Predictors of psychosis: a 50-year follow-up of the Lundby population.
Behavioural and neuropsychological vulnerability have been associated with an increased risk of psychosis. We investigated whether certain clusters of premorbid behavioural and personality-related signs and symptoms were predictors of nonaffective and/or affective psychosis and schizophrenia, respectively, in a 50-year follow-up of an unselected general community population. Total population cohorts from the same catchment area in 1947 (n = 2,503) and 1957 (n = 3,215) that had been rated for behavioural items and enduring symptoms were followed up to 1997 regarding first-incidence of DSM-IV nonaffective and/or affective psychosis. Attrition was 1-6%. The influence of the background factors, aggregated in dichotomous variables (predictors), on time to occurrence of nonaffective and/or affective psychosis was assessed by means of Cox regression models. In multivariate models the predictors nervous-tense, blunt-deteriorated, paranoid-schizotypal and tired-distracted were significantly associated with subsequent nonaffective and/or affective psychosis. In simple models, down-semidepressed, sensitive-frail and easily hurt were significantly associated with development of psychosis. When schizophrenia was analysed separately nervous-tense remained significant in the multivariate model, although blunt-deteriorated, paranoid-schizotypal and tired-distracted did not; and abnormal-antisocial reached significance. To conclude, we found some evidence for anxiety-proneness, affective/cognitive blunting, poor concentration, personality cluster-A like traits and interpersonal sensitivity to be associated with general psychosis vulnerability.
Bogren
Mats
M
Division of Psychiatry, The Lundby Study, Department of Clinical Neuroscience, Lund University Hospital, St Lars, Lund, Sweden. mats.bogren@med.lu.se
Mattisson
Cecilia
C
Tambs
Kristian
K
Horstmann
Vibeke
V
Munk-Jørgensen
Povl
P
Nettelbladt
Per
P
D000293:Adolescent; D000328:Adult; D000341:Affective Disorders, Psychotic / Q000150:complications / Q000453:epidemiology; D000367:Age Factors; D017668:Age of Onset; D001526:Behavioral Symptoms / Q000150:complications / Q000453:epidemiology; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000209:etiology*; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult