Sexual orientation and psychotic-like experiences among Chinese college students: the role of gender.

Objective: The mental health of sexual minorities has received increasing attention, but there are few studies on the risk of psychotic-like experiences (PLEs) among sexual minorities. The purpose of this study is to explore the relationship between different sexual orientations and PLEs among college students and the moderating effect of gender. Methods: A total of 4,460 college students from seven provinces participated in this cross-sectional survey. The χ2 test and logistic regression were used to investigate the relationship between sexual orientation and PLEs. Results: Of the participants, 4.9% identified as bisexual, 1.1% as lesbian/gay, and 5.6% were questioning/unsure; 60.1% of the sample experienced at least one PLE item, 59.2% reported delusional experiences (DEs), and 20.6% had hallucinatory experiences (HEs). Compared with heterosexual college students, bisexual and questioning students showed a higher risk of PLEs, DEs, and HEs, and lesbian/gay students showed a higher risk of HEs. Stratified analysis indicated that sexual orientation was significantly associated with PLEs only for female college students. Conclusion: Sexual orientation is a predictive factor of PLEs. In particular, different sexual minority subgroups show the different effects on PLEs between male and female college students. Mental health interventions for PLEs could employ distinct strategies based on different sexual orientations and gender disparity.

The heterogeneity of attenuated and brief limited psychotic symptoms: association of contents with age, sex, country, religion, comorbidities, and functioning.

Introduction: The Attenuated Psychosis Symptoms (APS) syndrome mostly represents the ultra-high-risk state of psychosis but, as does the Brief Intermittent Psychotic Symptoms (BIPS) syndrome, shows a large variance in conversion rates. This may be due to the heterogeneity of APS/BIPS that may be related to the effects of culture, sex, age, and other psychiatric morbidities. Thus, we investigated the different thematic contents of APS and their association with sex, age, country, religion, comorbidity, and functioning to gain a better understanding of the psychosis-risk syndrome. Method: A sample of 232 clinical high-risk subjects according to the ultra-high risk and basic symptom criteria was recruited as part of a European study conducted in Germany, Italy, Switzerland, and Finland. Case vignettes, originally used for supervision of inclusion criteria, were investigated for APS/BIPS contents, which were compared for sex, age, country, religion, functioning, and comorbidities using chi-squared tests and regression analyses. Result: We extracted 109 different contents, mainly of APS (96.8%): 63 delusional, 29 hallucinatory, and 17 speech-disorganized contents. Only 20 contents (18.3%) were present in at least 5% of the sample, with paranoid and referential ideas being the most frequent. Thirty-one (28.5%) contents, in particular, bizarre ideas and perceptual abnormalities, demonstrated an association with age, country, comorbidity, or functioning, with regression models of country and obsessive-compulsive disorders explaining most of the variance: 55.8 and 38.3%, respectively. Contents did not differ between religious groups. Conclusion: Psychosis-risk patients report a wide range of different contents of APS/BIPS, underlining the psychopathological heterogeneity of this group but also revealing a potential core set of contents. Compared to earlier reports on North-American samples, our maximum prevalence rates of contents were considerably lower; this likely being related to a stricter rating of APS/BIPS and cultural influences, in particular, higher schizotypy reported in North-America. The various associations of some APS/BIPS contents with country, age, comorbidities, and functioning might moderate their clinical severity and, consequently, the related risk for psychosis and/or persistent functional disability.

Evidence that infant and early childhood developmental impairments are associated with hallucinatory experiences: results from a large, population-based cohort study.

BACKGROUND: Cognitive and motor dysfunction are hallmark features of the psychosis continuum, and have been detected during late childhood and adolescence in youth who report psychotic experiences (PE). However, previous investigations have not explored infancy and early childhood development. It remains unclear whether such deficits emerge much earlier in life, and whether they are associated with psychotic, specifically hallucinatory, experiences (HE). METHODS: This study included data from Gen2 participants of The Raine Study (n = 1101), a population-based longitudinal cohort study in Western Australia. Five areas of childhood development comprising: communication; fine motor; gross motor; adaptive (problem-solving); and personal-social skills, were assessed serially at ages 1, 2 and 3 years. Information on HE, depression and anxiety at ages 10, 14 and 17 years was obtained. HE were further subdivided into those with transient or recurrent experiences. Mixed effects logistic regression models and cumulative risk analyses based on multiple domain delays were performed. RESULTS: Early poorer development in multiple areas was noted from ages 1, 2 and 3 years among youth who reported HE. Early developmental delays significantly increased the risk for later HE. This association was particularly marked in the recurrent HE group, with over 40% having early developmental delays in multiple domains. There was no significant association between early childhood development and later anxiety/depression apart from lower gross motor scores at age 3. CONCLUSIONS: The findings suggest that early pan-developmental deficits are associated with later HE, with the effect strongest for young people who report recurrent HE throughout childhood and adolescence.

Prevalence and Phenomenology of Sensory Experiences of a Deceased Spouse: A Survey of Bereaved Older Adults.

Sensory and quasi-sensory experiences of the deceased (SED), also called bereavement hallucinations, are common in bereavement, but research detailing these experiences is limited. Methods: An in-depth survey of SED was developed based on existing research, and 310 older adults from the general Danish population participated in the study 6-10 months after their spouse died. Results: SED were reported by 42% of the participants with wide-ranging phenomenological features across sensory-modalities. In particular, seeing and hearing the deceased spouse was experienced as very similar to the couple's everyday contacts before death. SED were endorsed as positive by a majority of experiencers, and the experiences were often shared with family and friends. Discussion: SED are conceptualized as social and relational phenomena, which may comfort the surviving spouse in late-life bereavement, but also provide tangible help to some experiencers. In clinical practice, SED may be considered a potential resource for the therapeutic grief process.

Psychotic Experiences and Hikikomori in a Nationally Representative Sample of Adult Community Residents in Japan: A Cross-Sectional Study.

Psychotic experiences (PEs) may be associated with hikikomori. In the present study, we analyzed interview data from a community-based representative sample (N = 1,616) in Japan to know the association of PEs over a life time, as well as the two components, hallucinatory experiences (HEs) and delusional experiences (DEs), with lifetime experience of hikikomori (severe social withdrawal). Logistic regression analysis was used to estimate the association between any PE, any HE, and any DE; and hikikomori, adjusting for socio-demographics and other psychopathologies (mental disorder in the past 12 months or having autistic spectrum disorder trait). Any PE was significantly associated with hikikomori [odds ratio (OR) =3.44, 95% CI = 1.14-10.33] after adjustment for sociodemographic factors, although the association attenuated after adjusting for other psychopathologies. Any DE remained significantly associated with hikikomori, even after adjustment for all the covariates (OR = 10.50, 95% CI = 1.57-70.29). Any HE was not significantly associated with hikikomori. DEs may be associated with hikikomori. However, because the study sample was small and the temporal association between DEs and hikikomori was unclear, a future study is needed to examine a causal relationship between DEs and hikikomori.

Autonomic arousal during psychosis spectrum experiences: Results from a high resolution ambulatory assessment study over the course of symptom on- and offset.

INTRODUCTION: Ecological momentary assessment (EMA) studies show that stressors trigger the onset or increase of psychotic symptoms. These studies, however, predominantly rely on large sampling intervals and self-report assessment. This study aims to identify the autonomic stress-response to psychosis-spectrum experiences by using a one-day high-resolution EMA with continuous skin conductance and heart rate monitoring in a sample with attenuated positive symptoms. METHODS: Sixty-two participants were equipped with a smartphone and wearable sensors to monitor skin conductance level (SCL) and heart rate variability (HRV) for 24 h. Every 20 min, participants answered questions on current stress, hallucination spectrum experiences (HSE), and paranoia. Sampling intervals were categorized into no event, pre-onset, event, pre-offset, and post-offset phases. We contrasted stress, SCL, and HRV between phases using multilevel regression models of sampling intervals nested in participants. RESULTS: For paranoia, we found alterations in the autonomic and self-reported stress response prior to the onset that persisted until the episodes had ended. For HSE, we found no effects. Exploratory separate analyses of the different items aggregated into HSE yielded diverging results for intrusive thoughts, perceptual sensitivity, and hallucinations. CONCLUSION: Physiological parameters are sensitive indicators of the onset of paranoia, which holds implications for preventive mobile interventions. To further explore the autonomic stress-response associated with HSE, further studies of the different HSE are needed.

Very early hallucinatory experiences: a school-based study.

BACKGROUND: The prevalence and clinical significance of hallucinatory experiences among children below 7 years of age remain unknown. We aimed to determine the independent influences of sensory deficits, the presence of an imaginary companion and metacognition on hallucinatory experiences. We assumed that hallucinatory experiences were associated with (a) sensory deficits, (b) the presence of an imaginary companion (IC) and (c) metacognition defaults (i.e. first- and second-order theory of mind default). METHODS: All children in the third year of preschool from a region of Northern France underwent medical screening. We compared the prevalence rates of visual, auditory and audio-visual hallucinatory experiences based on (a) the presence of visual or auditory deficits, (b) the actual presence of an IC and (c) metacognition. The analyses were adjusted for age. RESULTS: A total of 1,087 children aged between 5 and 7 years were included. The prevalence rates of auditory, visual and audio-visual hallucinatory experiences were 15.8%, 12.5% and 5.8%, respectively. The prevalences of different types of hallucinatory experiences were not significantly different according to sensory deficit. The prevalences of all types of hallucinatory experiences were significantly higher among children with an IC and among children with metacognition defaults. CONCLUSIONS: The association between hallucinatory experiences and sensory deficits might concern only long-lasting deficits. The association with the presence of an IC confirms experimental findings of the likelihood of perceiving words among meaningless auditory stimuli. Relations between hallucinatory experiences and theory of mind need to be addressed in longitudinal studies.

Psychotic-like experiences and correlation with childhood trauma and other socio-demographic factors: A cross-sectional survey in adolescence and early adulthood in China.

Psychotic-like experiences (PLEs) in adolescence are found to be risk factors for later mental disorders. Previous research has also found that childhood trauma has a positive correlation with mental health problems. However, few studies have focused on the relationship between them, especially in adolescence and early adulthood. A total of 9122 students (age between 10 and 23.3) were surveyed and assessed with the positive and depressive subscales of the Community Assessment of Psychic Experiences and the Trauma History Questionnaire. A total of 20.7% students experienced frequent PLEs, 17.5% had frequent delusional experiences, and 7.6% had frequent hallucinatory experiences. Only a small portion of this sample experienced frequent PLEs, associated with more types of PLEs, more distress, and more depressive experiences. Several socio-demographic factors were associated with frequent PLEs in this sample, which could be further examined in future prevention studies. Students with frequent PLEs experienced significantly higher impact from trauma events, both at the time of the events and in the present, indicating a possible reciprocal effect between childhood trauma and PLEs. The impact of childhood trauma played an important role in the relationship between childhood trauma and PLEs.