The continuity of psychotic experiences in the general population.

Schizophrenia is a severe mental illness that affects 1% of the population. The diagnosis is made according to current diagnostic systems of DSM-IV (American Psychiatric Association, 1994) and ICD-10 (World Health Association, 1992) on the basis of characteristic 'positive' and 'negative' symptoms. The traditional medical model assumes a categorical view of the schizophrenia syndrome and its core symptoms, in which differences between psychotic symptoms and their normal counterparts are considered to be qualitative. An alternative, dimensional approach assumes that schizophrenia is not a discrete illness entity, but that psychotic symptoms differ in quantitative ways from normal experiences and behaviours. This paper reviews evidence for the continuity of psychotic symptoms with normal experiences, focusing on the symptoms of hallucinations and delusions. It concludes by discussing the theoretical and treatment implications of such a continuum.

[1]  G. Claridge Single indicator of risk for schizophrenia: probable fact or likely myth? , 1994, Schizophrenia bulletin.

[2]  L. J. Chapman,et al.  Putatively psychosis-prone subjects 10 years later. , 1994, Journal of abnormal psychology.

[3]  G. Nestadt,et al.  Screening for Psychosis in the General Population with a Self‐Report Interview , 1991, The Journal of nervous and mental disease.

[4]  P. McKellar Experience and behaviour , 1963 .

[5]  E. Kuipers,et al.  A cognitive model of the positive symptoms of psychosis , 2001, Psychological Medicine.

[6]  P. Costa,et al.  Covariance of personality, neurocognition, and schizophrenia spectrum traits in the community , 1992, Schizophrenia Research.

[7]  Gordon Claridge,et al.  Theoretical background and issues , 1997 .

[8]  J. Os,et al.  Strauss (1969) revisited: A psychosis continuum in the general population? , 2000, Schizophrenia Research.

[9]  J. Strauss Hallucinations and delusions as points on continua function. Rating scale evidence. , 1969, Archives of general psychiatry.

[10]  M. Losch,et al.  Auditory Hallucinations of Hearing Voices in 375 Normal Subjects , 1983 .

[11]  M. Romme,et al.  Coping with Hearing Voices: An Emancipatory Approach , 1992, British Journal of Psychiatry.

[12]  S. Landau,et al.  Group treatment of auditory hallucinations , 1999, British Journal of Psychiatry.

[13]  S. Weich,et al.  EDITORIAL Prevention of the common mental disorders: a public health perspective , 1997, Psychological Medicine.

[14]  L. J. Chapman,et al.  Magical ideation and social anhedonia as predictors of psychosis proneness: a partial replication. , 1997, Journal of abnormal psychology.

[15]  F. Huppert,et al.  Changes in the prevalence of psychiatric disorder in a community are related to changes in the mean level of psychiatric symptoms , 1996, Psychological Medicine.

[16]  K. Kendler,et al.  Schizotypal personality disorder in parents and the risk for schizophrenia in siblings. , 1995, Schizophrenia bulletin.

[17]  A. Yung,et al.  Is Pre-Psychotic Intervention Realistic in Schizophrenia and Related Disorders? , 1997, The Australian and New Zealand journal of psychiatry.

[18]  P. Kinderman A multicentre, randomised controlled trial of cognitive- behaviour therapy in first- and second-episode schizophrenia: The SoCRATES trial , 1999 .

[19]  H. Hoijtink,et al.  The multidimensionality of self-report schizotypy in a psychiatric population: an analysis using multidimensional Rasch models. , 2000, Schizophrenia bulletin.

[20]  R. Murray,et al.  Urbanization and psychosis: a study of 1942–1978 birth cohorts in The Netherlands , 1998, Psychological Medicine.

[21]  Measurement of Delusional Ideation in the Normal Population: Introducing the PDI (Peters et al. Delusions Inventory) , 1999 .

[22]  S. Wessely,et al.  Reasoning in Deluded Schizophrenic and Paranoid Patients: Biases in Performance on a Probabilistic Inference Task , 1991, The Journal of nervous and mental disease.

[23]  F. Huppert,et al.  Normality, deviance and minor psychiatric morbidity in the community , 1993, Psychological Medicine.

[24]  C. Frith,et al.  Exploring ‘theory of mind’ in people with schizophrenia , 1996, Psychological Medicine.

[25]  M. Lenzenweger Confirming schizotypic personality configurations in hypothetically psychosis-prone university students , 1991, Psychiatry Research.

[26]  Gordon Claridge,et al.  Schizotypy: Implications for Illness and Health , 2002 .

[27]  R. Kessler,et al.  Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. , 1996, Archives of general psychiatry.

[28]  R. Bentall,et al.  The multidimensional nature of schizotypal traits: a factor analytic study with normal subjects. , 1989, The British journal of clinical psychology.

[29]  A. Caspi,et al.  Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. , 2000, Archives of general psychiatry.

[30]  R. Bentall,et al.  The factor structure of "schizotypal' traits: a large replication study. , 1996, The British journal of clinical psychology.

[31]  R. Salamon,et al.  A survey of delusional ideation in primary-care patients , 1998, Psychological Medicine.

[32]  P. Liddle The Symptoms of Chronic Schizophrenia , 1987, British Journal of Psychiatry.

[33]  K. Kendler,et al.  Boundaries of major depression: an evaluation of DSM-IV criteria. , 1998, The American journal of psychiatry.

[34]  I. Falloon,et al.  Early intervention for first episodes of schizophrenia: a preliminary exploration. , 1992, Psychiatry.

[35]  P. Garety,et al.  Cognitive approaches to delusions: a critical review of theories and evidence. , 1999, The British journal of clinical psychology.

[36]  P. Venables,et al.  The structure of schizotypy, its relation to subdiagnoses of schizophrenia and to sex and age. , 1994, The British journal of clinical psychology.

[37]  R. Bijl,et al.  The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design , 1998, Social Psychiatry and Psychiatric Epidemiology.

[38]  M. Vollema Schizotypy: toward the psychological heart of schizophrenia , 1999 .

[39]  W. Gattaz,et al.  Search for the Causes of Schizophrenia , 1987, Springer Berlin Heidelberg.

[40]  E. Peters,et al.  Delusional ideation in religious and psychotic populations. , 1999, The British journal of clinical psychology.

[41]  John K. Wing,et al.  Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and Catego Program , 1974 .

[42]  D. Barker,et al.  Epidemiology for the uninitiated. What is a case? Dichotomy or continuum? , 1978, British medical journal.

[43]  Philip K McGuire,et al.  Verbal self-monitoring and auditory hallucinations in schizophrenia , 1999, The Lancet.

[44]  G. Dunn,et al.  The London-East Anglia randomized controlled trial of cognitive-behaviour therapy for psychosis. IV: Self-esteem and persecutory delusions. , 1998, The British journal of clinical psychology.

[45]  J. Nazroo,et al.  Occurrence of hallucinations in a community sample , 1998, Schizophrenia Research.

[46]  Mike C. Jackson,et al.  New scales for the assessment of schizotypy , 1995 .

[47]  R. Bentall,et al.  Reality testing and auditory hallucinations: a signal detection analysis. , 1985, The British journal of clinical psychology.

[48]  van den Robert Bosch,et al.  The multidimensionality of schizotypy. , 1995, Schizophrenia bulletin.

[49]  P. Tata,et al.  The Rust Inventory of Schizotypal Cognitions RISC , 2022 .

[50]  Gilles Launay,et al.  The measurement of hallucinatory predisposition in male and female prisoners. , 1981 .

[51]  R. Murray,et al.  Puberty and the onset of psychosis , 1993, Schizophrenia Research.

[52]  B. Maher,et al.  Delusional thinking and perceptual disorder. , 1974, Journal of individual psychology.

[53]  G. Claridge Final remarks and future directions , 1997 .

[54]  B. Maher,et al.  Anomalous experience and delusional thinking: The logic of explanations. , 1988 .

[55]  J. Gold,et al.  Cognitive rehabilitation for schizophrenia: problems, prospects, and strategies. , 1999, Schizophrenia bulletin.

[56]  J. Os,et al.  Is early adulthood a critical developmental stage for psychosis proneness? A survey of delusional ideation in normal subjects , 1998, Schizophrenia Research.

[57]  J. Gruzelier The factorial structure of schizotypy: Part I. Affinities with syndromes of schizophrenia. , 1996, Schizophrenia bulletin.

[58]  G C Patton,et al.  Monitoring and care of young people at incipient risk of psychosis. , 1996, Schizophrenia bulletin.

[59]  P. Huxley Mental Illness in the Community , 1981 .

[60]  A. Tien,et al.  Distributions of hallucinations in the population. , 1991, Social psychiatry and psychiatric epidemiology.

[61]  P. Venables,et al.  The content and structure of schizotypy: a study using confirmatory factor analysis. , 2000, Schizophrenia bulletin.

[62]  V. Carr Patients' techniques for coping with schizophrenia: an exploratory study. , 1988, The British journal of medical psychology.

[63]  J. Os,et al.  Psychosis as an Extreme of Continuous Variation in Dimensions of Psychopathology , 1999 .

[64]  J. Jenner,et al.  Effectiveness of cognitive therapy with coping training for persistent auditory hallucinations a retrospective study of attenders of a psychiatric out‐patient department , 1998, Acta psychiatrica Scandinavica.

[65]  E. Kuipers The Management of Difficult to Treat Patients with Schizophrenia, Using Non-drug Therapies , 1996, British Journal of Psychiatry.

[66]  G. Dunn,et al.  Cognitive behavioural therapy for drug-resistant psychosis. , 1994, The British journal of medical psychology.

[67]  H. Häfner What is schizophrenia? Changing perspectives in epidemiology. , 1988, European Archives of Psychiatry and Neurological Sciences.

[68]  L. J. Chapman,et al.  Body-image aberration in Schizophrenia. , 1978, Journal of abnormal psychology.

[69]  V. Peralta,et al.  Are There More Than Two Syndromes in Schizophrenia? , 1992, British Journal of Psychiatry.

[70]  J. Os,et al.  Characteristics of early- and late-diagnosed schizophrenia: implications for first-episode studies , 1998, Schizophrenia Research.

[71]  J. Os,et al.  Prevalence of psychotic disorder and community level of psychotic symptoms: an urban-rural comparison. , 2001, Archives of general psychiatry.

[72]  J. Os,et al.  Risk factors for onset and persistence of psychosis , 1998, Social Psychiatry and Psychiatric Epidemiology.

[73]  G. Claridge,et al.  Schizotypy and hemisphere function—I: Theoretical considerations and the measurement of schizotypy , 1984 .

[74]  T. R. Barrett,et al.  Verbal hallucinations in normals, I: People who hear ‘voices’ , 1992 .

[75]  L. J. Chapman,et al.  Scales for physical and social anhedonia. , 1976, Journal of abnormal psychology.

[76]  M. Jackson Benign schizotypy? The case of spiritual experience. , 1997 .

[77]  P. Delespaul,et al.  MACS‐II: does coping enhance subjective control over psychotic symptoms? , 2001, Acta psychiatrica Scandinavica.

[78]  A. Raine,et al.  Cognitive-perceptual, interpersonal, and disorganized features of schizotypal personality. , 1994, Schizophrenia bulletin.

[79]  P. Jones,et al.  The new epidemiology of schizophrenia. , 1998, The Psychiatric clinics of North America.

[80]  P. Delespaul,et al.  Maastricht Assessment of Coping Strategies (MACS‐I): a brief instrument to assess coping with psychotic symptoms , 2001, Acta psychiatrica Scandinavica.

[81]  P. Delespaul,et al.  Early detection of schizophrenia , 1997, British Journal of Psychiatry.

[82]  T. McGlashan,et al.  Early detection and intervention of schizophrenia: rationale and research , 1998, British Journal of Psychiatry.

[83]  A. Raine The SPQ: a scale for the assessment of schizotypal personality based on DSM-III-R criteria. , 1991, Schizophrenia bulletin.

[84]  H. Häfner [Is schizophrenia a disease? Epidemiologic data and speculative conclusions]. , 1989, Der Nervenarzt.

[85]  K. Kendler,et al.  Recurrence risks in an oligogenic threshold model: the effect of alterations in allele frequency , 1986, Annals of human genetics.

[86]  N. Tarrier,et al.  Randomised controlled trial of intensive cognitive behaviour therapy for patients with chronic schizophrenia , 1998, BMJ.

[87]  J. Whittington Normality, deviance and minor psychiatric morbidity in the community – a re-interpretation , 1996, Psychological Medicine.

[88]  R. Bentall,et al.  The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions. , 1994, Behaviour research and therapy.

[89]  K. Kendler,et al.  The Roscommon Family Study. III. Schizophrenia-related personality disorders in relatives. , 1993, Archives of general psychiatry.

[90]  R. Bentall,et al.  Disposition towards hallucination, gender and EPQ scores: a brief report , 1986 .

[91]  K. Kendler,et al.  Schizotypal symptoms and signs in the Roscommon Family Study. Their factor structure and familial relationship with psychotic and affective disorders. , 1995, Archives of general psychiatry.

[92]  R. Bilder,et al.  Symptomatic and neuropsychological components of defect states. , 1985, Schizophrenia bulletin.