Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study

D'Andrea, Giuseppe, Quattrone, Diego, Malone, Kathryn, Tripoli, Giada, Trotta, Giulia, Spinazzola, Edoardo, Gayer-Anderson, Charlotte, Jongsma, Hannah, Sideli, Lucia, Stilo, Simona, La Cascia, Caterina, Ferraro, Laura, Lasalvia, Antonio, Tosato, Sarah, Tortelli, Andrea, Velthorst, Eva, de Haan, Lieuwe, Llorca, Pierre-Michel, Menezes, Paulo Rossi, Santos, Jose Luis, Arrojo, Manuel, Bobes, Julio, Sanjuan, Julio, Bernado, Miguel, Arango, Celso, Kirkbride, James, Jones, Peter, Rutten, Bart, Van Os, Jim, Selten, Jean-Paul, Vassos, Evangelos, Schurhoff, Franck, Szoke, Andrei, Pignon, Baptiste, O'Donovan, Michael ORCID: https://orcid.org/0000-0001-7073-2379, Richards, Alexander, Morgan, Craig, Di Forti, Marta, Tarricone, Ilaria and Murray, Robin 2024. Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study. Psychological Medicine 54 (8) , pp. 1810-1823. 10.1017/S0033291723003781

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Abstract

Background Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. Methods We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. Results Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. Conclusions Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	Cambridge University Press
ISSN:	0033-2917
Date of First Compliant Deposit:	9 January 2024
Date of Acceptance:	20 December 2023
Last Modified:	04 Jun 2024 14:37
URI:	https://orca.cardiff.ac.uk/id/eprint/165377

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