Cardno Alastair G, Selzam Saskia, Freeman Daniel, Ronald Angelica
Division of Psychological and Social Medicine Faculty of Medicine and Health University of Leeds Leeds.
Social, Genetic and Developmental Psychiatry Centre Institute of Psychiatry, Psychology and Neuroscience King's College London London.
Psychiatr Res Clin Pract. 2021 Summer;3(2):67-75. doi: 10.1176/appi.prcp.20200010. Epub 2021 Jan 18.
Individual adolescent psychotic-like experiences (PLEs) are associated with schizophrenia risk factors. As DSM-5 schizophrenia requires the co-occurrence of at least two psychotic symptoms, we investigated whether co-occurring adolescent PLEs have stronger associations with schizophrenia risk factors, lower quality of life and functioning, and have higher heritability, than individual PLEs.
Participants were 9646 16-year-old twins from the longitudinal Twins Early Development Study. We investigated co-occurrence of high questionnaire scores for three PLE combinations: (1) paranoia and hallucinations; (2) paranoia or hallucinations, and cognitive disorganization; and (3) paranoia or hallucinations, and negative symptoms, and their associations with 11 schizophrenia-relevant variables by regression analysis and structural equation twin modeling.
Against expectation, none of the co-occurring PLEs had the nominally strongest associations significantly more often than individual PLEs. Co-occurring PLEs had the strongest associations with bullying victimization, cannabis use and lower life satisfaction, but individual PLEs had the strongest associations with cognitive function variables. Obstetric complications were most associated with negative symptoms. Secondary analysis revealed that co-occurrence of cognitive disorganization and negative symptoms had the nominally strongest associations with most schizophrenia-relevant variables overall and relatively high heritability (67%).
Focusing on co-occurrence enhances some individual PLE associations but obscures others. The combination of subjective cognitive disorganization plus observed negative symptoms showed a broad range of enhanced associations with schizophrenia-relevant variables. Future research could investigate associations with other risk factors and the ability of this PLE combination to predict onset of schizophrenia.
个体青少年类精神病体验（PLEs）与精神分裂症风险因素相关。由于《精神疾病诊断与统计手册》第5版（DSM - 5）中精神分裂症要求至少两种精神病性症状同时出现，我们研究了同时出现的青少年PLEs与精神分裂症风险因素、较低生活质量和功能的关联是否比个体PLEs更强，以及其遗传性是否更高。
参与者为来自纵向双生子早期发展研究的9646名16岁双胞胎。我们研究了三种PLE组合的高问卷得分同时出现的情况：（1）妄想和幻觉；（2）妄想或幻觉与认知紊乱；（3）妄想或幻觉与阴性症状，并通过回归分析和结构方程双生子模型研究它们与11个精神分裂症相关变量的关联。
与预期相反，没有一种同时出现的PLEs比个体PLEs更频繁地具有名义上最强的关联。同时出现的PLEs与受欺凌、使用大麻和较低生活满意度的关联最强，但个体PLEs与认知功能变量的关联最强。产科并发症与阴性症状关联最为密切。二次分析显示，认知紊乱和阴性症状同时出现总体上与大多数精神分裂症相关变量具有名义上最强的关联，且遗传性相对较高（67%）。
关注同时出现的情况增强了一些个体PLE关联，但也掩盖了其他关联。主观认知紊乱加上观察到的阴性症状的组合与精神分裂症相关变量显示出广泛增强的关联。未来研究可以调查与其他风险因素的关联以及这种PLE组合预测精神分裂症发病的能力。
