Psychosis as a transdiagnostic and extended phenotype in the general population
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A large body of research indicates that weak expressions of positive psychotic symptoms (“psychotic experiences”) can be measured in the general population, and likely represent the behavioural manifestation of distributed multifactorial (genetic and non‐genetic) risk for psychosis. Psychotic experiences are a transdiagnostic phenomenon: the majority of individuals with these experiences have a diagnosis of non‐psychotic disorder, particularly common mental disorder, in which psychotic experiences predict greater illness severity and poorer treatment response. Some of the people with common mental disorder and psychotic experiences will present to mental health services meeting criteria for “clinical high risk”. Treatment of the transdiagnostic dimension of psychosis in individuals with common mental disorder who meet “clinical high risk” criteria thus may improve outcome (which cannot be interpreted as prevention of “schizophrenia”). Subthreshold psychotic experiences are transitory in about 80% of individuals, while around 20% go on to develop persistent psychotic experiences and 7% a psychotic disorder, with an annual transition rate of 0.5‐1%. Persistence is associated, on the one hand, with environmental exposures, particularly childhood trauma, and, on the other, with network‐type dynamic interactions between psychotic experiences themselves (e.g., interactions between hallucinatory experiences and delusional ideation) and between symptom dimensions (e.g., interactions between affective symptoms and psychotic experiences, or interactions between subthreshold negative symptoms and psychotic experiences). The study of psychotic experiences is helping to elucidate the mechanisms by which environmental and genetic influences shape the transdiagnostic expression of psychosis proneness, that is mostly transitory but may first become persistent over time and eventually give rise to transition to a psychotic disorder.
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Current models of autism are strikingly similar to the predictive coding account of psychosis.
“For example, current models of autism are strikingly similar to the predictive coding account of psychosis (118–120)”
From The Predictive Coding Account of Psychosis (2018) · cites this paper as [119]
The Neurocognition, Aberrant Salience, Reasoning Biases and the Extended Psychosis Phenotype section discusses top-down processing and salience in psychosis, but does not compare psychosis models with autism models. Searches for predictive coding and autism-related models found no passage addressing the claimed similarity. Page numbers were unavailable in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measured'Psychotic experiences' are relatively frequent at the population level (prevalence about 8% in young adults aged 24) and can be measured through self-administered questionnaires.
“For example, 'psychotic experiences' 159 are relatively frequent at the population level (prevalence about 8% in young adults aged 24 160 ) and can be measured through self-administered questionnaires (e.g., Prodromal Questionnaire, PQ) 161”
From Preventive psychiatry: a blueprint for improving the mental health of young people (2021) · cites this paper as [159]
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Lataster, T., Myin‐Germeys, I., Derom, C. A., Thiery, E. W., & van Os, J. (2009) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30933 · Cited by 46 · see citing works
Jeppesen, P., Larsen, J. T., Clemmensen, L., Munkholm, A., Rimvall, M. K., Rask, C. U., van Os, J., Petersen, L. V., & Skovgaard, A. M. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu167 · Cited by 46 · see citing works
Barnett, J. H., McDougall, F., Xu, M. K., Croudace, T. J., Richards, M., & Jones, P. B. (2012) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.102053 · Cited by 45 · see citing works
Can we identify and treat "schizophrenia light" to prevent true psychotic illness?
van Os, J., & Murray, R. M. (2013) · BMJ · doi:10.1136/bmj.f304 · Cited by 44 · see citing works
Ethnic identity, perceptions of disadvantage, and psychosis
Reininghaus, U., Craig, T., Fisher, H. L., Hutchinson, G. A., Fearon, P., Morgan, K. D., Dazzan, P., Doody, G. A., Jones, P. B., Murray, R. M., et al. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.08.038 · Cited by 44 · see citing works
Self-citationSmeets, F., Lataster, T., Viechtbauer, W., Delespaul, P., & G.R.O.U.P. (2014) · Schizophrenia Bulletin · doi:10.1093/schbul/sbu122 · Cited by 35 · see citing works
Catalan, A., Simons, C. J. P., Bustamante, S., Drukker, M., Madrazo, A., de Artaza, M. G., Gorostiza, I., van Os, J., & Gonzalez-Torres, M. A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0102520 · Cited by 32 · see citing works
The transdiagnostic dimension of psychosis: implications for psychiatric nosology and research.
van Os, J. (2015) · Europe PMC (PubMed Central) · doi:10.11919/j.issn.1002-0829.215041 · Cited by 23 · see citing works
Weiser, M., Reichenberg, A., Kravitz, E., Lubin, G., Shmushkevich, M., Glahn, D. C., Gross, R., Rabinowitz, J., Noy, S., & Davidson, M. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.05.029 · Cited by 18 · see citing works
Reininghaus, U., Kempton, M. J., Craig, T., et al. (2014) · Schizophrenia Research · doi:10.1016/s0920-9964(14)71011-4 · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 6
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“Third, predictive coding can relate psychosis to “normal” brain function, which may help to destigmatize the disorder (92): psychosis may be understood as a variety of brain function, in line with the so-called continuum view (119), which considers psychotic symptoms as extreme expressions of normal traits.”
BackgroundPreventive psychiatry: a blueprint for improving the mental health of young people
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- Authors
- van Os, J., & Reininghaus, U.
- Affiliations
- Department of Psychiatry and Psychology Maastricht University Medical Centre P.O. Box 616 (DOT12) 6200 MD Maastricht The Netherlands
- King's College London (GB)
- Venue
- World Psychiatry
- Publisher
- Wiley
- Published
- 2016-06
- Volume
- 15
- Issue
- 2
- Pages
- 118-124
- ISSN
- 1723-8617 (ISSN-L)
- 2051-5545
- PMC
- PMC4911787
- OpenAlex
- W2442768873
- Cited by
- 531
- References
- 98
- Citations by year
- 2026: 40 · 2025: 47 · 2024: 40 · 2023: 52 · 2022: 52 · 2021: 71 · 2020: 69 · 2019: 47 · 2018: 58 · 2017: 42 · 2016: 13
- FWCI
- 46.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- World Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Lirias (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Organization for Autism Research (451‐13‐022)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- psychotic experiences, extended phenotype, common mental disorders, clinical high risk, psychosis proneness, transition to psychosis, childhood trauma, hallucinations, delusional ideation, negative symptoms, psychosis prevention
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