class types across all samples suggests that they may endure across developmental periods (though longitudinal data are required to confirm this hypothesis). Two classes ( Moderate and Strong ) showed consistent patterns of responding across all nine PLE items that differed from each other quantitatively rather than qualitatively, akin to the ‘intermediate’ and ‘psychosis’ classes described by Shevlin et al .…”

“…Several prior studies of adults (Gale, Wells, McGee, & Browne, ; Mamah et al ., ; Ndetei et al ., ; Pignon et al ., ), and one of adolescents (Mamah et al ., ), have employed latent class analysis (LCA) to identify homogeneous classes of individuals who display similar patterns of PLEs. Three studies (Gale et al ., ; Mamah et al ., ; Ndetei et al ., ) using the Composite International Diagnostic Interview (CIDI) 6‐item lifetime screener (Kessler & Ustun, ) each differentiated three PLE profiles: a ‘normal’ class characterized by low probability of any PLEs (between 83 and 93% of individuals); an ‘hallucinatory’ class (7–13%) characterized by a high probability of auditory and visual hallucinations but a low probability of delusions; and a ‘psychosis’ class (0.2–7.2%) characterized by a high probability of reporting all six items. Based on 13 PLE lifetime items from the CIDI (four hallucinations and nine delusions), Shevlin, Murphy, Dorahy, and Adamson () differentiated an additional, ‘intermediate’, profile (6% of individuals).…”

A comparative study of psychotic and affective symptoms in Rwandan and Kenyan students

“…Assessing clinical risk early has significantly advanced the possibility of indicated prevention of full-blown psychotic disorders (Yung et al 1996(Yung et al , 2004Miller et al 1999). Our group has conducted multiple studies in Kenya, investigating the prevalence of PLEs and risk for developing illness using self-report questionnaires (Mamah et al , 2013Ndetei et al 2012;Owoso et al 2014). The Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen ) was developed to overcome some of the challenges in assessing risk of developing psychotic disorders, guided by the existing literature on risk assessment and our previous efforts in Africa and the USA.…”