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Cited by 960Schizophrenia research and treatmentMental Health and PsychiatryHallucinations in medical conditions

THE CONTINUITY OF PSYCHOTIC EXPERIENCES IN THE GENERAL POPULATION

Johns, Louise C, van Os, Jim·2001·Clinical Psychology Review
DOI 10.1016/s0272-7358(01)00103-9
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Abstract

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.

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  • Non-clinical and clinical psychotic experiences exist on the same continuum, supported by similar environmental and psychological factors in both groups.

    “The evidence is threefold supporting the idea that non-clinical and clinical psychotic experiences exist on the same continuum: in both groups they are associated with similar environmental (e.g. trauma, cannabis use) and psychological factors (e.g. anomalous experiences, worry) (Freeman et al., 2010b, Johns and van Os, 2001)”

    From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Johns and van Os, 2001

  • Psychotic symptoms (e.g., delusions, hallucinations) exist in a continuum ranging from normality to pathology.

    “The first one refers to the idea that psychotic symptoms (e.g., delusions, hallucinations) exist in a continuum ranging from normality to pathology (Carvalho, Pinto-Gouveia, Peixoto, & Motta, 2014;Johns & Van Os, 2001;Shevlin, McElroy, Bentall, Reininghaus, & Murphy, 2016;Van Os, Linscott, Myin-Germeys, Delespaul, & Krabbendam, 2009).”

    From Contextual Cognitive-Behavioral Therapies Across the Psychosis Continuum: A Review of Evidence for Schizophrenia, Schizoaffective and Bipolar Disorders (2017) · cites this paper as Johns & Van Os, 2001

  • Psychosis lies on a continuum with normality.

    “As well as offering a purer assessment of the emergence of psychotic experiences, this approach is inspired by growing evidence suggesting that psychosis lies on a continuum with normality (19,20) and is associated with a range of different psychiatric disorders (15,21).”

    From Shift toward prior knowledge confers a perceptual advantage in early psychosis and psychosis-prone healthy individuals (2015) · cites this paper as [19]

  • The finding that healthy individuals who score high on CAPS share this marker with the clinical group is in line with the growing belief that psychotic mental illnesses are part of a continuum with normality.

    “The finding that healthy individuals that score high on this scale share this marker with our clinical group is in line with the growing belief that psychotic mental illnesses are part of a continuum with normality (19,20).”

    From Shift toward prior knowledge confers a perceptual advantage in early psychosis and psychosis-prone healthy individuals (2015) · cites this paper as [19]

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Authors
Johns, L. C., & van Os, J.
Affiliations
University of Manchester (GB)
ORCID
Johns, Louise C
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2001-11
Volume
21
Issue
8
Pages
1125-1141
ISSN
0272-7358 (ISSN-L)
DOI
10.1016/s0272-7358(01)00103-9
OpenAlex
W2146069882
Cited by
960
References
100
Citations by year
2026: 23 · 2025: 30 · 2024: 20 · 2023: 31 · 2022: 37 · 2021: 37 · 2020: 46 · 2019: 33 · 2018: 44 · 2017: 63 · 2016: 59 · 2015: 50 · 2014: 42 · 2013: 41 · 2012: 58
FWCI
2.77
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Psychology Review (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
Keywords
schizophrenia, psychotic symptoms, dimensional model of psychosis, hallucinations, delusions, positive and negative symptoms, categorical models, general population
MeSH terms
Delusions, Hallucinations, Humans, Personality, Psychotic Disorders, Risk Factors, Schizophrenia, Schizophrenic Psychology

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