Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model
Open accessAbstract
BACKGROUND: Research suggests that low-grade psychotic experiences in the general population are a common but transitory developmental phenomenon. Using two independent general population samples, the hypothesis was examined that common, non-clinical developmental expression of psychosis may become abnormally persistent when synergistically combined with developmental exposures that may impact on behavioural and neurotransmitter sensitization such as cannabis, trauma and urbanicity. METHOD: The amount of synergism was estimated from the additive statistical interaction between baseline cannabis use, childhood trauma and urbanicity on the one hand, and baseline psychotic experiences on the other, in predicting 3-year follow-up psychotic experiences, using data from two large, longitudinal, random population samples from the Netherlands [The Netherlands Mental Health Survey and Incidence Study (NEMESIS)] and Germany [The Early Developmental Stages of Psychopathology (EDSP) study]. RESULTS: The 3-year persistence rates of psychotic experiences were low at 26% in NEMESIS and 31% in EDSP. However, persistence rates were progressively higher with greater baseline number of environmental exposures in predicting follow-up psychotic experiences (chi2=6.9, df=1, p=0.009 in NEMESIS and chi2=4.2, df=1, p=0.04 in EDSP). Between 21% and 83% (NEMESIS) and 29% and 51% (EDSP) of the subjects exposed to both environmental exposures and psychotic experiences at baseline had persistence of psychotic experiences at follow-up because of the synergistic action of the two factors. CONCLUSION: The findings suggest that environmental risks for psychosis act additively, and that the level of environmental risk combines synergistically with non-clinical developmental expression of psychosis to cause abnormal persistence and, eventually, need for care.
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Three studies have found that presence of both childhood trauma and cannabis use increased the absolute risk of psychosis to a greater degree than the sum of either risk factor alone.
“Three studies have found that presence of both childhood trauma and cannabis use increased the absolute risk of psychosis to a greater degree than the sum of either risk factor alone (42)(43)(44).”
From Association Between Cannabis and Psychosis: Epidemiologic Evidence (2016) · cites this paper as [42]
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- Authors
- COUGNARD, A., MARCELIS, M., MYIN-GERMEYS, I., DE GRAAF, R., VOLLEBERGH, W., KRABBENDAM, L., LIEB, R., WITTCHEN, H.-U., HENQUET, C., SPAUWEN, J., & VAN OS, J.
- Affiliations
- Maastricht University (NL)
- Trimbos Institute (NL)
- Max Planck Institute of Psychiatry (DE)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-02-09
- Volume
- 37
- Issue
- 4
- Pages
- 513-527
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W1967348227
- Cited by
- 276
- References
- 71
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 5 · 2023: 14 · 2022: 8 · 2021: 12 · 2020: 6 · 2019: 13 · 2018: 14 · 2017: 9 · 2016: 13 · 2015: 17 · 2014: 12 · 2013: 21 · 2012: 25
- FWCI
- 13.06
- Type
- journal article
- Language
- en
- Open access
- green
- tud.qucosa.de
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- 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 › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Keywords
- psychosis proneness, psychotic experiences, environmental risk factors, cannabis use, childhood trauma, urbanicity, synergistic interaction, Nemesis
- MeSH terms
- Adolescent, Adult, Delusions, Female, Follow-Up Studies, Hallucinations, Humans, Male, Psychotic Disorders, Surveys and Questionnaires, Risk Factors, Severity of Illness Index, Social Environment, Incidence, Disease Progression, Substance-Related Disorders
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Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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