ArticleWorld psychiatry : official journal of the World Psychiatric Association (WPA)2020
Association of preceding psychosis risk states and non-psychotic mental disorders with incidence of clinical psychosis in the general population: a prospective study in the NEMESIS-2 cohort.
Article in World psychiatry : official journal of the World Psychiatric Association (WPA), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis.Molecular psychiatry · 2024Pooled it
- Meta-analytic prevalence of comorbid mental disorders in individuals at clinical high risk of psychosis: the case for transdiagnostic assessment.Molecular psychiatry · 2023Pooled it
- Public health primary prevention implemented by clinical high-risk services for psychosis.Translational psychiatry · 2022Pooled it
- The associations between migrant status and ethnicity and the identification of individuals at ultra-high risk for psychosis and transition to psychosis: a systematic review.Social psychiatry and psychiatric epidemiology · 2021Pooled it
- The Staging Model in Psychosis and Preventive Interventions: An Emerging Field With Debates on Conceptual Models and Interpretation of the Evidence Base.Early intervention in psychiatry · 2026Review
- Transdiagnostic prevention in youth mental health, Part I: rationale, shared risk factors.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Do Obsessive-Compulsive Symptoms Increase the Risk of Developing Psychosis? A Systematic Review and Meta-analysis.Schizophrenia bulletin open · 2026Article
- Transdiagnostic prevention in youth mental health, Part II: interventions.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Review
- Does treatment of adolescent depression reduce risk of later psychosis: A quasi-experimental study of selective serotonin reuptake inhibitor treatment in a total population cohort.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- The impact of affective and negative symptoms on the development of psychosis in a six-year follow-up of a community-based population.Social psychiatry and psychiatric epidemiology · 2025Article
- Exposome-Wide Gene-By-Environment Interaction Study of Psychotic Experiences in the UK Biobank.Biological psychiatry global open science · 2025Article
- PSYSCAN multi-centre study: baseline characteristics and clinical outcomes of the clinical high risk for psychosis sample.Schizophrenia (Heidelberg, Germany) · 2025Article
- The Complex Latent Structure of Attenuated Psychotic Symptoms: Hierarchical and Bifactor Models of SIPS Symptoms Replicated in Two Large Samples at Clinical High Risk for Psychosis.Schizophrenia bulletin · 2024Article
- An exploratory study of psychosis risk factors in individuals who are referred but do not meet criteria for an early intervention in psychosis service.BJPsych open · 2024Article
- Associations between digital media use and psychotic experiences in young adults of Quebec, Canada: a longitudinal study.Social psychiatry and psychiatric epidemiology · 2024Article
- Psychometric Properties and Diagnostic Associations of the Short-Form Community Assessment of Psychic Experiences in a Population-Based Sample of 29 021 Adult Men.Schizophrenia bulletin · 2023Article
- Sampling from different populations: Sociodemographic, clinical, and functional differences between samples of first episode psychosis individuals and clinical high-risk individuals who progressed to psychosis.Schizophrenia research · 2023Article
- Associations with youth psychotic-like experiences over time: Evidence for trans-symptom and specific cognitive and neural risk factors.Journal of psychopathology and clinical science · 2023Article
- ContextPsychological medicine · 2023Article
- "It has to be better, otherwise we will get stuck." A Review of Novel Directions for Mental Health Reform and Introducing Pilot Work in the Netherlands.Clinical practice and epidemiology in mental health : CP & EMH · 2023Review
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The validity and clinical utility of the concept of "clinical high risk" (CHR) for psychosis have so far been investigated only in risk-enriched samples in clinical settings. In this population-based prospective study, we aimed - for the first time - to assess the incidence rate of clinical psychosis and es-timate the population attributable fraction (PAF) of that incidence for preceding psychosis risk states and DSM-IV diagnoses of non-psychotic mental disorders (mood disorders, anxiety disorders, alcohol use disorders, and drug use disorders). All analyses were adjusted for age, gender and education. The incidence rate of clinical psychosis was 63.0 per 100,000 person-years. The mutually-adjusted Cox proportional hazards model indicated that preceding diagnoses of mood disorders (hazard ratio, HR=10.67, 95% CI: 3.12-36.49), psychosis high-risk state (HR=7.86, 95% CI: 2.76-22.42) and drug use disorders (HR=5.33, 95% CI: 1.61-17.64) were associated with an increased risk for clinical psychosis incidence. Of the clinical psychosis incidence in the population, 85.5% (95% CI: 64.6-94.1) was attributable to prior psychopathology, with mood disorders (PAF=66.2, 95% CI: 33.4-82.9), psychosis high-risk state (PAF=36.9, 95% CI: 11.3-55.1), and drug use disorders (PAF=18.7, 95% CI: -0.9 to 34.6) as the most important factors. Although the psychosis high-risk state displayed a high relative risk for clinical psychosis outcome even after adjusting for other psychopathology, the PAF was comparatively low, given the low prevalence of psychosis high-risk states in the population. These findings provide empirical evidence for the "prevention paradox" of targeted CHR early intervention. A comprehensive prevention strategy with a focus on broader psychopathology may be more effective than the current psychosis-focused approach for achieving population-based improvements in prevention of psychotic disorders.
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