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Psychotic experiences and mood episodes predict each other bidirectionally: a 6-year follow-up study in a community-based population

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Abstract

Background

Psychotic experiences (PEs) are not exclusive to psychotic disorders and highly correlated with mood episodes. In this representative general population-based study, longitudinal bidirectional associations between the extended psychosis phenotype and mood episodes were investigated, accounting for other possible causes.

Methods

Households were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011) and at 6-year follow-up (n = 2185). Participants were interviewed with the relevant sections of the composite international diagnostic interview both at baseline and at follow-up. Sociodemographic, familial and environmental risk factors associated with the extended psychosis phenotype and mood episodes were assessed. Logistic regression and cross-lagged panel correlation models were used for the associations between the extended psychosis phenotype and mood episodes.

Results

PEs were associated with subsequent depressive and manic episodes. There was bidirectionality in that mood episodes were associated with subsequent PEs, and PEs were associated with subsequent mood episodes. The associations occurred in a sub-additive pattern. There were substantial synchronous and cross-lagged correlations between these psychopathology domains, with reciprocally similar cross-lagged correlations. Familial risk and adverse life events were associated with both psychopathology domains, whereas some sociodemographic risk factors and alcohol/cannabis use were associated with only one domain.

Conclusion

The sub-additive bidirectional associations between PEs and mood episodes over time and the similarity of cross-lagged correlations are suggestive of mutually causal connections between affective and psychotic domains of psychopathology.

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Funding

This work is part of the TürkSch project and is funded by the Scientific and Technological Council of Turkey 1001 programme, project nos: 107S053 and 112S476.

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Authors and Affiliations

  1. Psychiatry Unit, Van Education and Research Hospital, Van, Turkey

    Umut Kırlı

  2. Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands

    Umut Kırlı, Marjan Drukker & Jim van Os

  3. Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, 35340, Izmir, Turkey

    Tolga Binbay & Köksal Alptekin

  4. Department of Psychosis Studies, Institute of Psychiatry, King’s Health Partners, King’s College London, London, UK

    Jim van Os

  5. Department of Psychiatry, Brain Center Rudolf Magnus Institute, University Medical Center Utrecht, Utrecht, The Netherlands

    Jim van Os

  6. Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey

    Bülent Kayahan & Hayriye Elbi

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  1. Umut Kırlı
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  2. Tolga Binbay
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  4. Jim van Os
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  5. Köksal Alptekin
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Correspondence to Tolga Binbay.

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Kırlı, U., Binbay, T., Drukker, M. et al. Psychotic experiences and mood episodes predict each other bidirectionally: a 6-year follow-up study in a community-based population. Soc Psychiatry Psychiatr Epidemiol 54, 331–341 (2019). https://doi.org/10.1007/s00127-018-1641-8

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