| Abstrakt: |
Background The concept of a psychosis continuum implies that the same symptoms seen in patients with psychotic disorders can be measured in a healthy population. The assumption is that experiencing symptoms of psychosis such as delusions and hallucinations is not inevitably associated with the presence of the disorder. Surveys of unselected general population samples have consistently shown that a large number of individuals report experiences that strongly resemble the symptoms seen in psychotic patients. Only a fraction of these individuals met criteria for a clinical disorder such as schizophrenia. Alterations in the metabolic system in antipsychotic-naïve first-episode schizophrenia have been described, posing the question whether these metabolic markers are altered in persons with subclinical psychotic experiences as well. Methods We used cross-sectional data of 1890 participants of a prospective population-based cohort study, 'the Rotterdam Study (ERGO)'. The ages ranged from 45 to 54 years and the participants filled in a self-report questionnaire, 'The Community Assessment of Psychic Experience'. To assess subclinical psychotic symptoms, the frequency and distress ratings of the positive symptom dimension from this questionnaire were used. These items were offset against metabolic measured parameters. The metabolic parameters used were body-mass index (BMI; body weight in kg/m2), fasting glucose levels, low-density lipoproteins (LDL), high-density lipoproteins (HDL), triglycerides and cholesterol. Linear regression analyses were used with adjustment for age, gender, ethnicity, education level, employment status and marital status. The influences of psychopharmacology use, anxiety disorder, depressive symptoms and use of lipid reducing agents on the subclinical psychotic symptoms were analysed in sensitivity analyses. Results We observed a strong positive association between BMI and the frequency of subpsychotic symptoms, and also with the perceived distress of these subpsychotic symptoms. In participants with a BMI ≥ 30 we observed an even stronger association with the frequency score and distress rating of subpsychotic symptoms. In a restricted sample to non-lipid reducing agent users only, we observed that LDL is negatively associated with the frequency of subpsychotic symptoms and perceived distress of these subpsychotic symptoms. For HDL, we observed a negative association with only the frequency of subpsychotic symptoms. The other metabolic markers, total cholesterol, triglycerides and fasting glucose, did not show any significant associations with subpsychotic symptoms. The use of psychopharmaceuticals, the presence of an anxiety disorder or experiencing depressive symptoms did not alter our results. Discussion In this study of a large community sample we found that increased BMI and metabolic dysfunctions are associated with subclinical psychotic experiences. Our findings add to the evidence that psychotic phenomena are related to alterations in the metabolism and obesity even without antipsychotic medication use. Noticeably, this association seems also to hold for subclinical psychotic phenomena, present in the normal population. [ABSTRACT FROM AUTHOR] |
