Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Department of Clinical, Educational and Health Psychology, University College London, London, UK.
Transl Psychiatry. 2021 Apr 19;11(1):226. doi: 10.1038/s41398-021-01265-2.
Psychotic experiences (PE) are associated with poorer functioning, higher distress and the onset of serious mental illness. Environmental exposures (e.g. childhood abuse) are associated with the development of PE. However, which specific exposures convey risk for each type or dimension of PE has rarely been explored. The Oxford Wellbeing Life and Sleep (OWLS) survey includes 22 environmental risk factors for psychosis and was designed to examine how environmental risks are associated with specific dimensions of PE. Multivariate logistic regression models were fit using these risk factors to predict six dimensions of PE (perceptual abnormalities, persecutory ideation, bizarre ideas, cognitive disorganisation, delusional mood and negative symptoms). Models were built using only 70% of the data, and then fit to the remaining data to assess their generalisability and quality. 1789 (27.2% men; mean age = 27.6; SD = 10.9) survey responses were analysed. The risk factors predictive of the most PE were anxiety, social withdrawal during childhood and trauma. Cannabis and depression predicted three dimensions with both predicting bizarre ideas and persecutory ideation. Psychological abuse and sleep quality each predicted two dimensions (persecutory ideation and delusional mood). Risk factors predicting one PE dimension were age (predicting cognitive disorganisation), physical abuse (bizarre ideas), bullying and gender (persecutory ideation); and circadian phase (delusional mood). These results lend support for a continuum of psychosis, suggesting environmental risks for psychotic disorders also increase the risk of assorted dimensions of PE. Furthermore, it advocates the use of dimensional approaches when examining environmental exposures for PE given that environmental risks distribute differently across dimensions.
精神病性体验（PE）与功能较差、痛苦增加以及严重精神疾病的发生有关。环境暴露（例如儿童期虐待）与 PE 的发展有关。然而，哪些特定的暴露会增加每种类型或维度的 PE 的风险，很少被探索过。牛津幸福生活与睡眠（OWLS）调查包括 22 种精神病的环境风险因素，旨在研究环境风险如何与 PE 的特定维度相关。使用这些风险因素对多变量逻辑回归模型进行拟合，以预测 PE 的六个维度（感知异常、被害妄想、奇特观念、认知紊乱、妄想情绪和阴性症状）。仅使用 70%的数据构建模型，然后将其拟合到剩余数据中，以评估其泛化能力和质量。分析了 1789 份（27.2%为男性；平均年龄=27.6；SD=10.9）调查回复。预测 PE 最多的风险因素是焦虑、儿童期社交退缩和创伤。大麻和抑郁预测了三个维度，都预测了奇特观念和被害妄想。心理虐待和睡眠质量各预测了两个维度（被害妄想和妄想情绪）。预测一个 PE 维度的风险因素是年龄（预测认知紊乱）、身体虐待（奇特观念）、欺凌和性别（被害妄想）；以及昼夜节律相位（妄想情绪）。这些结果为精神病的连续体提供了支持，表明精神障碍的环境风险也会增加各种 PE 维度的风险。此外，鉴于环境风险在不同维度上的分布不同，当使用维度方法来研究 PE 的环境暴露时，它提倡使用维度方法。
