Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions

Abstract

Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.

A cluster randomised, 16-week, parallel-group multicentre trial to compare the effectiveness of a digital school-based cognitive behavioural resilience/wellbeing-building intervention targeting emotional and behavioural problems in vulnerable Year 4 primary school children in whole classes, to the usual school curriculum: a study protocol to the “CUES for Schools” trial

“…CUES is designed to reduce emotional/ behavioural problems, particularly for vulnerable children, by promoting emotional literacy and emotional/ behavioural regulation, both linked with childhood social and academic functioning [14,15]. CUES also aims to reduce cognitive vulnerability to mental health problems by reducing stigma and promoting flexible thinking and normalising explanations of unusual perceptual experiences, such as seeing or hearing things which others cannot [16].…”

“…Scores range from 0 to 20, with lower scores indicating more positive outcomes (clinical cut-off > 9). • M&MF-B 6-item subscale (M&MF items [11][12][13][14][15][16] at 16 weeks. Scores range from 0 to 12, with lower scores indicating more positive outcomes (clinical cut-off > 5).…”

Religiousness and psychotic experiences among young adult college students in the United States

“…Psychotic disorders are rare conditions characterized by a constellation of symptoms including hallucinations, delusions, negative symptoms, and thought disorder. However, recent decades of research have shown that psychosis can occur in the general population without reaching a clinical level of impairment or distress (Linscott & Van Os, 2010; Staines et al, 2022). In the United States, for example, approximately 10–20% of the general adult population report a psychotic experience at some point in life depending on how psychotic experiences are measured (Cohen & Marino, 2013; Oh et al, 2020), and most of these individuals will not develop a psychotic disorder.…”

Personality pathology as a driver of positive psychotic symptoms beyond diagnostic borders

“…10 This means that positive psychotic symptoms in adolescents and young adults are predictive for a wide range of negative outcomes, including the development of psychotic and nonpsychotic mental disorders, multimorbidity, functional impairments, and suicidal behavior. 11 Thus, they are no longer seen as pathognomic for psychotic disorders such as schizophrenia, but may be understood as a transdiagnostic risk maker for severe psychopathology and impairment. In addition, there is increasing evidence suggesting that affective instability and emotional reactivity to stress are related to psychotic experiences along the continuum.…”

“…Even though they are most prevalent in childhood (with decreasing prevalence rates over the rest of the life span), they become more clinically significant with the transition into adolescence and early adulthood 10 . This means that positive psychotic symptoms in adolescents and young adults are predictive for a wide range of negative outcomes, including the development of psychotic and non‐psychotic mental disorders, multimorbidity, functional impairments, and suicidal behavior 11 . Thus, they are no longer seen as pathognomic for psychotic disorders such as schizophrenia, but may be understood as a transdiagnostic risk maker for severe psychopathology and impairment.…”