Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.
China National Clinical Research Center on Mental Health Disorders, China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Mental Health Institute of Central South University, Changsha, China.
J Clin Psychiatry. 2019 Jul 23;80(4):18m12437. doi: 10.4088/JCP.18m12437.
Psychotic-like experiences (PLEs) may be important antecedents of psychosis and other mental disorders.
To investigate distinct longitudinal trajectories of the frequency of PLEs and their relationship to subsequent development of mental disorders.
A longitudinal study of self-reported PLEs and concurrent traumatic experiences was conducted among 6,198 adolescents through annual classroom assessments over 3 years (2014-2016) using the Community Assessment of Psychic Experiences and the Trauma History Questionnaire. Diagnoses of mental disorders were based on the Mini-International Neuropsychiatric Interview in the final year. Growth mixture modeling was used to identify distinct growth trajectories in the frequency of PLEs. Logistic regression was then used to explore relationships between different PLE trajectories and emergence of psychiatric disorders, taking account of sociodemographic characteristics and childhood antecedents.
Two different PLE trajectories were identified, one characterized by stable low levels of PLE frequency and the other by progressively increasing PLE frequency. Transition to mental disorder occurred in 3.39% of the increasing-frequency group and 1.28% of the stable low-level group. The increasing-frequency group had a significantly higher risk of transition to any psychiatric disorder (OR = 2.7; 95% CI, 1.56-4.66), to a psychotic disorder (OR = 22.14; 95% CI, 2.30-213.25), and to a nonpsychotic psychiatric disorder (OR = 2.28; 95% CI, 1.27-4.10). Besides increasing PLEs (OR = 3.33; 95% CI, 1.55-7.19), other risk factors for any psychiatric disorder included childhood trauma (OR = 1.17; 95% CI, 1.01-1.36), family divorce (OR = 2.86; 95% CI, 1.24-6.61), and minority ethnicity (OR = 2.91; 95% CI, 1.18-7.20).
The pattern of increasing PLEs predominates in predicting emergent mental disorder, particularly psychosis, along with minority status, trauma, and family divorce, suggesting potential targets for preventive intervention.
类精神病体验（PLEs）可能是精神病和其他精神障碍的重要前兆。
研究 PLE 频率的不同纵向轨迹及其与随后精神障碍发展的关系。
对 6198 名青少年进行了一项纵向研究，使用社区心理体验评估和创伤史问卷，在三年内（2014-2016 年）每年通过课堂评估报告自我报告的 PLE 和同时发生的创伤经历。在最后一年，根据 Mini-国际神经精神访谈进行精神障碍诊断。使用增长混合模型来确定 PLE 频率的不同增长轨迹。然后使用逻辑回归来探索不同的 PLE 轨迹与精神障碍出现之间的关系，同时考虑社会人口学特征和儿童期前因。
确定了两种不同的 PLE 轨迹，一种以 PLE 频率稳定低水平为特征，另一种以逐渐增加 PLE 频率为特征。在递增频率组中，有 3.39%的人过渡到精神障碍，在稳定低水平组中，有 1.28%的人过渡到精神障碍。递增频率组过渡到任何精神障碍（OR=2.7；95%CI，1.56-4.66）、精神病障碍（OR=22.14；95%CI，2.30-213.25）和非精神病精神障碍（OR=2.28；95%CI，1.27-4.10）的风险显著更高。除了 PLE 的增加（OR=3.33；95%CI，1.55-7.19），其他精神障碍的风险因素包括儿童时期的创伤（OR=1.17；95%CI，1.01-1.36）、家庭离异（OR=2.86；95%CI，1.24-6.61）和少数民族身份（OR=2.91；95%CI，1.18-7.20）。
PLE 增加的模式在预测新出现的精神障碍，特别是精神病方面占主导地位，同时还与少数民族地位、创伤和家庭离异有关，这表明可能存在预防干预的目标。
