European Psychiatry - Volume 33 - March 2016

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S48 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S18–S55
Subthreshold psychotic experiences in the general
population. Predictors for the development of
psychotic disorders?
S94
Exploring full-blown psychotic
experiences in ‘non-need for care’
populations: Findings from the
UNIQUE Study
E. Peters ∗, T. Ward , M. Jackson , C. Morgan , P. Mc Guire ,
P. Woodruff , P. Garety
1 Institute of Psychiatry-Psychology & Neuroscience (IoPPN), King’s
College London (KCL), Psychology Department, London, United
Kingdom
2 Bangor University, School of Psychology, Bangor, United Kingdom
3 IoPPN-KCL, Health Services & Population Research, London, United
Kingdom
4 IoPPN-KCL, Psychosis Studies, London, United Kingdom
5 University of Sheffield, Academic Psychiatry, Sheffield, United
Kingdom
∗ Corresponding author.
Background People displaying persistent, full-blown psychotic
experiences without a need-for-care in the general population are
an ideal group to investigate to differentiate those factors that
are linked to distress and dysfunction from those that are merely
associated with benign anomalous experiences. The UNIQUE study
investigated the cognitive and social processes predicted by cog-
nitive models of psychosis to differentiate between benign and
pathological outcomes of psychotic experiences (PEs).
Method Two hundred and fifty-nine individuals were recruited
(84 clinical participants with PEs; 92 non-clinical participants with
PEs; 83 controls without PEs) from urban (South-East London)
and rural (North Wales) UK sites. The three groups were com-
pared on clinical and psychological measures, on reasoning tasks,
and on their appraisals of experimental tasks inducing anomalous
experiences (of thought interference symptoms and auditory hal-
lucinations).
Results The clinical picture demonstrated a distinctive pattern
of similarities and differences on PEs between the clinical and non-
clinical groups, while their demographic and psychological profiles
were markedly different. As predicted, the clinical group showed a
‘jump-to-conclusions’ reasoning style, and endorsed more threat-
ening appraisals ratings of the experimentally-induced anomalous
experiences than the non-clinical group, who did not differ from
the controls.
Conclusions The results of this study identified a number of spe-
cific factors that may be protective against transition to psychosis
in individuals with persistent PEs. They also provide robust exper-
imental evidence for the key role of appraisals in determining
outcome, as postulated by cognitive models of psychosis.
Funding Medical research Council, UK.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
S95
Prevention of psychotic disorders in
the general population
W. Rössler
University of Zurich, Psychiatric University Hospital, Zurich,
Switzerland
Subthreshold psychotic experiences are widely reported within
otherwise healthy populations. Their phenomenology is broad and
very heterogeneous ranging from meaningful coincidences and
precognitive dreams over haunting to out-of-body experiences and
visual as well as auditory hallucinations.
Although creative aspects of these experiences are implied too, a
similarity in form and content to positive symptoms in schizophre-
nia (e.g., delusion, disordered thought, and hallucinations) or
schizotypy (e.g. magical thinking, unusual perceptual experiences,
ideas of reference or paranoid ideation) seems to be obvious. How-
ever, the borderline between normal and pathological experiences
and behaviour is unclear.
The so called “continuum approach” assumes that schizophrenia or
schizotypy are not discrete or categorical illness entities. It implies
a gradient in the severity of the symptoms, ranging from healthy
population to full-blown schizophrenia. As such, psychotic signs are
no longer restricted to formal diagnoses according to DSM or ICD,
but would, instead, complete the spectrum of psychological and
biological features that characterize individual variations among
human beings.
Can subthreshold psychotic experiences be integrated in this con-
tinuum? Do individuals indicating such experiences lack some
social cognitive abilities and are particularly vulnerable to false
inferences in their social world. How are these experiences related
to increased neural activity or an abnormal dopaminergic neuro-
transmission?
These and similar questions will be discussed in the presentation.
Disclosure of interest The author has not supplied his declaration
of competing interest.
S96
Psychotic experiences as precursors in
schizophrenia? Findings from a
population-based sample in Germany
(DEGS1-MH)
C. Schmidt-Kraepelin
Medical Faculty, Department of Psychiatry and Psychotherapy,
Düsseldorf, Germany
There are only a few studies that have studied the prevalence of
psychotic experiences (PEs) in a representative population-based
sample and a broad range of age. The association and predictive
role of PEs in the context of psychotic and other mental disorders
remains a subject of discussion. The Mental Health Module of the
German Health Interview and Examination Survey for Adults is the
first wave of a German health monitoring survey describing:
– the distribution and frequency, the severity and the impairments
of a wide range of mental disorders;
– risk factors as well as patterns of help-seeking and health care
utilization;
– associations between mental and somatic disorders.
A total of 4483 participants participated in the mental health
section of the survey. The Composite International Diagnostic Inter-
view, the Launay-Slade Hallucination Scale and the Peter’s Delusion
Inventory were used to assess PEs by clinically experienced inter-
viewers. We can confirm and extend previous findings for younger
age groups that PEs are very frequent psychopathological expres-
sions in the general population across genders and all age groups.
PEs rates were elevated among those with other mental disorders,
particularly among possible psychotic disorders, PTSD and affec-
tive disorders. This points to the relevant role of PEs as a marker for
psychopathology and mental disorders. Future prospective studies
will have to focus on specific properties of psychotic experiences
such as their appraisal or underlying social influences to determine
their significance for the prediction of psychotic and other mental
disorders.
Disclosure of interest The author has not supplied his declaration
of competing interest.