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Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results

  • N. Kaymaz (a1) (a2), M. Drukker (a1), R. Lieb (a3) (a4), H.-U. Wittchen (a3) (a5), N. Werbeloff (a6), M. Weiser (a6), T. Lataster (a1) and J. van Os (a1) (a7)...

Abstract

Background

The base rate of transition from subthreshold psychotic experiences (the exposure) to clinical psychotic disorder (the outcome) in unselected, representative and non-help-seeking population-based samples is unknown.

Method

A systematic review and meta-analysis was conducted of representative, longitudinal population-based cohorts with baseline assessment of subthreshold psychotic experiences and follow-up assessment of psychotic and non-psychotic clinical outcomes.

Results

Six cohorts were identified with a 3–24-year follow-up of baseline subthreshold self-reported psychotic experiences. The yearly risk of conversion to a clinical psychotic outcome in exposed individuals (0.56%) was 3.5 times higher than for individuals without psychotic experiences (0.16%) and there was meta-analytic evidence of dose–response with severity/persistence of psychotic experiences. Individual studies also suggest a role for motivational impairment and social dysfunction. The evidence for conversion to non-psychotic outcome was weaker, although findings were similar in direction.

Conclusions

Subthreshold self-reported psychotic experiences in epidemiological non-help-seeking samples index psychometric risk for psychotic disorder, with strong modifier effects of severity/persistence. These data can serve as the population reference for selected and variable samples of help-seeking individuals at ultra-high risk, for whom much higher transition rates have been indicated.

Copyright

Corresponding author

*Address for correspondence: J. van Os, Ph.D., Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (DRT 12), 6200MD Maastricht, The Netherlands. (Email: j.vanos@maastrichtuniversity.nl)

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Keywords

Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results

  • N. Kaymaz (a1) (a2), M. Drukker (a1), R. Lieb (a3) (a4), H.-U. Wittchen (a3) (a5), N. Werbeloff (a6), M. Weiser (a6), T. Lataster (a1) and J. van Os (a1) (a7)...

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