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Prediction of psychosis in clinical high-risk patients by the Schizotypal Personality Questionnaire. Results of the EPOS project

Published online by Cambridge University Press:  15 April 2020

R.K.R. Salokangas ,
P. Dingemans ,
M. Heinimaa ,
T. Svirskis ,
S. Luutonen ,
J. Hietala ,
S. Ruhrmann ,
G. Juckel ,
H. Graf von Reventlow  and
D. Linszen
...Show all authors
R.K.R. Salokangas*
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland Psychiatric Clinic, Turku University Central Hospital, Turku, Finlandst Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland
P. Dingemans
Affiliation:
Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands Mediant, Enschede, Netherlands
M. Heinimaa
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland
T. Svirskis
Affiliation:
Department of Psychiatry, University of Helsinki, Helsinki, Finland Peijas Hospital, Helsinki University Central Hospital, Helsinki, Finland
S. Luutonen
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland Psychiatric Clinic, Turku University Central Hospital, Turku, Finlandst
J. Hietala
Affiliation:
Department of Psychiatry, University of Turku, Turku, Finland Psychiatric Clinic, Turku University Central Hospital, Turku, Finlandst Turku Psychiatric Clinic, Turku Mental Health Centre, Turku, Finland
S. Ruhrmann
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
G. Juckel
Affiliation:
Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany
H. Graf von Reventlow
Affiliation:
Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany
D. Linszen
Affiliation:
Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands Department of Psychiatry and Psychology, University of Maastricht, Maastricht, Netherlands
M. Birchwood
Affiliation:
School of Psychology, University of Birmingham, Birmingham, United Kingdom
P. Patterson
Affiliation:
Youthspace–Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
F. Schultze-Lutter
Affiliation:
University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
J. Klosterkötter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
*
*Corresponding author. FIN-20520 Turku, Finland. Tel.: +358 2 3131 740; fax: +358 2 3132 730. E-mail address:Raimo.K.R.Salokangas@tyks.fi (R.K.R. Salokangas).
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Abstract

Objective

Schizotypal features indicate proneness to psychosis in the general population. It is also possible that they increase transition to psychosis (TTP) among clinical high-risk patients (CHR). Our aim was to investigate whether schizotypal features predict TTP in CHR patients.

Methods

In the EPOS (European Prediction of Psychosis Study) project, 245 young help-seeking CHR patients were prospectively followed for 18 months and their TTP was identified. At baseline, subjects were assessed with the Schizotypal Personality Questionnaire (SPQ). Associations between SPQ items and its subscales with the TTP were analysed in Cox regression analysis.

Results

The SPQ subscales and items describing ideas of reference and lack of close interpersonal relationships were found to correlate significantly with TTP. The co-occurrence of these features doubled the risk of TTP.

Conclusions

Presence of ideas of reference and lack of close interpersonal relations increase the risk of full-blown psychosis among CHR patients. This co-occurrence makes the risk of psychosis very high.

Keywords

Schizotypal featuresClinical high-risk patientsTransition to psychosis
Type
Original article
Information
European Psychiatry , Volume 28 , Issue 8 , October 2013 , pp. 469 - 475
Copyright
Copyright © 2013 Elsevier Masson SAS

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References

American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder: DSM–IV APA 4th edn.American Psychiatric Association; 1994.Google Scholar
Bedwell, JSDonnelly, RSSchizotypal personality disorder or prodromal symptoms of schizophrenia?. Schizophr Res 2005; 80:263–269.CrossRefGoogle ScholarPubMed
Bentall, RPRowse, GShryane, NKinderman, PHoward, RBlackwood, N, et al.The cognitive and affective structure of paranoid delusions: a transdiagnostic investigation of patients with schizophrenia spectrum disorders and depression. Arch Gen Psychiatry 2009; 66:236–247.CrossRefGoogle ScholarPubMed
Birchwood, MSpencer, EEarly intervention in psychotic relapse. Clin Psychol Rev 2001; 21:1211–1226.CrossRefGoogle ScholarPubMed
Blanchard, JJCollins, LMAghevli, MLeung, WWCohen, ASSocial anhedonia and schizotypy in a community sample: the Maryland longitudinal study of schizotypy. Schizophr Bull 2011; 37:587–602.CrossRefGoogle Scholar
Boeing, LMurray, VPelosi, AMcCabe, RBlackwood, DWrate, RAdolescent-onset psychosis: prevalence, needs and service provision. Br J Psychiatry 2007; 190:18–26.CrossRefGoogle ScholarPubMed
Cannon, TDCadenhead, KCornblatt, BWoods, SWAddington, JWalker, E, et al.Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry 2008; 65:28–37.CrossRefGoogle ScholarPubMed
Correll, CUSmith, CWAuther, AMMcLaughlin, DShah, MFoley, C, et al.Predictors of remission, schizophrenia, and bipolar disorder in adolescents with brief psychotic disorder or psychotic disorder not otherwise specified considered at very high risk for schizophrenia. J Child Adolesc Psychopharmacol 2008; 18:475–490.CrossRefGoogle Scholar
Conrad, KDie beginnende Schizophrenie Stuttgart: Thieme Verlag; 1958.Google Scholar
Dragt, SNieman, DHSchultze-Lutter, Fvan der Meer, FBecker, Hde Haan, L, et al.Cannabis use and age at onset of symptoms in subjects at clinical high risk for psychosis. Acta Psychiatr Scand 2012; 125:45–53.CrossRefGoogle ScholarPubMed
First, MBSpitzer, RLGibbon, MWilliams, JBWStructured clinical interview for DSM-IV axis I disorders (SCID-I) Arlington, USA: American Psychiatric Publishing; 1997.Google Scholar
Fonseca-Pedrero, EPaíno-Piñeiro, MLemos-Giráldez, SVillazón-García, UMuñiz, JValidation of the Schizotypal Personality Questionnaire-Brief Form in adolescents. Schizophr Res 2009; 111:53–60.CrossRefGoogle ScholarPubMed
Fusar-Poli, PBechdolf, ATaylor, MJBonoldi, ICarpenter, WTYung, AR, et al.At risk for schizophrenic or affective psychoses? A meta-analysis of DSM/ICD diagnostic outcomes in individuals at high clinical risk. Schizophr Bull 2012 [Epub ahead of print]Google ScholarPubMed
Fusar-Poli, PNelson, BValmaggia, LYung, ARMcGuire, PKComorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull 2012 [Epub ahead of print].Google ScholarPubMed
Glatt, SJStone, WSFaraone, SVSeidman, LJTsuang, MTPsychopathology, personality traits and social development of young first-degree relatives of patients with schizophrenia. Br J Psychiatry 2006; 189:337–345.CrossRefGoogle ScholarPubMed
Heinz, ASchlagenhauf, FDopaminergic dysfunction in schizophrenia: salience attribution revisited. Schizophr Bull 2010; 36:472–485.CrossRefGoogle ScholarPubMed
Horan, WPBlanchard, JJClark, LAGreen, MFAffective traits in schizophrenia and schizotypy. Schizophr Bull 2008; 34:856–874.CrossRefGoogle ScholarPubMed
Howes, ODBose, SKTurkheimer, FValli, IEgerton, AValmaggia, LR, et al.Dopamine synthesis capacity before onset of psychosis: a prospective [18F]-DOPA PET imaging study. Am J Psychiatry 2011; 168:1311–1317.CrossRefGoogle ScholarPubMed
Häfner, HNowotny, BLöffler, WWhen and how does schizophrenia produce social deficits?. Eur Arch Psychiatry Clin Neurosci 1995; 246:17–28.CrossRefGoogle ScholarPubMed
Johnstone, ECEbmeier, KPMiller, POwens, DGLawrie, SMPredicting schizophrenia: findings from the Edinburgh High-Risk Study. Br J Psychiatry 2005; 186:18–25.CrossRefGoogle ScholarPubMed
Kapur, SPsychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 2003; 160:13–23.CrossRefGoogle Scholar
Klosterkötter, JHellmich, MSteinmeyer, EMSchultze-Lutter, FDiagnosing schizophrenia in the initial prodromal phase. Arch Gen Psychiatry 2001; 58:158–164.CrossRefGoogle ScholarPubMed
Klosterkötter, JRuhrmann, SSchultze-Lutter, FSalokangas, RKRLinszen, DBirchwood, M, et al.The European Prediction of Psychosis Study (EPOS): integrating early recognition and intervention in Europe. World Psychiatry 2005; 4:161–167.Google ScholarPubMed
Masillo, ADay, FLaing, JHowes, OFusar-Poli, PByrne, M, et al.Interpersonal sensitivity in the at-risk mental state for psychosis. Psychol Med 2012; 42:1835–1845.CrossRefGoogle ScholarPubMed
Mason, OStartup, MHalpin, SSchall, UConrad, ACarr, VRisk factors for transition to first episode psychosis among individuals with “at-risk mental states”. Schizophr Res 2004; 71:227–237.CrossRefGoogle Scholar
Maurer, KHoermann, FHäfner, HEvaluation of psychosis risk by the schedule ERIraos. Results based in the German Schizophrenia Network Study. Schizophr Res 2006; 86:19.CrossRefGoogle Scholar
McGlashan, THMiller, TJWoods, SWStructured interview for prodromal syndromes (Version 3.0) New Haven: PRIME Research Clinic, Yale School of Medicine; 2001.Google Scholar
McGlashan, THPremorbid adjustment onset types, and prognostic scaling: still informative?. Schizophr Bull 2008; 34:801–805.CrossRefGoogle ScholarPubMed
Meehl, PESchizotaxia, schizotypy, schizophrenia. Am Psychol 1962; 17:827–838.CrossRefGoogle Scholar
Nordentoft, MThorup, APetersen, LÖhlenschlaeger, JMalau, MÖstergaard, C, et al.Transition rates from schizotypal disorder to psychotic disorder fro first-contact patients included in the OPUS trial. A randomized clinical trial of integrated treatment and standard treatment. Schizophr Res 2006; 82:29–40.CrossRefGoogle Scholar
Owens, DGJohnstone, ECPrecursors and prodromata of schizophrenia: findings from the Edinburgh High Risk Study and their literature context. Psychol Med 2006; 36:1501–1514.CrossRefGoogle ScholarPubMed
Raballo, AParnas, JThe silent side of the spectrum: schizotypy and the schizotaxic self. Schizophr Bull 2011; 37:1017–1026.CrossRefGoogle ScholarPubMed
Raine A, Schizotypal personality: neuro developmental and psychosocial trajectories. Annu Rev Clin Psychol 2006; 2:291–326.CrossRefGoogle Scholar
Raine, AThe, SPQA scale for the assessment of schizotypal personality based on DSM-III-R criteria. Schizophr Bull 1991; 17:555–564.CrossRefGoogle ScholarPubMed
Roiser, JPHowes, ODChaddock, CAJoyce, EMMcGuire, PNeural and behavioral correlates of aberrant salience in individuals at risk for psychosis. Schizophr Bull 201210.1093/schbul/sbs147Google ScholarPubMed
Ruhrmann, SSchultze-Lutter, FSalokangas, RKRHeinimaa, MLinszen, DDingemans, P, et al.Prediction of psychosis in adolescents and young adults at high risk: results from the Prospective European Prediction of Psychosis Study. Arch Gen Psychiatry 2010; 67:241–251.CrossRefGoogle Scholar
Rössler, WHengartner, MPAjdacic-Gross, VHaker, HGamma, AAngst, JSub-clinical psychosis symptoms in young adults are risk factors for subsequent common mental disorders. Schizophr Res 2011; 131:18–23.CrossRefGoogle ScholarPubMed
Rössler, WSalize, HJvan Os, JRiecher-Rössler, ASize of burden of schizophrenia and psychotic disorders. Eur Neuropsychopharmacol 2005; 15:399–409.CrossRefGoogle ScholarPubMed
Salokangas, RKRHeinimaa, MSvirskis, TLaine, THuttunen, JRistkari, T, et al.Perceived negative attitude of others as an early sign of psychosis. Eur Psychiatry 2009; 24:233–238.CrossRefGoogle Scholar
Salokangas, RKRMcGlashan, THEarly detection and intervention of psychosis. A review. Nord J Psychiatry 2008; 62:92–105.CrossRefGoogle ScholarPubMed
Salokangas, RKRPatterson, PHeinimaa, MSvirskis, TPerceived negative attitude of others predicts transition to psychosis in patients at risk of psychosis. Short communication. Eur Psychiatry 2012; 27:264–266.CrossRefGoogle Scholar
Salokangas, RKRuhrmann, Svon Reventlow, HGHeinimaa, MSvirskis, TAxis I diagnoses and transition to psychosis in clinical high-risk patients EPOS project: prospective follow-up of 245 clinical high-risk outpatients in four countries. Schizophr Res 2012; 138:192–197.CrossRefGoogle ScholarPubMed
Salokangas, RKRPsychosocial prognosis in schizophrenia. Formation of the prognosis for schizophrenic patients: a multivariate analysis. Annales Universitatis Turkuensis. Ser. D 9 Turku: University of Turku; 1978.Google Scholar
Schultze-Lutter, FRuhrmann, SBerning, JMaier, WKlosterkötter, JBasic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state. Schizophr Bull 2010; 36:182–191.CrossRefGoogle ScholarPubMed
Sullivan, HSThe interpersonal theory of psychiatry New York: WW Norton; 1953.Google Scholar
Velthorst, ENieman, DHBecker, HEvan de Fliert, RDingemans, PMKlaassen, R, et al.Baseline differences in clinical symptomatology between ultra high risk subjects with and without a transition to psychosis. Schizophr Res 2009; 109:60–65.CrossRefGoogle ScholarPubMed
Velthorst, ENieman, DHLinszen, DBecker, Hde Haan, LDingemans, PM, et al.Disability in people clinically at high risk of psychosis. Br J Psychiatry 2010; 197:278–284.CrossRefGoogle ScholarPubMed
von Weizsäcker, VGestaltkreis. Theorie der Einheit von Wahrnehmung und Bewegung Thieme Verlag: Stuttgart; 1968 [Originally published in 1959].Google Scholar
Yung, ARMcGorry, PDThe prodromal phase of first episode psychosis: past and current conceptualizations. Schizophr Bull 1996; 22:353–370.CrossRefGoogle ScholarPubMed
Yung, ARYuen, HPMcGorry, PDPhillips, LJKelly, DDell”Olio, M, et al.Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Aust N Z J Psychiatry 2005; 39:964–971.CrossRefGoogle ScholarPubMed
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