Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study

TY - JOUR

T1 - Variation of subclinical psychosis across 16 sites in Europe and Brazil

T2 - findings from the multi-national EU-GEI study

AU - D'Andrea, Giuseppe

AU - Quattrone, Diego

AU - Malone, Kathryn

AU - Tripoli, Giada

AU - Trotta, Giulia

AU - Spinazzola, Edoardo

AU - Gayer-Anderson, Charlotte

AU - Jongsma, Hannah E.

AU - Sideli, Lucia

AU - Stilo, Simona A.

AU - La Cascia, Caterina

AU - Ferraro, Laura

AU - Lasalvia, Antonio

AU - Tosato, Sarah

AU - Tortelli, Andrea

AU - Velthorst, Eva

AU - De Haan, Lieuwe

AU - Llorca, Pierre Michel

AU - Rossi Menezes, Paulo

AU - Santos, Jose Luis

AU - Arrojo, Manuel

AU - Bobes, Julio

AU - Sanjuán, Julio

AU - Bernardo, Miguel

AU - Arango, Celso

AU - Kirkbride, James B.

AU - Jones, Peter B.

AU - Rutten, Bart P.

AU - Van Os, Jim

AU - Selten, Jean Paul

AU - Vassos, Evangelos

AU - Schürhoff, Franck

AU - Szöke, Andrei

AU - Pignon, Baptiste

AU - O'donovan, Michael

AU - Richards, Alexander

AU - Morgan, Craig

AU - Di Forti, Marta

AU - Tarricone, Ilaria

AU - Murray, Robin M.

N1 - Publisher Copyright: Copyright 2024 © The Author(s). Published by Cambridge University Press.

PY - 2024/6/1

Y1 - 2024/6/1

N2 - BackgroundIncidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. MethodsWe used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. ResultsSchizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. ConclusionsSchizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

AB - BackgroundIncidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. MethodsWe used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. ResultsSchizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. ConclusionsSchizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

KW - incidence of psychosis

KW - psychosis epidemiology

KW - psychosis prevention

KW - psychosis spectrum

KW - psychotic experiences

KW - schizotypy

KW - subclinical psychosis

UR - https://www.scopus.com/pages/publications/85194592177

U2 - 10.1017/S0033291723003781

DO - 10.1017/S0033291723003781

M3 - Article

C2 - 38288603

AN - SCOPUS:85194592177

SN - 0033-2917

VL - 54

SP - 1810

EP - 1823

JO - Psychological Medicine

JF - Psychological Medicine

IS - 8

ER -