Replication in two independent population-based samples that childhood maltreatment and cannabis use synergistically impact on psychosis risk

2011 ◽  
Vol 42 (1) ◽  
pp. 149-159 ◽  
Author(s):  
M. Konings ◽  
N. Stefanis ◽  
R. Kuepper ◽  
R. de Graaf ◽  
M. ten Have ◽  
...  
Keyword(s):  
Childhood Maltreatment ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Study Data ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Data Sets ◽  
Independent Population ◽  
Study Test

BackgroundThere may be biological plausibility to the notion that cannabis use and childhood trauma or maltreatment synergistically increase the risk for later development of psychotic symptoms. To replicate and further investigate this issue, prospective data from two independent population-based studies, the Greek National Perinatal Study (n=1636) and The Netherlands Mental Health Survey and Incidence Study (NEMESIS) (n=4842), were analyzed.MethodTwo different data sets on cannabis use and childhood maltreatment were used. In a large Greek population-based cohort study, data on cannabis use at age 19 years and childhood maltreatment at 7 years were assessed. In addition, psychotic symptoms were assessed using the Community Assessment of Psychic Experiences (CAPE). In NEMESIS, the Composite International Diagnostic Interview (CIDI) was used to assess psychotic symptoms at three different time points along with childhood maltreatment and lifetime cannabis use.ResultsA significant adjusted interaction between childhood maltreatment and later cannabis use was evident in both samples, indicating that the psychosis-inducing effects of cannabis were stronger in individuals exposed to earlier sexual or physical mistreatment [Greek National Perinatal Study: test for interactionF(2, 1627)=4.18,p=0.02; NEMESIS: test for interaction χ2(3)=8.08,p=0.04].ConclusionsCross-sensitivity between childhood maltreatment and cannabis use may exist in pathways that shape the risk for expression of positive psychotic symptoms.

scholarly journals Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study

2011 ◽  
Vol 41 (10) ◽  
pp. 2121-2129 ◽  
Author(s):  
R. Kuepper ◽  
J. van Os ◽  
R. Lieb ◽  
H.-U. Wittchen ◽  
C. Henquet
Keyword(s):  
Cohort Study ◽  
Urban Environment ◽  
Developmental Stages ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Risk Difference ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Adjusted Risk

BackgroundCannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk.MethodProspective data (n=1923, aged 14–24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview.ResultsAnalyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2–18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0–12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference −4.1%, 95% CI −9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism.ConclusionsExposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

Social support and delusional-like experiences: a nationwide population-based study

2012 ◽  
Vol 21 (2) ◽  
pp. 203-212 ◽  
Author(s):  
S. Saha ◽  
J. Scott ◽  
D. Varghese ◽  
J. McGrath
Keyword(s):  
Social Support ◽  
General Population ◽  
Community Sample ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Confounding Factors ◽  
Poor Social Support ◽  
Physical Disorders ◽  
The Relationship

Background.Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community sample.Methods.Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse/partners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors.Results.Of the sample, 8.4% (n = 776) positively endorsed one or more DLEs. Individuals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse/partner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors.Conclusions.DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.

Empirical Investigation of Two Assumptions in the Diagnosis of DSM-IV Major Depressive Episode

2007 ◽  
Vol 41 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Chika Sakashita ◽  
Tim Slade ◽  
Gavin Andrews
Keyword(s):  
Depressive Episode ◽  
Major Depressive Episode ◽  
Sleep Problems ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Major Depressive ◽  
Diagnostic Threshold ◽  
Dsm Iv ◽  
The Relationship

Objective: The aim of the current study was to examine two major assumptions behind the DSM-IV diagnosis of major depressive episode (MDE): that depression represents a distinct category defined by a valid symptom threshold, and that each depressive symptom contributes equally to the diagnosis. Methods: Data were from the Australian National Survey of Mental Health and Wellbeing. Participants consisted of a random population-based sample of 10 641 community volunteers, representing a response rate of 78%. DSM-IV diagnoses of MDE and other mental disorders were obtained using the Composite International Diagnostic Interview, version 2.0. Analyses were carried out on the subsample of respondents who endorsed either depressed mood or loss of interest (n =2137). Multivariate linear regression analyses examined the relationship between the number and type of symptoms and four independent measures of impairment. Results: The relationship between the number of depressive symptoms and the four measures of impairment was purely linear. Three individual symptoms (sleep problems, energy loss, and psychomotor disturbance) were all independent predictors of three of the four measures of impairment. Conclusions: Counting symptoms alone is limited in guiding a clear diagnostic threshold. The differential impact of individual symptoms on impairment suggests that impairment levels may be more accurately estimated by weighting the particular symptoms endorsed.

scholarly journals Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies

2012 ◽  
Vol 201 (1) ◽  
pp. 26-32 ◽  
Author(s):  
I. Kelleher ◽  
H. Keeley ◽  
P. Corcoran ◽  
F. Lynch ◽  
C. Fitzpatrick ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Early Adolescence ◽  
Longitudinal Research ◽  
Age Groups ◽  
Population Based ◽  
Diagnostic Interview ◽  
Psychotic Symptoms ◽  
Childhood And Adolescence ◽  
Wide Range ◽  
Clinicopathological Significance

BackgroundEpidemiological research has shown that hallucinations and delusions, the classic symptoms of psychosis, are far more prevalent in the population than actual psychotic disorder. These symptoms are especially prevalent in childhood and adolescence. Longitudinal research has demonstrated that psychotic symptoms in adolescence increase the risk of psychotic disorder in adulthood. There has been a lack of research, however, on the immediate clinicopathological significance of psychotic symptoms in adolescence.AimsTo investigate the relationship between psychotic symptoms and non-psychotic psychopathology in community samples of adolescents in terms of prevalence, co-occurring disorders, comorbid (multiple) psychopathology and variation across early v. middle adolescence.MethodData from four population studies were used: two early adolescence studies (ages 11–13 years) and two mid-adolescence studies (ages 13–16 years). Studies 1 and 2 involved school-based surveys of 2243 children aged 11–16 years for psychotic symptoms and for emotional and behavioural symptoms of psychopathology. Studies 3 and 4 involved in-depth diagnostic interview assessments of psychotic symptoms and lifetime psychiatric disorders in community samples of 423 children aged 11–15 years.ResultsYounger adolescents had a higher prevalence (21–23%) of psychotic symptoms than older adolescents (7%). In both age groups the majority of adolescents who reported psychotic symptoms had at least one diagnosable non-psychotic psychiatric disorder, although associations with psychopathology increased with age: nearly 80% of the mid-adolescence sample who reported psychotic symptoms had at least one diagnosis, compared with 57% of the early adolescence sample. Adolescents who reported psychotic symptoms were at particularly high risk of having multiple co-occurring diagnoses.ConclusionsPsychotic symptoms are important risk markers for a wide range of non-psychotic psychopathological disorders, in particular for severe psychopathology characterised by multiple co-occurring diagnoses. These symptoms should be carefully assessed in all patients.

Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence

2009 ◽  
Vol 40 (10) ◽  
pp. 1627-1634 ◽  
Author(s):  
M. Harley ◽  
I. Kelleher ◽  
M. Clarke ◽  
F. Lynch ◽  
L. Arseneault ◽  
...  
Keyword(s):  
Childhood Trauma ◽  
Substance Misuse ◽  
Psychiatric Symptoms ◽  
Population Based ◽  
Cannabis Use ◽  
School Age Children ◽  
Psychotic Symptoms ◽  
Vulnerable Group ◽  
Additive Interaction ◽  
Population Based Study

BackgroundAdolescent cannabis use has been shown in many studies to increase the risk of later psychosis. Childhood trauma is associated with both substance misuse and risk for psychosis. In this study our aim was to investigate whether there is a significant interaction between cannabis use and childhood trauma in increasing the risk for experiencing psychotic symptoms during adolescence.MethodPsychiatric interviews using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) semi-structured instrument were carried out with 211 adolescents aged between 12 and 15 years and their parents as part of a population-based study. The interview enquired about early traumatic events, cannabis use and psychiatric symptoms in adolescence.ResultsIn separate analyses both cannabis use and childhood trauma were significantly associated with risk of experiencing psychotic symptoms. However, the presence of both childhood trauma and early cannabis use significantly increased the risk for psychotic symptoms beyond the risk posed by either risk factor alone, indicating that there was a greater than additive interaction between childhood trauma and cannabis use.ConclusionOur finding of a greater than additive interaction between childhood trauma and cannabis use may have implications for the identification of individuals at high risk of experiencing psychotic symptoms. For example, measures to actively discourage or intensively treat cannabis use in children and adolescents who have experienced abuse may help to prevent the development of psychosis in this vulnerable group. Our findings require replication in larger samples to confirm this interaction effect.

Socio-Economic Disadvantage and Delusional-Like Experiences: A Nationwide Population-Based Study

2013 ◽  
Vol 28 (1) ◽  
pp. 59-63 ◽  
Author(s):  
S. Saha ◽  
J.G. Scott ◽  
D. Varghese ◽  
J.J. McGrath
Keyword(s):  
Low Income ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Sensitivity Analyses ◽  
Economic Disadvantage ◽  
Confounding Factors ◽  
Never Married ◽  
Individual Level ◽  
Physical Disorders

AbstractPurposeDelusional-like experiences (DLE) have been associated with low income, suggesting that more broadly defined socio-economic disadvantage may be associated with these experiences. We had the opportunity to explore the association between DLE and both individual- and area-level measures of socio-economic disadvantage.MethodSubjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and physical disorders. Individual-level and area-level socio-economic disadvantage measures were available based on variables including income, educational attainment, employment status, and housing. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors.ResultsOf the 8773 subjects, 8.4% (n = 776) positively endorsed one or more DLE. DLE screen items were more likely to be endorsed by those who were (a) younger, (b) never married, or widowed, separated or divorced status, (c) migrants, or (d) living in rented houses. There were significant associations between socio-economic disadvantage and increased DLE endorsement, and this was found for both individual-level and area-level measures of socio-economic disadvantage. In general, the associations remained significant after adjusting for a range of potential confounding factors and in planned sensitivity analyses.ConclusionsDLE are associated with socio-economic disadvantage in the general population. We speculate that the link between socio-economic disadvantage and DLE may be mediated by psychosocial stress and general psychological distress.

Flourishing After a Stroke: A Nationally Representative Portrait of Resilience and Mental Health Among Older Canadians

2019 ◽  
Vol 32 (5-6) ◽  
pp. 308-316 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Lisa A. Jensen
Keyword(s):  
Mental Health ◽  
Childhood Maltreatment ◽  
Composite International Diagnostic Interview ◽  
Well Being ◽  
Canadian Community Health Survey ◽  
Diagnostic Interview ◽  
World Health ◽  
Stroke Survivors ◽  
Generalized Anxiety Disorders ◽  
Nationally Representative

Objectives: The objective of this study is to estimate the prevalence of, and factors associated with, complete mental health (CMH) among stroke survivors aged 50+ years. Method: Bivariate and logistic regression analyses of nationally representative data from the 2012 Canadian Community Health Survey–Mental Health of 11,157 older adults aged 50+ years (300 stroke survivors). CMH included all of these elements: (a) absence of any past-year mental illness (measured by the World Health Organization version of the Composite International Diagnostic Interview [WHO-CIDI] scales), (b) almost daily happiness or satisfaction, and (c) psychological and social well-being. Results: Two thirds of the stroke survivors (68%) were in CMH. Among stroke survivors, the odds of CMH were higher among those with at least one confidant (odds ratio [OR] = 4.34; 95% confidence interval [CI] = [1.52, 12.41]), those without disabling chronic pain (OR = 2.34; 95% CI = [1.24, 4.41]), and those without a history of childhood maltreatment (OR = 2.10; 95% CI = [1.09, 4.05]), depression (OR = 3.83; 95% CI = [1.10, 13.37]), or generalized anxiety disorders (OR = 3.42; 95% CI = [1.19, 9.79]). Discussion: These findings provide encouraging information for stroke survivors.

scholarly journals The jumping to conclusions reasoning bias as a cognitive factor contributing to psychosis progression and persistence: findings from NEMESIS-2

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Christian Rauschenberg ◽  
Ulrich Reininghaus ◽  
Margreet ten Have ◽  
Ron de Graaf ◽  
Saskia van Dorsselaer ◽  
...  
Keyword(s):  
Help Seeking ◽  
Statistical Power ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Psychotic Symptoms ◽  
Relative Risk Ratio ◽  
Prospective Design ◽  
Affective Dysregulation ◽  
Jumping To Conclusions ◽  
Reasoning Bias

Abstract Background Contemporary models of psychosis implicate the importance of affective dysregulation and cognitive factors (e.g. biases and schemas) in the development and maintenance of psychotic symptoms, but studies testing proposed mechanisms remain limited. This study, uniquely using a prospective design, investigated whether the jumping to conclusions (JTC) reasoning bias contributes to psychosis progression and persistence. Methods Data were derived from the second Netherlands Mental Health Survey and Incidence Study (NEMESIS-2). The Composite International Diagnostic Interview and an add-on instrument were used to assess affective dysregulation (i.e. depression, anxiety and mania) and psychotic experiences (PEs), respectively. The beads task was used to assess JTC bias. Time series analyses were conducted using data from T1 and T2 (N = 8666), excluding individuals who reported high psychosis levels at T0. Results Although the prospective design resulted in low statistical power, the findings suggest that, compared to those without symptoms, individuals with lifetime affective dysregulation were more likely to progress from low/moderate psychosis levels (state of ‘aberrant salience’, one or two PEs) at T1 to high psychosis levels (‘frank psychosis’, three or more PEs or psychosis-related help-seeking behaviour) at T2 if the JTC bias was present [adj. relative risk ratio (RRR): 3.8, 95% confidence interval (CI) 0.8–18.6, p = 0.101]. Similarly, the JTC bias contributed to the persistence of high psychosis levels (adj. RRR: 12.7, 95% CI 0.7–239.6, p = 0.091). Conclusions We found some evidence that the JTC bias may contribute to psychosis progression and persistence in individuals with affective dysregulation. However, well-powered prospective studies are needed to replicate these findings.

Biopsychosocial correlates of lifetime major depression in a multiple sclerosis population

2000 ◽  
Vol 6 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Scott B Patten ◽  
Luanne M Metz ◽  
Marlene A Reimer
Keyword(s):  
Multiple Sclerosis ◽  
Major Depression ◽  
Depressive Disorders ◽  
Causal Effect ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Cross Sectional ◽  
Multiple Sclerosis Population ◽  
Additional Data Collection

The objective of this paper was to evaluate the lifetime and point prevalence of major depression in a population-based Multiple Sclerosis (MS) clinic sample, and to describe associations between selected biopsychosocial variables and the prevalence of lifetime major depression in this sample. Subjects who had participated in an earlier study were re-contacted for additional data collection. Eighty-three per cent (n=136) of those eligible consented to participate. Each subject completed the Composite International Diagnostic Interview (CIDI) and an interviewer-administered questionnaire evaluating a series of biopsychosocial variables. The lifetime prevalence of major depression in this sample was 22.8%, somewhat lower than previous estimates in MS clinic populations. Women, those under 35, and those with a family history of major depression had a higher prevalence. Also, subject reporting high levels of stress and heavy ingestion of caffeine (>400 mg) had a higher prevalence of major depression. As this was a cross-sectional analysis, the direction of causal effect for the observed associations could not be determined. By identifying variables that are associated with lifetime major depression, these data generate hypotheses for future prospective studies. Such studies will be needed to further understand the etiology of depressive disorders in MS.

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