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Testing extra-linearity across a psychosis continuum.

Jeremy W Coid1, Yamin Zhang1, Jinkun Zeng1

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Summary
This summary is machine-generated.

Psychotic experiences may follow a continuum with depression or non-affective psychosis, with distinct risk factors influencing outcomes at severe levels. Four latent classes emerged at the highest severity, aligning with diagnostic categories.

Keywords:
EtiologyExtra-linearityPsychosis continuumPsychosis subtypesPsychotic experiences

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Area of Science:

  • Psychiatry
  • Psychopathology
  • Epidemiology

Background:

  • The relationship between psychotic experiences (PEs) and clinical psychosis remains unclear, with debate on whether it's a dimensional continuum or involves distinct latent classes.
  • Understanding this spectrum is crucial for accurate diagnosis and treatment of psychosis.

Purpose of the Study:

  • To investigate the structure of psychotic experiences along a continuum and identify potential latent classes.
  • To examine the influence of etiological risk factors on different levels of psychopathology.

Main Methods:

  • Utilized annual cross-sectional survey data from 47,004 Chinese undergraduates (2014-2019).
  • Measured PEs, depression, and risk factors using standardized self-report instruments.
  • Employed latent class analysis and tested linear/extra-linear contrasts for risk factors across a five-level psychosis continuum.

Main Results:

  • Four latent classes emerged at the most severe level (level 5), corresponding to schizophrenia symptoms, schizophrenia with depressive symptoms, severe depression, and an unclassified category.
  • Child maltreatment impacted both psychosis and depression extra-linearly. Family history of psychosis, male sex, and urban birth showed specific linear or extra-linear impacts on psychosis.
  • Depression was more associated with linearly impacting risk factors across the continuum.

Conclusions:

  • Quantitative and qualitative structural changes in psychosis occur at severe levels, supporting the emergence of latent classes.
  • PEs appear non-specific, with some on a continuum with depression and others with non-affective psychosis.
  • Etiological risk factor patterns significantly influence outcomes at the severe end of these psychopathological continua.