Timing, Distribution, and Relationship Between Nonpsychotic and Subthreshold Psychotic Symptoms Prior to Emergence of a First Episode of Psychosis

Cupo, Lani; McIlwaine, Sarah V; Daneault, Jean-Gabriel; Malla, Ashok; Iyer, Srividya N.; Joober, Ridha; Shah, Jai

doi:10.1093/schbul/sbaa183

Cited by 22 publications

(18 citation statements)

References 83 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although the incidence of PE-only was not clinically neutral – as evidenced by some degree of association with most of the 17 factors under examination, these associations were (significantly) weaker as compared to PE + NPD and there was no association with health care use. These results concur with the previously documented suggestion that clinically relevant psychosis is an indicator of severity in the constellation with non-psychotic psychopathology, and should not be considered in isolation (van Os and Reininghaus, 2016 ; van Os and Guloksuz, 2017 ; Cupo et al ., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…In the same direction, our evidence supports further investigation, in prospective CHR-P settings, of the hypothesis that non-psychotic psychopathology represents a necessary factor in the ontogenesis of psychotic disorders, such that the pathway from psychosis risk to clinical psychosis outcome requires a non-psychotic intermediary state, interacting with multiple conditions including cognitive alteration, high PRS-SZ and environmental exposure. Indeed, a recent follow-back study of a representative incidence sample confirmed this supposition (Cupo et al ., 2021 ). Therefore, CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes (van Os and Reininghaus, 2016 ; Guloksuz et al ., 2020 ; Cupo et al ., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, a recent follow-back study of a representative incidence sample confirmed this supposition (Cupo et al ., 2021 ). Therefore, CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes (van Os and Reininghaus, 2016 ; Guloksuz et al ., 2020 ; Cupo et al ., 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…PE may be associated with subjective (Koyanagi et al ., 2018 ) or objective cognitive alterations (Niarchou et al ., 2013 ; Gur et al ., 2014 ; Rossler et al ., 2015 ); there is evidence, however, that the association with cognitive alterations is dependent on the degree of comorbid non-psychotic psychopathology (Reininghaus et al ., 2019 ). Indeed, recent follow-back studies from representative incidence samples of psychotic disorder have shown that the origins of psychotic disorder can be traced to NPDs, the severest of which develop a degree of psychosis admixture over time (Cupo et al ., 2021 ). Indeed, studies using prospective approaches show that nonpsychotic syndromes are frequently observed not just alongside psychotic experiences (PE)/symptoms, but even before them (Hafner et al ., 1999 ; Shah et al ., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

Hasmi

Pries

Have

et al. 2021

Epidemiol Psychiatr Sci

View full text Add to dashboard Cite

Aims Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired ‘comorbidity’ epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the ‘risk’ in CHR-P is indexed by co-present NPD rather than attenuated psychosis per se. Methods We examined the incidence of early psychotic experiences (PE) with and without NPD (mood disorders, anxiety disorders, alcohol/drug use disorders), in a prospective general population cohort (n = 6123 at risk of incident PE at baseline). Four interview waves were conducted between 2007 and 2018 (NEMESIS-2). The incidence of PE, alone (PE-only) or with NPD (PE + NPD) was calculated, as were differential associations with schizophrenia polygenic risk score (PRS-Sz), environmental, demographical, clinical and cognitive factors. Results The incidence of PE + NPD (0.37%) was lower than the incidence of PE-only (1.04%), representing around a third of the total yearly incidence of PE. Incident PE + NPD was, in comparison with PE-only, differentially characterised by poor functioning, environmental risks, PRS-Sz, positive family history, prescription of antipsychotic medication and (mental) health service use. Conclusions The risk in ‘clinical high risk’ states is mediated not by attenuated psychosis per se but specifically the combination of attenuated psychosis and NPD. CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of non-psychotic DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

Hasmi

Pries

Have

et al. 2021

Epidemiol Psychiatr Sci

View full text Add to dashboard Cite

show abstract

“…Onset of psychosis is characterized by presence of active psychotic symptoms and occurs during early adulthood. Psychosis onset is also better understood as a continuum with psychosis patients reporting proportionally more nonpsychotic symptoms (such as depression and anxiety among others) prior to the onset of psychosis [22]. As symptoms segregate with growth and development psychopathology symptom relationships potentially become statistically more independent.…”

Section: Parameter Estimatesmentioning

confidence: 99%

Community Detection in Weighted Multilayer Networks with Ambient Noise

He¹,

Lu²,

Xu³

et al. 2021

Preprint

View full text Add to dashboard Cite

We introduce a novel class of stochastic blockmodel for multilayer weighted networks that accounts for the presence of a global ambient noise that governs betweenblock interactions. We induce a hierarchy of classifications in weighted multilayer networks by assuming that all but one cluster (block) are governed by unique local signals, while a single block is classified as ambient noise, which behaves identically as interactions across differing blocks. Hierarchical variational inference is employed to jointly detect and typologize block-structures as local signals or global noise. These principles are incorporated into novel community detection algorithm called Stochastic Block (with) Ambient Noise Model (SBANM) for multilayer weighted networks. We apply this method to several different domains. We focus on the Philadelphia Neurodevelopmental Cohort to discover communities of subjects that form diagnostic categories relating psychopathological symptoms to psychosis.

show abstract