Perceived negative attitude of others as an early sign of psychosis.
OBJECTIVE
Risk of psychosis is defined by the presence of positive psychotic-like symptoms, by subtle self-perceived cognitive and perceptual deficiencies, or by decreased functioning with familial risk of psychosis. We studied the associations of psychiatric outpatients' self-reported functioning and interpersonal relationships with vulnerability to and risk of psychosis.


METHODS
A total of 790 young patients attending psychiatric outpatient care completed the PROD screen [Heinimaa M, Salokangas RKR, Ristkari T, Plathin M, Huttunen J, Ilonen T, et al. PROD-screen - a screen for prodromal symptoms of psychosis. Int J Meth Psychiatr Res 2003;12:92-04.], including questions on functioning, interpersonal relationships and subtle specific (psychotic-like) and non-specific symptoms. Vulnerability to psychosis was assessed employing the patient's written descriptions of specific symptoms. Of the patients vulnerable to psychosis, those at current risk of psychosis were assessed using the Bonn Scale for Assessment of Basic Symptoms [Schultze-Lutter F, Klosterkötter J. Bonn scale for assessment of basic symptoms - prediction list, BSABS-P. Cologne: University of Cologne; 2002] and the Structured Interview for Positive symptoms [Miller TJ, McGlashan TH, Rosen JL, Somjee L, Markovich PJ, Stein K, et al. Prospective diagnosis of the initial prodrome for schizophrenia based on the structured interview for prodromal syndromes: preliminary evidence of interrater reliability and predictive validity. Am J Psychiatry 2002;159:863-65.].


RESULTS
In all, 219 patients vulnerable to and 55 patients at current risk of psychosis were identified. Vulnerability to psychosis was associated with all items of functioning and interpersonal relationships. Current risk of psychosis, however, was associated only with the subjectively reported negative attitude of others. Negative attitude of others was also associated with feelings of reference at both vulnerability and risk levels.


CONCLUSIONS
The subjective experience of negative attitude of others towards oneself may be an early indicator of psychotic development.
Salokangas
Raimo K R
RK
Department of Psychiatry, University of Turku, Turku, Finland. raimo.k.r.salokangas@tyks.fi
Heinimaa
Markus
M
Svirskis
Tanja
T
Laine
Tiina
T
Huttunen
Jukka
J
Ristkari
Terja
T
Ilonen
Tuula
T
Korkeila
Jyrki
J
Vaskelainen
Leena
L
Rekola
Jaakko
J
Hietala
Jarmo
J
Klosterkötter
Joachim
J
Ruhrmann
Stephan
S
Graf von Reventlow
Heinrich
H
Linszen
Don
D
Dingemans
Peter
P
Birchwood
Max
M
Patterson
Paul
P
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis; D012565:Schizophrenic Psychology; D012649:Self Concept; D012917:Social Adjustment; D012938:Social Perception; D011795:Surveys and Questionnaires