Developing Psychosis and Its Risk States Through the Lens of Schizotypy

Abstract

Starting from the early descriptions of Kraepelin and Bleuler, the construct of schizotypy was developed from observations of aberrations in nonpsychotic family members of schizophrenia patients. In contemporary diagnostic manuals, the positive symptoms of schizotypal personality disorder were included in the ultra high-risk (UHR) criteria 20 years ago, and nowadays are broadly employed in clinical early detection of psychosis. The schizotypy construct, now dissociated from strict familial risk, also informed research on the liability to develop any psychotic disorder, and in particular schizophrenia-spectrum disorders, even outside clinical settings. Against the historical background of schizotypy it is surprising that evidence from longitudinal studies linking schizotypy, UHR, and conversion to psychosis has only recently emerged; and it still remains unclear how schizotypy may be positioned in high-risk research. Following a comprehensive literature search, we review 18 prospective studies on 15 samples examining the evidence for a link between trait schizotypy and conversion to psychosis in 4 different types of samples: general population, clinical risk samples according to UHR and/or basic symptom criteria, genetic (familial) risk, and clinical samples at-risk for a nonpsychotic schizophrenia-spectrum diagnosis. These prospective studies underline the value of schizotypy in high-risk research, but also point to the lack of evidence needed to better define the position of the construct of schizotypy within a developmental psychopathology perspective of emerging psychosis and schizophrenia-spectrum disorders.

Associations between Electrophysiological Evidence of Reward and Punishment-Based Learning and Psychotic Experiences and Social Anhedonia in At-Risk Groups

“…Extremely elevated SocAnh 'is rather selectively associated with the emergence of nonpsychotic schizophrenic-spectrum disorders' (Debbané et al, 2015). In order to more clearly distinguish psychosis risk from elevated SocAnh, to be recruited for this study the SocAnh (and control) groups had to be rated as never having PE (ie,o2) on the SIPS.…”

Investigation of associations between attachment, parenting and schizotypy during the postnatal period

“…Barrantes-Vidal et al (2013) advocate the study of schizotypy to facilitate understanding of the development of clinical level psychosis. Investigating schizotypy may also contribute to the identification of protective factors, as the presence of schizotypy does not necessarily lead to the development of clinical symptoms (Debbane et al, 2015). Furthermore, research into schizotypy may facilitate a clearer understanding of the aetiology and trajectory of psychosis without debilitating extraneous variables being present, such as distress, hospitalisation and medication effects (Lenzenweger, 2015) which may be present in clinical level psychosis.…”

Experiencias psicóticas atenuadas y consumo de sustancias en universitarios

“…Estudios previos han llegado a conclusiones similares, analizando tanto adolescentes como adultos no clínicos de la población general (Debbané et al, 2015;Fonseca-Pedrero, Santarén-Rosell, Paino, y Lemos Giraldez, 2013;Ibáñez-Casas et al, 2015;McGrath et al, 2015). Por ejemplo, en un estudio llevado a cabo por McGrath et al (2015), utilizando una muestra de 31.261 adultos procedentes de 18 países, se encontró que la prevalencia media de haber tenido una experiencias psicótica atenuada era del 5,8%, siendo para las experiencias alucinatorias del 5,2% y del 1,3% para las experiencias delirantes.…”

“…A este conjunto de experiencias atenuadas, cuando persisten en el tiempo y se acompañan de cierto malestar, preocupación y búsqueda de ayuda, se les suele denominar síntomas psicóticos atenuados (Fonseca-Pedrero, Paino, y Fraguas, 2013;Yung et al, 2007). Este tipo de experiencias atenuadas son consideradas como un marcador fenotípico de vulnerabilidad para los trastornos del espectro psicótico, en general, y para la esquizofrenia en particular (Debbané et al, 2015;Linscott y van Os, 2013). En este sentido, es posible que la identificación de este conjunto de experiencias subclínicas permita la detección e identificación temprana de participantes vulnerables a un trastorno mental grave, como la psicosis.…”