Guide Psychotic Continuum

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Fusar-Poli , A. DOI : The continuum model of psychosis posits that psychotic symptoms are distributed throughout the population, with diagnosable clinical disorder existing at a certain point along this continuum. The total continuum is made up mainly of non-clinical cases with clinical cases of psychosis representing only a small proportion of the total extended psychosis phenotype.

This paper is a narrative review of studies of psychotic experiences in the general population. The evidence indicates reasonably high prevalence rates of psychotic experiences in the general population, substantially higher than the prevalence of psychotic disorders, and that they are associated with increased risk of future onset of diagnosable disorder, particularly when the experiences are persistent.


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Psychotic experiences in the general population share an extensive range of risk factors with schizophrenia and therefore provide a useful phenotype in which to study the aetiology of clinical psychosis. Some types of psychotic experiences, such as paranoid ideas, bizarre thinking and perceptual abnormalities, may indicate a greater level of risk for psychotic disorder than other psychotic experiences, such as magical thinking.

Background and objectives We aimed to study the psychopathological profile in different disorders across the psychotic continuum and to demonstrate that negative symptoms are not so rare in delusional disorder, as it was traditionally considered. Methods This was an observational study utilizing a sample of patients with a psychotic disorder delusional disorder, schizophrenia or schizoaffective disorder. Additionally, t -tests were performed to explore the difference between positive and negative symptomatology in the delusional disorder group.

Positive symptoms were also present in all three categories but were significantly more apparent among schizoaffective disorder patients. Conclusions Our results support the notion of a psychopathological gradient across the psychosis continuum from patients with delusional disorder, at one extreme of the scope, to those with schizoaffective disorder, at the other.

We proposed that the assessment of negative symptoms should be routine as part of clinical mental status examination of delusional disorder patients. Psychotic spectrum. Introduction Even though categorical diagnoses are useful in psychiatry, some psychotic disorders overlap in genetics, risk factors, clinical presentation, management needs and outcomes. And second, we wanted to demonstrate that negative symptoms are not so rare in DD when compared with positive symptoms.

In addition, a composite scale can be calculated to determine the positive or negative subtype of every patient. This formula uses the sociodemographic variables age, sex, educational level, urbanicity and geographical region to estimate a participant's IQ. Statistical analyses Descriptive statistics for age, sex, educational level, premorbid IQ, illness duration, and PANSS score were calculated for the three groups of patients. The sociodemographic and clinical characteristics of the sample are shown in Table 1. Demographic and clinical data of patients. Percentage of patients from each group taking different types of medication.

Mean values and standard deviations on the clinical assessment for the three groups of patients. Bramon, P. The common genetic liability between schizophrenia and bipolar disorder: a review. Curr Psychiatry Rep, 3 , pp.

Can We Detect Psychotic-like Experiences in the General Population?

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Defining the schizophrenia spectrum: issues for genetic linkage studies. Schizophr Bull, 17 , pp. Cuesta, M. Ugarte, T. Goicoa, S.


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    Ibanez-Casas, E.

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    Ochoa, M. Dolz, J. Haro, et al. A dimensional comparison between delusional disorder, schizophrenia and schizoaffective disorder. Schizophr Res, , pp. Serretti, P. Dimensions of major psychoses: a confirmatory factor analysis of six competing models. Psychiatry Res, , June , pp. Kendler, D. Schizophreniform disorder, delusional disorder and psychotic disorder not otherwise specified: clinical features, outcome and familial psychopathology. Acta Psychiatr Scand, 91 , pp.

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    Diversity Within the Psychotic Continuum | Schizophrenia Bulletin | Oxford Academic

    Gonzalez, K. McKenney, J. Haro, J. Usall, et al. Deficits in executive and memory processes in delusional disorder: a case-control study. Rink, T. Pagel, J. Franklin, C. Characteristics and heterogeneity of schizoaffective disorder compared with unipolar depression and schizophrenia — a systematic literature review and meta-analysis. This is where people who seem not to fit either of the broad patterns may be particularly illuminating. There are those who seem to have frequent sensory voice-hearing experiences, yet appear to meet no other criteria for psychosis.

    I have spoken with a handful of religious practitioners who appeared to have audible or quasi-audible experiences of invisible others several times a week. Most but not all score highly in absorption. These practitioners sometimes report that they heard murmuring at times; 2 said that they had first heard voices in childhood and described no childhood trauma.

    I suggest that the careful, rich phenomenological description such as an anthropologist can provide of these and other frequent voice-hearers, with and without a trauma history, could be useful in specifying the role of absorption-dissociation and other factors in voice-hearing by identifying different patterns of experience. Such interviews would not only ask for relevant history and administer relevant scales but also explore experiential details like number of words heard, sense of command, physicality, relationship with the voice, positive or negative valence, etc.

    This is particularly true of those whose reputations rest on their visionary abilities, like prophets, psychics, channelers, and the like. It certainly may be the case that such practitioners are more likely to experience actually sensory events than other people, but it is important not to take their self-reporting seriously without understanding their particular culture and without in-person interviewing which includes follow-up probes: was that outside your head, did you hear it with your ears, did you turn your head?

    We need an interdisciplinary approach 37 that includes observational and phenomenological data alongside epidemiological surveys and neuroscientific techniques in order to sort out the many components and continua 38 of this most remarkable human experience. Oxford University Press is a department of the University of Oxford.

    It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Diversity Within the Psychotic Continuum T. Oxford Academic. Google Scholar. Cite Citation. Permissions Icon Permissions. Abstract There has been great interest in the hallucination-like events experienced by the general nonclinical population.

    A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Search ADS. Psychotic experiences in the general population: a cross-national analysis based on 31, respondents from 18 countries. Introduction: the extended psychosis phenotype—relationship with schizophrenia and with ultrahigh risk status for psychosis. Psychosis as a transdiagnostic and extended phenotype in the general population.

    Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study. Google Preview. God put a thought into my mind: the charismatic Christian experience of receiving communications from God. Experiences of hearing voices: analysis of a novel phenomenological survey. The absorption hypothesis: learning to hear God in Evangelical Christianity.