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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; ... Murray, Robin M; + view all (2024) Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study. Psychological Medicine pp. 1-14. 10.1017/S0033291723003781. (In press). Green open access

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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.

Type: Article
Title: Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S0033291723003781
Publisher version: http://dx.doi.org/10.1017/s0033291723003781
Language: English
Additional information: Copyright © The Author(s), 2024. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Keywords: Incidence of psychosis; psychotic experiences; psychosis prevention; schizotypy; subclinical psychosis; psychosis spectrum; psychosis epidemiology
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research
URI: https://discovery.ucl.ac.uk/id/eprint/10186918
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