Psychotic experiences in daily-life in adolescents and young adults with 22q11.2 deletion syndrome: an Ecological Momentary Assessment study

Abstract

Objectives: 22q11.2 deletion syndrome (22q11DS) is a genetic condition associated with a markedly increased risk for psychosis. Psychotic experiences (PE) are classically evaluated by clinical interviews that give little information about the fluctuation of these symptoms in daily-life. Therefore, the current study aims to investigate these phenomena using the Ecological Momentary Assessment (EMA), a structured diary technique that collects real-life measures in the everyday-life context, and to examine how these manifestations relate to a goal standard semi-structured assessment of PE. Method: Eighty-six adolescents and young adults with 22q11DS as well as healthy controls (HC) aged 12-27 were recruited. All participants completed a 6-day ESM protocol assessing momentary psychotic experiences as well as their current mood (measured by positive and negative affects). The presence of (attenuated) psychotic symptoms was assessed in the 22q11DS group with a clinical interview (SIPS).Results: Our main findings indicate that participants with 22q11DS reported more intense and more frequent momentary PE than HC and similar associations between affects (both PA and NA) and momentary PE. In participants with 22q11DS, more intense and more frequent momentary PE measured by EMA were associated with the severity of SIPS positive symptoms. Finally, participants with 22q11DS reporting at least attenuated positive symptoms of psychosis on the SIPS had more frequent and more intense momentary PE than participants with 22q11DS without psychotic symptoms.Conclusions: Altogether, this study highlights the validity of EMA to assess PE and broadens previous findings about mood and PE associations.

Increased affective reactivity to daily social stressors is associated with more severe psychotic symptoms in youth with 22q11.2 deletion syndrome

“…Momentary psychotic experiences were assessed using the mean score of three items: "I feel like I have to be on my guard, that I'm not safe", "I feel like my imagination is mixing with reality", "I feel like I'm hearing or seeing things that other people don't perceive" (respective loadings were 0.62, 0.65 and 0.77; Cronbach's a = 0.43). This method was found to be a reliable measure of psychotic experiences (43).…”