Characteristics and Factors Associated with Psychotic-like Experiences in Remission: a Cross-sectional Study of 4208 College Students in China

Overview

Journal BMJ Open

Specialty General Medicine

Date 2024 Oct 1

PMID 39353694

Authors

Xin-Hu Yang

Rui Wang

Yue Li

Hong-Ling Zhou

Liang Zhou

Meng Sun

Affiliations

Soon will be listed here.

Abstract

Objectives: Previous research has extensively explored the factors associated with psychotic-like experiences (PLEs). However, the characteristics and associated factors of remitted PLEs, which refer to the absence of current PLEs following previous PLEs, remain unclear. Therefore, this study aims to describe the characteristics of adolescents who reported remitted PLEs.

Design: Cross-sectional study.

Setting: The survey was conducted from October to December 2020 in three colleges located in Guangzhou, China.

Participants: A total of 4208 college freshmen aged from 15 to 24 participated in our survey.

Primary And Secondary Outcome Measures: The 15-item positive subscale of the Community Assessment of the Psychic Experience was used to assess both lifetime and current PLEs. Multivariate logistic regression models were used to examine the associations between remitted PLEs and a range of demographic factors, lifestyle, psychosocial factors, lifetime affective symptoms and sleep problems.

Results: Three groups of PLEs were observed: non-PLEs (47.27% of the sample), remitted PLEs (40.42%) and current PLEs (12.31%). Several factors have been identified as shared correlates of remission and absence of PLEs, including fewer recent adverse life events, greater resilience, fewer symptoms of depression and anxiety, and early waking. Furthermore, higher levels of social support (OR 1.48, 95% CI 1.01 to 2.17; OR 1.53, 95% CI 1.18 to 1.97) was a specific factor associated with the remission of PLEs. Compared with individuals without PLEs, those with remitted PLEs were more likely to be female (OR 1.50, 95% CI 1.28 to 1.75), less likely to be younger (OR 0.88, 95% CI 0.81 to 0.95) and prone to have more chronic physical illness (OR 1.67, 95% CI 1.29 to 2.16), habitual alcohol intake (OR 1.85, 95% CI 1.19 to 2.88), more childhood trauma (OR for low vs high=0.72, 95% CI 0.57 to 0.91) and the sleep problems of waking up easily (OR 1.36, 95% CI 1.12 to 1.65).

Conclusion: These findings suggest that remitted PLEs play a vital, unique role among three groups and provide preliminary targets for the intervention for adolescents at risk of mental health problems. Further investigation may shed light on the causality of the relationship between remitted PLEs and associated factors.

References

Sun M, Hu X, Zhang W, Guo R, Hu A, Mwansisya T . Psychotic-like experiences and associated socio-demographic factors among adolescents in China. Schizophr Res. 2015; 166(1-3):49-54. DOI: 10.1016/j.schres.2015.05.031. View

van Os J, Linscott R, Myin-Germeys I, Delespaul P, Krabbendam L . A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychol Med. 2008; 39(2):179-95. DOI: 10.1017/S0033291708003814. View

Sun M, Wang D, Jing L, Yang N, Zhu R, Wang J . Comparisons between self-reported and interview-verified psychotic-like experiences in adolescents. Early Interv Psychiatry. 2021; 16(1):69-77. DOI: 10.1111/eip.13132. View

Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D . Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med. 2022; :1-12. PMC: 9772919. DOI: 10.1017/S0033291722002550. View

Wu Z, Liu Z, Zou Z, Wang F, Zhu M, Zhang W . Changes of psychotic-like experiences and their association with anxiety/depression among young adolescents before COVID-19 and after the lockdown in China. Schizophr Res. 2021; 237:40-46. PMC: 8437585. DOI: 10.1016/j.schres.2021.08.020. View

Barton J, Kyle S, Varese F, Jones S, Haddock G . Are sleep disturbances causally linked to the presence and severity of psychotic-like, dissociative and hypomanic experiences in non-clinical populations? A systematic review. Neurosci Biobehav Rev. 2018; 89:119-131. DOI: 10.1016/j.neubiorev.2018.02.008. View

Grey I, Arora T, Thomas J, Saneh A, Tohme P, Abi-Habib R . The role of perceived social support on depression and sleep during the COVID-19 pandemic. Psychiatry Res. 2020; 293:113452. PMC: 7500407. DOI: 10.1016/j.psychres.2020.113452. View

McMahon E, Corcoran P, Keeley H, Clarke M, Coughlan H, Wasserman D . Risk and protective factors for psychotic experiences in adolescence: a population-based study. Psychol Med. 2020; 51(7):1220-1228. DOI: 10.1017/S0033291719004136. View

Chen T, Saito Y . Longitudinal effects of nocturnal insomnia symptom subtypes and nonrestorative sleep on the incidence of depression among community-dwelling older adults: results from the Health and Retirement Study. Sleep Med. 2021; 79:155-163. DOI: 10.1016/j.sleep.2021.01.003. View

10.

Cristobal-Narvaez P, Sheinbaum T, Myin-Germeys I, Kwapil T, de Castro-Catala M, Dominguez-Martinez T . The role of stress-regulation genes in moderating the association of stress and daily-life psychotic experiences. Acta Psychiatr Scand. 2017; 136(4):389-399. PMC: 5697578. DOI: 10.1111/acps.12789. View

11.

Maric N, Krabbendam L, Vollebergh W, de Graaf R, van Os J . Sex differences in symptoms of psychosis in a non-selected, general population sample. Schizophr Res. 2003; 63(1-2):89-95. DOI: 10.1016/s0920-9964(02)00380-8. View

12.

Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W . Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 2012; 38(4):661-71. PMC: 3406538. DOI: 10.1093/schbul/sbs050. View

13.

Debbane M, Barrantes-Vidal N . Schizotypy from a developmental perspective. Schizophr Bull. 2014; 41 Suppl 2:S386-95. PMC: 4373627. DOI: 10.1093/schbul/sbu175. View

14.

Healy C, Brannigan R, Dooley N, Coughlan H, Clarke M, Kelleher I . Childhood and adolescent psychotic experiences and risk of mental disorder: a systematic review and meta-analysis. Psychol Med. 2019; 49(10):1589-1599. DOI: 10.1017/S0033291719000485. View

15.

Evangelou E, Gao H, Chu C, Ntritsos G, Blakeley P, Butts A . New alcohol-related genes suggest shared genetic mechanisms with neuropsychiatric disorders. Nat Hum Behav. 2019; 3(9):950-961. PMC: 7711277. DOI: 10.1038/s41562-019-0653-z. View

16.

Sullivan S, Kounali D, Cannon M, David A, Fletcher P, Holmans P . A Population-Based Cohort Study Examining the Incidence and Impact of Psychotic Experiences From Childhood to Adulthood, and Prediction of Psychotic Disorder. Am J Psychiatry. 2020; 177(4):308-317. DOI: 10.1176/appi.ajp.2019.19060654. View

17.

DeLuca J, Rouhakhtar P, Klaunig M, Akouri-Shan L, Jay S, Todd T . Psychosis-like experiences and resilience: A systematic and critical review of the literature. Psychol Serv. 2022; 19(Suppl 1):120-138. PMC: 10141510. DOI: 10.1037/ser0000585. View

18.

Cristobal-Narvaez P, Sheinbaum T, Ballespi S, Mitjavila M, Myin-Germeys I, Kwapil T . Impact of Adverse Childhood Experiences on Psychotic-Like Symptoms and Stress Reactivity in Daily Life in Nonclinical Young Adults. PLoS One. 2016; 11(4):e0153557. PMC: 4833319. DOI: 10.1371/journal.pone.0153557. View

19.

Linscott R, van Os J . An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med. 2012; 43(6):1133-49. DOI: 10.1017/S0033291712001626. View

20.

Killgore W, Taylor E, Cloonan S, Dailey N . Psychological resilience during the COVID-19 lockdown. Psychiatry Res. 2020; 291:113216. PMC: 7280133. DOI: 10.1016/j.psychres.2020.113216. View