Hanssen Manon, Bak Maarten, Bijl Rob, Vollebergh Wilma, van Os Jim
Department of Psychiatry and Neuropsychology, Universiteit Maastricht, The Netherlands.
Br J Clin Psychol. 2005 Jun;44(Pt 2):181-91. doi: 10.1348/014466505X29611.
To examine the incidence and 2-year stability and outcome of subclinical psychotic experiences in the general population.
The Netherlands Mental Health Survey and Incidence Study (NEMESIS), a longitudinal general population study.
A representative population sample of 7,076 participants was interviewed with the composite international diagnostic interview at baseline, 1 year later at T(1) and again 2 years later at T(2). A sample of individuals was identified who had onset of a new, broadly defined psychotic experience between baseline and T(1) (N = 79; incidence = 2%). Stability and outcome of these incident positive psychotic experiences was reassessed by interview at T(2), at which 25 individuals had a CIDI rating of broadly defined psychotic experience (subclinical outcome) and 11 individuals had psychotic experiences with functional impairment and need for care (clinical outcome).
The majority of individuals with an incident psychotic experience did not display persistence of the experience. Only 8% of individuals with a T1 incident psychotic experience had evidence of a T2 subclinical outcome, and only 8% had evidence of a T2 clinical outcome. The emotional context and the number of the T1 incident psychotic experiences were strong modifiers of predictive power for the clinical outcome, but not (or to a much lesser extent) for the subclinical outcome.
The incidence of positive psychotic experiences in the general population is around 100 times greater than traditional estimates of incidence of psychotic disorder such as schizophrenia. The far most likely outcome for these experiences is discontinuity. For the small proportion who display continuity, there is an equally large likelihood of subclinical and clinical 2-year outcomes. Emotional appraisal and degree of intrusiveness of psychotic experiences are important modifiers not for continuity per se but for clinical outcome specifically.
研究普通人群中亚临床精神病性体验的发生率、2年稳定性及转归情况。
荷兰精神健康调查与发病率研究（NEMESIS），一项纵向普通人群研究。
对7076名具有代表性的人群样本在基线时、1年后的T(1)以及2年后的T(2)进行综合国际诊断访谈。确定在基线至T(1)期间出现新的、广义定义的精神病性体验的个体样本（N = 79；发病率 = 2%）。在T(2)时通过访谈重新评估这些新发阳性精神病性体验的稳定性及转归情况，此时有25名个体的复合国际诊断访谈评定为广义定义的精神病性体验（亚临床转归），11名个体有伴有功能损害及需要护理的精神病性体验（临床转归）。
大多数有新发精神病性体验的个体未出现该体验的持续存在。T1期有新发精神病性体验的个体中，仅8%有T2期亚临床转归的证据，仅8%有T2期临床转归的证据。T1期精神病性体验的情感背景及数量对临床转归的预测能力有很强的调节作用，但对亚临床转归的预测能力没有（或程度小得多）调节作用。
普通人群中阳性精神病性体验的发生率比精神分裂症等传统精神病性障碍发病率估计值高约100倍。这些体验最可能的结果是间断性。对于表现出连续性的一小部分人，亚临床和临床2年转归的可能性相同。精神病性体验的情感评估及侵扰程度不是连续性本身的重要调节因素，而是临床转归的重要调节因素。
