Testing the hypothesis that psychotic illness begins when subthreshold hallucinations combine with delusional ideation.
Summary of "Testing the hypothesis that psychotic illness begins when subthreshold hallucinations combine with delusional ideation."
Smeets F, Lataster T, van Winkel R, de Graaf R, ten Have M, van Os J. Testing the hypothesis that psychotic illness begins when subthreshold hallucinations combine with delusional ideation. Objective: While hallucinations and delusions are often considered as a single class of 'positive symptoms', little is known about their dynamic cooccurrence in relation to clinical outcome in non-help-seeking people. Method: The Netherlands Mental Health and Incidence Study (NEMESIS-1) is a longitudinal study of mental disorders (n = 7075) with three measurements over a 3-year period. Risk factors, persistence of psychotic experiences, and clinical outcome were analyzed for groups with: i) no psychotic experiences, ii) only delusions, iii) only hallucinations, and iv) both delusions and hallucinations. Results: Hallucinations and delusions occurred together more often (T0, 3.5%; T1, 1.0%; T2, 0.9%) than that predicted by chance (T0, 1.0%; T1, 0.1%; T2, 0.04%). The group with both symptoms showed more 'first-rank'-like delusions compared with the group with only delusions. Having both hallucinations and delusions, compared to isolated symptoms, was associated more strongly with risk factors, comorbid affective symptoms, negative symptoms, and persistence of psychotic experiences. This was not an artifact of having more symptoms in general. Conclusion: Experiencing both delusions and hallucinations is an indicator of greater etiological load resulting in more clinical outcome. A specific 'hallucinatory-delusional state' may represent an early phase of exacerbation of aberrant attribution of salience, increasing risk for clinical outcome.
Affiliation
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, Maastricht, the Netherlands Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands Dep
Journal Details
This article was published in the following journal.
Name: Acta psychiatrica Scandinavica
ISSN: 1600-0447
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22676336
- DOI: http://dx.doi.org/10.1111/j.1600-0447.2012.01888.x
Medical and Biotech [MESH] Definitions
Affective Disorders, Psychotic
Disorders in which the essential feature is a severe disturbance in mood (depression, anxiety, elation, and excitement) accompanied by psychotic symptoms such as delusions, hallucinations, gross impairment in reality testing, etc.
Psychotic Disorders
Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)
Antipsychotic Agents
Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus.
Genetic Testing
Detection of or testing for certain ALLELES, mutations, genotypes, or karyotypes that are associated with genetic traits, heritable diseases, or with a predisposition to a disease, or that may lead to the disease in descendants. It includes prenatal genetic testing.
Anonymous Testing
Testing in which the source of the specimen or the person being tested is not individually identified.
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