Clinician‐rated and self‐reported psychotic‐like experiences in individuals accessing a specialist Youth Mental Health Service

Abstract

Clinical Implications Psychotic-like experiences are common in young people with severe non-psychotic mental health problems and should be routinely screened in mental health services. Psychotic-like experiences were found to be more prevalent when using a self-report screening tool compared to a clinician-rated measure. The presence of psychotic-like experiences may reflect more severe and complex mental health problems and may also cause delays in young people accessing the right kind of support. ;Limitations This study only assessed the presence or absence of psychotic-like experiences. Further studies should use more detailed assessments to understand more about the nature of such experiences and how they are appraised and responded to. This study is cross-sectional, and therefore, the direction of the relationships between psychotic-like experiences and depression, anxiety, functioning, and trauma cannot be specified. Longitudinal studies are needed to examine the impact of psychotic-like experiences on long-term outcomes.

Comparison of self-report and clinician-rated schizotypal traits in schizotypal personality disorder and community controls

“…For example, mobile technology-based activity measures using actigraphy and measures of negative symptoms through video may provide more objective measures. Our findings support recommendation by others on using multiple sources of information for assessing personality (Dinger et al, 2013;McDonald, 2008) and psychotic-like experiences (Hodgekins et al, 2018).…”

“…In two studies that examined relatives of patients with schizophrenia, self-report measures of schizotypy performed worse than clinical interviews at identifying relatives of patients with schizophrenia, suggesting that questionnaires are less successful at assessing underlying vulnerability for schizophrenia (Kendler et al, 1996(Kendler et al, , 1993. Self-report questionnaires assessing psychotic-like experiences greatly overestimate the prevalence of psychosis and attenuated positive symptoms when compared with clinician ratings on the same individuals using a clinical interview (Schultze-Lutter et al, 2014) or checklists (Hodgekins et al, 2018). Spitz et al (2017) reported low correlations between self-and observer-rated positive, negative, and affective symptoms in at-risk mental state and first-episode psychosis patients.…”

Cohort profile: the Brain and Mind CentreOptymisecohort: tracking multidimensional outcomes in young people presenting for mental healthcare

“…Further, the prevalence of at-risk mental states was more substantial than both full-threshold and subthreshold bipolar and psychotic diagnoses, suggesting that such features are common in those presenting to youth mental health services, occurring much more frequently than overt psychotic or bipolar disorders. The prevalence of psychosis-like experiences in this sample is higher than the 6%–12% reported in adults and adolescents in the general population67–69 but lower than previous reports in young people presenting for mental healthcare, which have found prevalence closer to 50% even in non-psychotic samples 70 71. The more conservative prevalence in the current study is likely due to the method of data collection, as less severe psychosis-like symptoms may not have been specifically assessed or recorded by clinicians.…”

The mediating role of borderline personality features in the relationship between childhood trauma and psychotic-like experiences in a sample of help-seeking non-psychotic adolescents and young adults

“…This also holds for clinical samples. A study conducted on 108 adolescent outpatients (12–16 years) showed that 78% of those who reported PLEs also met the criteria for two or more non-psychotic psychiatric disorders [11] and the presence of PLEs were associated with poorer social and role functioning and increased severity of non-psychotic symptoms [14–16]. The occurrence of PLEs in adolescents seems closely linked to various psychiatric symptoms [12, 13, 17–19].…”