Abstract
Introduction: The Attenuated Psychosis Symptoms (APS) syndrome mostly represents the ultra-high-risk state of psychosis but, as does the Brief Intermittent Psychotic Symptoms (BIPS) syndrome, shows a large variance in conversion rates. This may be due to the heterogeneity of APS/BIPS that may be related to the effects of culture, sex, age, and other psychiatric morbidities. Thus, we investigated the different thematic contents of APS and their association with sex, age, country, religion, comorbidity, and functioning to gain a better understanding of the psychosis-risk syndrome. Method: A sample of 232 clinical high-risk subjects according to the ultra-high risk and basic symptom criteria was recruited as part of a European study conducted in Germany, Italy, Switzerland, and Finland. Case vignettes, originally used for supervision of inclusion criteria, were investigated for APS/BIPS contents, which were compared for sex, age, country, religion, functioning, and comorbidities using chi-squared tests and regression analyses. Result: We extracted 109 different contents, mainly of APS (96.8%): 63 delusional, 29 hallucinatory, and 17 speech-disorganized contents. Only 20 contents (18.3%) were present in at least 5% of the sample, with paranoid and referential ideas being the most frequent. Thirty-one (28.5%) contents, in particular, bizarre ideas and perceptual abnormalities, demonstrated an association with age, country, comorbidity, or functioning, with regression models of country and obsessive-compulsive disorders explaining most of the variance: 55.8 and 38.3%, respectively. Contents did not differ between religious groups. Conclusion: Psychosis-risk patients report a wide range of different contents of APS/BIPS, underlining the psychopathological heterogeneity of this group but also revealing a potential core set of contents. Compared to earlier reports on North-American samples, our maximum prevalence rates of contents were considerably lower; this likely being related to a stricter rating of APS/BIPS and cultural influences, in particular, higher schizotypy reported in North-America. The various associations of some APS/BIPS contents with country, age, comorbidities, and functioning might moderate their clinical severity and, consequently, the related risk for psychosis and/or persistent functional disability.
| Original language | English |
|---|---|
| Article number | 1209485 |
| Journal | Frontiers in Psychiatry |
| Volume | 14 |
| ISSN | 1664-0640 |
| DOIs | |
| Publication status | Published - 2023 |
Funding
NK reported receiving grants from the European Union (EU) during the conduct of the study and having a patent to US20160192889A1 issued. SR reported receiving grants from the European Commission during the conduct of the study. AR-R reported receiving grants from the EU during the conduct of the study. CA reported receiving non-financial support from Sunovion Pharmaceuticals, Inc. and H. Lundbeck A/S outside the submitted manuscript. JH reported receiving personal fees from Orion Company, Ltd., Otsuka Pharmaceutical Co, Ltd., and H. Lundbeck A/S and European College of Neuropsychopharmacology Congress participation support from Takeda Pharmaceutical Company Limited during the conduct of the study. FS-L reported receiving grants from the Swiss National Foundation during the conduct of the study. CP reported receiving grants from Australian National Health and the Medical Research Council during the conduct of the study and personal fees from H. Lundbeck A/S and Australia Pty Ltd outside the submitted manuscript. RU reported receiving personal fees from Sunovion Pharmaceuticals, Inc, outside the submitted manuscript. EM reported having a patent to US20160192889A1 licensed. TL reported receiving funding from the Koeln Fortune Program/Faculty of Medicine, University of Cologne (No. 370/2020). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The CHR sample (N = 232) was recruited as part of the PRONIA study, which was funded by a grant from the European Commission and carried out at ten early detection centers in Germany, Italy, England, Finland, and Switzerland between 02/2014 and 11/2018 (, ). CHR patients had to meet the following inclusion criteria: age between 15 and 40 years, meeting at least one of the three UHR criteria and/or the basic symptom criterion COGDIS, language skills sufficient for participation, and sufficient capacity to consent/assent. PRONIA (Personalized Prognostic Tools for Early Psychosis Management) is a Collaboration Project funded by the EU under the 7th Framework Programme and grant agreement No. 602152.
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)
