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DSM outcomes of psychotic experiences and associated risk factors: 6-year follow-up study in a community-based sample

  • Umut Kırlı (a1) (a2), Tolga Binbay (a3), Marjan Drukker (a2), Hayriye Elbi (a4), Bülent Kayahan (a4), Duygu Keskin Gökçelli (a4), Ferda Özkınay (a5), Hüseyin Onay (a5), Köksal Alptekin (a3) and Jim van Os (a2) (a6) (a7)...

Abstract

Background

Psychotic experiences (PEs) may predict a range of common, non-psychotic disorders as well as psychotic disorders. In this representative, general population-based cohort study, both psychotic and non-psychotic disorder outcomes of PE were analysed, as were potential moderators.

Methods

Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011). Participants were interviewed with the Composite International Diagnostic Interview (CIDI) both at baseline and at 6-year follow-up. Participants with PE at baseline were clinically re-interviewed with the SCID-I at follow-up. The role of socio-demographics, characteristics of PE, co-occurrence of mood disorders and family history of mental disorders were tested in the association between baseline PE and follow-up diagnosis.

Results

In the participants with baseline PE, the psychotic disorder diagnosis rate at follow up was 7.0% – much lower than the rates of DSM-IV mood disorders without psychotic features (42.8%) and other non-psychotic disorders (24.1%). Within the group with baseline PE, female sex, lower socio-economic status, co-occurrence of mood disorders, family history of a mental disorder and persistence of PE predicted any follow-up DSM diagnosis. Furthermore, onset of psychotic v. non-psychotic disorder was predicted by younger age (15–30 years), co-presence of delusional and hallucinatory PE and family history of severe mental illness.

Conclusion

The outcome of PE appears to be a consequence of baseline severity of multidimensional psychopathology and familial risk. It may be useful to consider PE as a risk indicator that has trans-diagnostic value.

Copyright

Corresponding author

Author for correspondence: Tolga Binbay, E-mail: tolga.binbay@deu.edu.tr

References

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