Butter, Sarah and Shevlin, Mark and McBride, Orla and Bentall, Richard P. and Hyland, Philip and Leavey, Gerard and Murphy, Jamie (2023) Functioning, symptom expression and risk along the psychosis continuum. Psychological Medicine, 53 (15). pp. 7407-7417. ISSN 0033-2917

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Abstract

Background. The psychosis continuum implies that subclinical psychotic experiences (PEs) can be differentiated from clinically relevant expressions since they are not accompanied by a ‘need for care’. Methods. Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 34 653), the current study examined variation in functioning, symptomology and aetiological risk across the psychosis phenotype [i.e. variation from (i) no PEs, ‘No PEs’ to (ii) non-distressing PEs, ‘PE-Experienced Only’ to (iii) distressing PEs, ‘PE-Impaired’ to (iv) clinically defined psychotic disorder, ‘Diagnosed’]. Results. A graded trend was present such that, compared to those with no PEs, the Diagnosed group had the poorest functioning, followed by the PE-Impaired then PE-Experienced Only groups. In relation to symptom expression, the PE-Impaired group were more likely than the PE-Experienced Only and the Diagnosed groups to endorse most PEs. Predictors of group membership tended to vary quantitatively rather than qualitatively. Trauma, current mental health diagnoses (anxiety and depression) and drug use variables differentiated between all levels of the continuum, with the exception of the extreme end (PE-Impaired v. Diagnosed). Only a few variables distinguished groups at the upper end of the continuum: female sex, older age, unemployment, parental mental health hospitalisation and lower likelihood of having experienced physical assault. Conclusions. The findings highlight the importance of continuum-based interpretations of the psychosis phenotype and afford valuable opportunities to consider if and how impairment, symptom expression and risk change along the continuum.

Item Type:	Article
Keywords:	Continuum; functioning; need for care; psychosis; risk factors; schizotypal;
Academic Unit:	Assisting Living & Learning,ALL institute Faculty of Science and Engineering > Psychology
Item ID:	19073
Identification Number:	https://doi.org/10.1017/S0033291723001046
Depositing User:	Philip Hyland
Date Deposited:	17 Oct 2024 11:09
Journal or Publication Title:	Psychological Medicine
Publisher:	Cambridge University Press
Refereed:	Yes
URI:	Publisher
Use Licence:	This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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