Different phenotypes of psychotic-like experiences and their associated factors

Research in heterogeneity within the lifetime psychotic-like experiences (PLEs) group remains insufficient. This study aims to identify phenotypes within the lifetime PLEs population and their correlates.

This cross-sectional study assessed PLEs with the 15-item positive subscale of the Community Assessment of Psychic Experiences (CAPE-P15), manic symptoms with the Mood Disorder Questionnaire (MDQ), and depressive/anxiety symptoms with modified Patient Health Questionnaire-9 (PHQ-9)/Generalized Anxiety Disorder-7 (GAD-7) (referring the worst two-week period in lifetime). Latent profile analysis was used to identify PLEs phenotypes, and multinomial logistic regression examined their associations with sociodemographic and psychosocial factors.

We identified 2087 individuals with lifetime PLEs and delineated three distinct classes: Class 1 (1552 [74.4%]) with the lowest symptom levels, Class 2 (224 [10.7%]) with prominent depression and anxiety symptoms, and Class 3 (311 [14.9%]) with prominent PLEs. All three phenotypes shared common associated factors, including younger age, chronic physical illness, childhood traumas, recent adverse life events, female sex, and lower resilience. Left-behind child status was associated with Class 1 (OR=1.19, 95% CI: 1.01-1.40) and Class 2 (OR=1.52, 95% CI: 1.09-2.10), while single-child status showed associations (Class 1: OR=0.82, 95% CI: 0.69-0.99; Class 2: OR=1.49, 95% CI: 1.04-2.11). Smoking was associated with Class 2 (OR=3.58, 95% CI: 1.57-8.19), and alcohol intake with Class 1 (OR=2.03, 95% CI: 1.31-3.15) and Class 3 (OR=2.74, 95% CI: 1.47-5.11).

This study identified three distinct PLEs phenotypes, supporting the heterogeneous nature of PLEs. These preliminary findings provide insights for phenotype-specific prevention and warrant longitudinal validation.