title: Phenotypically continuous with clinical psychosis, discontinuous in need for care: evidence for an extended psychosis phenotype.
abstract: BACKGROUND
  Rates of self-reported psychotic experiences (SRPEs) in general population samples are high; however the reliability against interview-based assessments and the clinical significance of false-positive (FP) ratings remain unclear.
  
  
  METHODS
  The second Netherlands Mental Health Survey and Incidence Study-2, a general population study.
  
  
  METHODS
  Trained lay interviewers administered a structured interview assessing psychopathology and psychosocial characteristics in 6646 participants. Participants with at least one SRPE (N = 1084) were reassessed by clinical telephone interview.
  
  
  RESULTS
  Thirty-six percent of participants with SRPEs were confirmed by clinical interview as true positive (TP). SPREs not confirmed by clinical interview (FP group) generated less help-seeking behavior and occurred less frequently compared with TP experiences (TP group). However, compared with controls without psychotic experiences, the FP group more often displayed mood disorder (relative risk [RR] 1.7, 1.4-2.2), substance use disorder (RR 2.0, 1.6-2.6), cannabis use (RR 1.5, 1.2-1.9), higher levels of neuroticism (RR 1.8, 1.5-2.2), affective dysregulation, and social dysfunction. The FP group also experienced more sexual (RR 2.0, 1.5-2.8) and psychological childhood trauma (RR 2.1, 1.7-2.6) as well as peer victimization (RR 1.5, 1.2-2.0) and recent life events (RR 2.0, 1.6-2.4) than controls without psychotic experiences. Differences between the FP group and the TP group across these domains were much smaller and less conclusive.
  
  
  CONCLUSIONS
  SRPEs not confirmed by clinical interview may represent the softest expression of an extended psychosis phenotype that is phenotypically continuous with clinical psychosis but discontinuous in need for care.
authors: Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD Maastricht, The Netherlands.
authors: Martine
authors: M
authors: van Nierop
authors: Jim
authors: J
authors: van Os
authors: Nicole
authors: N
authors: Gunther
authors: Inez
authors: I
authors: Myin-Germeys
authors: Ron
authors: R
authors: de Graaf
authors: Margreet
authors: M
authors: ten Have
authors: Saskia
authors: S
authors: van Dorsselaer
authors: Maarten
authors: M
authors: Bak
authors: Ruud
authors: R
authors: van Winkel
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000706:statistics & numerical data; D003702:Delusions / Q000453:epidemiology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology; D009426:Netherlands / Q000453:epidemiology; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000453:epidemiology*; D057566:Self Report; D019966:Substance-Related Disorders / Q000453:epidemiology