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Betz LT, Penzel N, Kambeitz-Ilankovic L, et al. General psychopathology links burden of recent life events and psychotic symptoms in a network approach. NPJ Schizophr. 2020;6(1):40doi: 10.1038/s41537-020-00129-w.
Betz, L. T., Penzel, N., Kambeitz-Ilankovic, L., Rosen, M., Chisholm, K., Stainton, A., Haidl, T. K., Wenzel, J., Bertolino, A., Borgwardt, S., Brambilla, P., Lencer, R., Meisenzahl, E., Ruhrmann, S., Salokangas, R. K. R., Schultze-Lutter, F., Wood, S. J., Upthegrove, R., Koutsouleris, N., Kambeitz, J. (2020). General psychopathology links burden of recent life events and psychotic symptoms in a network approach. NPJ schizophrenia, 6(1), 40. https://doi.org/10.1038/s41537-020-00129-w
Betz, Linda T, et al. "General psychopathology links burden of recent life events and psychotic symptoms in a network approach." NPJ schizophrenia vol. 6,1 (2020): 40. doi: https://doi.org/10.1038/s41537-020-00129-w
Betz LT, Penzel N, Kambeitz-Ilankovic L, Rosen M, Chisholm K, Stainton A, Haidl TK, Wenzel J, Bertolino A, Borgwardt S, Brambilla P, Lencer R, Meisenzahl E, Ruhrmann S, Salokangas RKR, Schultze-Lutter F, Wood SJ, Upthegrove R, Koutsouleris N, Kambeitz J. General psychopathology links burden of recent life events and psychotic symptoms in a network approach. NPJ Schizophr. 2020 Dec 15;6(1):40. doi: 10.1038/s41537-020-00129-w. PMID: 33319805; PMCID: PMC7738498.
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NPJ Schizophr. 2020 Dec 15;6(1):40. doi: 10.1038/s41537-020-00129-w.

General psychopathology links burden of recent life events and psychotic symptoms in a network approach.

NPJ schizophrenia

Linda T Betz, Nora Penzel, Lana Kambeitz-Ilankovic, Marlene Rosen, Katharine Chisholm, Alexandra Stainton, Theresa K Haidl, Julian Wenzel, Alessandro Bertolino, Stefan Borgwardt, Paolo Brambilla, Rebekka Lencer, Eva Meisenzahl, Stephan Ruhrmann, Raimo K R Salokangas, Frauke Schultze-Lutter, Stephen J Wood, Rachel Upthegrove, Nikolaos Koutsouleris, Joseph Kambeitz,

Affiliations

  1. Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany. [email protected].
  2. Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.
  3. Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
  4. Institute for Mental Health, University of Birmingham, Birmingham, UK.
  5. Department of Psychology, Aston University, Birmingham, UK.
  6. Orygen, Melbourne, VIC, Australia.
  7. Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
  8. Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy.
  9. Department of Psychiatry (UPK), University of Basel, Basel, Switzerland.
  10. Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany.
  11. Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
  12. Department of Psychiatry, University of Münster, Münster, Germany.
  13. Otto Creutzfeldt Center for Behavioral and Cognitive Neuroscience, University of Münster, Münster, Germany.
  14. Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
  15. Department of Psychiatry, University of Turku, Turku, Finland.
  16. Department of Psychology and Mental Health, Faculty of Psychology, Airlangga University, Surabaya, Indonesia.
  17. Max-Planck Institute of Psychiatry, Munich, Germany.
  18. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

PMID: 33319805 PMCID: PMC7738498 DOI: 10.1038/s41537-020-00129-w

Abstract

Recent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

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