title: Developmental course of subclinical positive and negative psychotic symptoms and their associations with genetic risk status and impairment.
abstract: The proneness-persistence-impairment (PPI) model states that psychotic experiences are more likely to lead to impairment if their expression becomes persistent. Higher genetic risk for psychosis is known to affect proneness and persistence of subclinical positive symptoms. Less is known about potential effects of genetic risk on the course of subclinical negative symptoms, impairment, and their subsequent associations. The current study examined these issues in a large sample (n=1131), consisting of individuals with higher genetic risk (siblings of patients with psychotic disorders, n=703) and lower genetic risk (controls without a family member with lifetime psychosis, n=428). Psychotic experiences were assessed with the CAPE questionnaire, at two time points three years apart. Participants were allocated to one of four groups representing developmental course: stable low, decreasing, increasing or persisting subclinical positive/negative symptoms. Lifetime clinical psychosis was an exclusion criterion at baseline. Higher genetic risk status was found to be associated with a persisting course of both subclinical positive and negative symptoms, symptom-related distress and functional impairment. There is no evidence for an effect of genetic risk status on the association between developmental course and impairment. The results of the current study underline the importance of assessing psychotic experiences in the context of genetic risk, multidimensional and over time. Additionally, the current findings both underscore and contribute to the PPI model: psychotic experiences are more likely to lead to impairment if their expression becomes persistent, both in individuals with higher and lower genetic risk for psychosis.
authors.affiliation: Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands; Faculty of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, the Netherlands.
authors.forename: Mayke
authors.initials: M
authors.lastname: Janssens
authors.affiliation: Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands; Faculty of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Lindy-Lou
authors.initials: LL
authors.lastname: Boyette
authors.affiliation: Academic Medical Center University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands.
authors.forename: Henriëtte D
authors.initials: HD
authors.lastname: Heering
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Groningen, The Netherlands.
authors.forename: Agna A
authors.initials: AA
authors.lastname: Bartels-Velthuis
authors.affiliation: Maastricht University Medical Center, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands.
authors.forename: Tineke
authors.initials: T
authors.lastname: Lataster
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008957:Models, Genetic; D008960:Models, Psychological; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000235:genetics* / Q000523:psychology*; D035781:Siblings / Q000523:psychology*; D012919:Social Behavior; D011795:Surveys and Questionnaires
keywords: Attenuated symptoms; Continuum model; Proneness-persistence-impairment model; Psychotic experiences; Schizophrenia relatives; Schizotypy