Temporal dynamics of suspiciousness and hallucinations in clinical high risk and first episode psychosis

Karlijn Hermans*, Yori van der Steen, Zuzana Kasanova, Ruud van Winkel, Ulrich Reininghaus, Tineke Lataster, Andreas Bechdolf, Judith Gimpel-Drees, Michael Wagner, Inez Myin-Germeys

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Web of Science)

Abstract

The objective of the current study is to elucidate the temporal dynamics of suspiciousness and hallucinations as they occur in daily life in the early stages of psychosis. Their prevalence and co-occurrence, as well as their temporal relation to affect and delusions, were compared between patients with a first psychotic episode (FEP) and individuals at clinical high risk for psychosis (CHRp). The Experience Sampling Method was used to investigate suspiciousness and hallucinatory experiences, delusions, and affect at semi-random moments throughout six days in 33 CHRp and 34 FEP. Overall, 91% of CHRp and 59% of FEP reported suspiciousness, and 24% and 39% reported hallucinations, respectively. Hallucinations almost always co-occurred with suspiciousness, whereas suspiciousness was often present without hallucinations. Suspicious episodes in CHRp occurred with marked increases in delusional intensity, while hallucinatory experiences were mostly absent. In FEP, a decrease of positive affect preceded suspicious episodes, while an increase of negative affect preceded hallucinatory episodes. Our results indicated the presence of a delusional mood (atmosphere) in CHRp as an experience in itself, without co-occurring or following hallucinations, thus refuting the anomalous experience hypothesis of psychosis. The co-occurrence of hallucinations, on the other hand, indicates a more severe stage of symptomatology.

Original languageEnglish
Article number113039
Number of pages8
JournalPsychiatry Research
Volume290
DOIs
Publication statusPublished - Aug 2020

Keywords

  • ANOMALOUS SELF-EXPERIENCE
  • AUDITORY HALLUCINATIONS
  • COMPREHENSIVE ASSESSMENT
  • DELUSIONS
  • DEPRESSION
  • ESTEEM
  • Early stage psychosis
  • Experience sampling methodology
  • INDIVIDUALS
  • PARANOIA
  • PERSISTENCE
  • Positive psychotic symptoms
  • SYMPTOMS
  • PSYCHOLOGY

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