Incidence and Persistence of Psychotic Experiences in the General Population: Systematic Review and Meta-Analysis

Abstract

Background and Hypothesis Psychotic experiences (PEs) are associated with increased risk for mental disorders, in particular persistent PEs. PEs therefore might be useful within intervention research. We sought to systematically determine the incidence and persistence of PEs in the general population. Study Design A double-blind search of databases (Embase, Pubmed PMC, Psychinfo, Medline, and Web of Science) from inception to January 2023 and data extraction, were conducted. Study quality was assessed using the NIH assessment tool. Random effects models were conducted to calculate pooled incidence rate per person-year and proportion of persistent PEs per year. Age and study design were all examined using subgroup analyses. Demographic, risk factors, and outcomes for incidence and persistence of PEs were reported in a narrative synthesis. Study Results Using a double-blind screening method for abstract (k = 5763) and full text (k = 250) were screened. In total 91 samples from 71 studies were included, of which 39 were included in a meta-analysis (incidence: k = 17, n = 56 089; persistence: k = 22, n = 81 847). Incidence rate was 0.023 per person-year (95% CI [0.0129;0.0322]). That is, for every 100 people, 2 reported first onset PEs in a year. This was highest in adolescence at 5 per 100(13–17 years). The pooled persistence rate for PEs was 31.0% (95% CI [26.65,35.35]) This was highest in adolescence at 35.8%. Cannabis was particularly associated with incidence of PEs, and persistence of PEs were associated with multiple mental disorders. Conclusions Each year incidence of PEs is 2 of every 100 people, and persists each year in 31% of cases, this risk is highest in adolescents.

Cognitive Biases and Socio-Occupational Functioning Mediate the Relationship between Executive Functions and the Severity of Psychopathology among Young Adults with Psychotic-like Experiences: 1-Year Follow-Up Study

“…Moreover, they often require greater healthcare support [7] and are at a high risk of engaging in suicidal behaviors (see the meta-analysis of Yates et al [8]). This highlights the utility of PLEs as indicators of adverse mental health outcomes, as confirmed by the latest meta-analysis by Staines et al [9].…”

Trajectories of Adolescent Media Use and Their Associations With Psychotic Experiences

“…These factors could include, for example, environmental exposures after 12 years of age (eg, substance use, interpersonal problems) or the effect of PEs themselves. The fact that most participants reported a first onset of PEs during adolescence (consistent with epidemiological literature) makes it possible that emerging or intensifying PEs during this critical period interfered with computer use for the curved trajectory group. Indeed, PEs have been associated with a range of mental health and functioning difficulties, which could hypothetically impact a person’s technological behaviors.…”

“…Surveys generally situate the prevalence of PEs in adults at 5% to 7%, with some evidence of a cumulative risk as high as 13% by 24 years of age . The first onset of PEs is typically between ages 13 and 17 years . While most individuals with PEs do not develop a major mental illness, PEs are nonetheless associated with 2- to 30-fold increased risk of psychotic, affective, and substance use disorders, as well as suicidal ideation and attempts .…”

Psychotic-like experiences: What are they and why are they important?

“…Young people are more likely to report PLE, with up to one in five stating that they have experienced a PLE at some time (Staines, Healy, Coughlan et al 2021). For most people (70%) who report PLEs, they occur just once or very rarely (Staines, Healy, Murphy, et al, 2023). However, about 30% of people who report PLE will experience these more than once.…”