Kaymaz N, Drukker M, Lieb R, Wittchen H-U, Werbeloff N, Weiser M, Lataster T, van Os J
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.
Division of Clinical Psychology and Epidemiology, Max Planck Institute of Psychiatry, Munich, Germany.
Psychol Med. 2012 Nov;42(11):2239-53. doi: 10.1017/S0033291711002911. Epub 2012 Jan 20.
The base rate of transition from subthreshold psychotic experiences (the exposure) to clinical psychotic disorder (the outcome) in unselected, representative and non-help-seeking population-based samples is unknown.
A systematic review and meta-analysis was conducted of representative, longitudinal population-based cohorts with baseline assessment of subthreshold psychotic experiences and follow-up assessment of psychotic and non-psychotic clinical outcomes.
Six cohorts were identified with a 3-24-year follow-up of baseline subthreshold self-reported psychotic experiences. The yearly risk of conversion to a clinical psychotic outcome in exposed individuals (0.56%) was 3.5 times higher than for individuals without psychotic experiences (0.16%) and there was meta-analytic evidence of dose-response with severity/persistence of psychotic experiences. Individual studies also suggest a role for motivational impairment and social dysfunction. The evidence for conversion to non-psychotic outcome was weaker, although findings were similar in direction.
Subthreshold self-reported psychotic experiences in epidemiological non-help-seeking samples index psychometric risk for psychotic disorder, with strong modifier effects of severity/persistence. These data can serve as the population reference for selected and variable samples of help-seeking individuals at ultra-high risk, for whom much higher transition rates have been indicated.
在未经选择的、具有代表性且未寻求帮助的基于人群的样本中，从阈下精神病性体验（暴露因素）转变为临床精神病性障碍（结局）的基线发生率尚不清楚。
对具有代表性的、基于人群的纵向队列进行系统评价和荟萃分析，这些队列对阈下精神病性体验进行了基线评估，并对精神病性和非精神病性临床结局进行了随访评估。
确定了6个队列，对基线时自我报告的阈下精神病性体验进行了3至24年的随访。暴露个体中每年转变为临床精神病性结局的风险（0.56%）比没有精神病性体验的个体（0.16%）高3.5倍，并且有荟萃分析证据表明存在与精神病性体验的严重程度/持续时间的剂量反应关系。个别研究还表明动机损害和社会功能障碍起到了一定作用。转变为非精神病性结局的证据较弱，尽管结果在方向上相似。
在非寻求帮助的流行病学样本中，自我报告的阈下精神病性体验表明存在精神病性障碍的心理测量风险，具有严重程度/持续时间的强烈修饰作用。这些数据可作为超高风险寻求帮助个体的选定和可变样本的人群参考，对于这些个体，已表明其转变率要高得多。
