Skip to main content

Advertisement

SpringerLink
Log in

The 3-year progression of clinically significant psychotic-like experiences in a general adult population in Lagos, Nigeria

  • Original Paper
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

The study assessed the 3-year progression of clinically significant psychotic-like experience (CS-PLE) symptoms in an adult general population in terms of stability or remission of symptoms and transition to psychosis.

Methods

Participants (n = 1292) aged 18–65 years with CS-PLE were assessed at baseline for sociodemographic details, family history of mental illness, functioning status, common mental disorders, alcohol, and substance use disorders. Three years later they were reassessed for diagnosis of psychosis, presence or remission of PLE symptoms, and contact with mental health services.

Results

The mean age of the participants at baseline in years was 36.56 (SD = 11.66) and there were 855 (66.2%) females. By the 3rd year follow-up, 95 (7.3%) had transited to psychosis, while 850 (65.5%) had persistent CS-PLE symptoms and the rest 347 (27.2%) were in remission. Only history of mental illness in the immediate family (HR 4.81, 95% CI 1.40–16.47, P = 0.013) and regular use of cannabis at less than 18 years of age (HR 0.65, 95% CI 0.55–0.77, P < 0.001) were the independent predictors of conversion to psychosis at 3 years.

Conclusion

The rate of TTP in the non-clinical population with elevated risk may be lower than that earlier reported in the western literature. Interventions aimed at preventing transition to psychosis in high risk groups must pay attention to early onset users of cannabis and those with family history of mental illness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. McGrath JJ, Saha S, Al-Hamzawi A, Alonso J, Bromet EJ, Bruffaerts R, Caldas-de-Almeida JM, Chiu WT, de Jonge P, Fayyad J, Florescu S (2015) Psychotic experiences in the general population: a cross-national analysis based on 31 261 respondents from 18 countries. JAMA Psychiat 72(7):697–705

    Article  Google Scholar 

  2. Preti A, Cella M, Raballo A, Vellante M (2012) Psychotic-like or unusual subjective experiences? The role of certainty in the appraisal of the subclinical psychotic phenotype. Psychiatry Res 200(2–3):669–673

    Article  Google Scholar 

  3. Van Os J, Linscott RJ, Myin-Germeys I, Delespaul P, Krabbendam LJ (2009) A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychol Med 39(2):179–195

    Article  Google Scholar 

  4. Lee KW, Chan KW, Chang WC, Lee EH, Hui CL, Chen EY (2016) A systematic review on definitions and assessments of psychotic-like experiences. Early Interv Psychiatry 10(1):3–16

    Article  Google Scholar 

  5. Hinterbuchinger B, Mossaheb N (2021) Psychotic-like experiences: a challenge in definition and assessment. Front Psychol 29(12):582392

    Article  Google Scholar 

  6. Kempton MJ, Bonoldi I, Valmaggia L, McGuire P, Fusar-Poli P (2015) Speed of psychosis progression in people at ultra-high clinical risk: a complementary meta-analysis. JAMA Psychiat 72(6):622–623

    Article  Google Scholar 

  7. Velthorst E, Nieman DH, Klaassen RM, Becker HE, Dingemans PM, Linszen DH, De Haan L (2011) Three-year course of clinical symptomatology in young people at ultra high risk for transition to psychosis. Acta Psychiatr Scand 123(1):36–42

    Article  CAS  Google Scholar 

  8. Nelson B, Yuen HP, Wood SJ, Lin A, Spiliotacopoulos D, Bruxner A, Broussard C, Simmons M, Foley DL, Brewer WJ, Francey SM, Amminger GP, Thompson A, McGorry PD, Yung AR (2013) Long-term follow-up of a group at ultra high risk (“prodromal”) for psychosis: the PACE 400 study. JAMA Psychiat 70(8):793–802

    Article  Google Scholar 

  9. Salokangas RK, Ruhrmann S, von Reventlow HG, Heinimaa M, Svirskis T, From T, Luutonen S, Juckel G, Linszen D, Dingemans P, Birchwood M, Patterson P, Schultze-Lutter F, Klosterkötter J; EPOS group (2012) Axis I diagnoses and transition to psychosis in clinical high-risk patients EPOS project: prospective follow-up of 245 clinical high-risk outpatients in four countries. Schizophr Res 138(2–3):192–7.

  10. Buchy L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Heinssen R, Bearden CE, Mathalon D, Addington J (2015) Substance use in individuals at clinical high risk of psychosis. Psychol Med 45(11):2275–2284

    Article  CAS  Google Scholar 

  11. Kraan T, Velthorst E, Koenders L, Zwaart K, Ising HK, van den Berg D, de Haan L, van der Gaag M (2016) Cannabis use and transition to psychosis in individuals at ultra-high risk: review and meta-analysis. Psychol Med 46(4):673–681

    Article  CAS  Google Scholar 

  12. Valmaggia LR, Day FL, Jones C, Bissoli S, Pugh C, Hall D, Bhattacharyya S, Howes O, Stone J, Fusar-Poli P, Byrne M, McGuire PK (2014) Cannabis use and transition to psychosis in people at ultra-high risk. Psychol Med 44(12):2503–2512

    Article  CAS  Google Scholar 

  13. Santesteban-Echarri O, Sandel D, Liu L, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Tsuang MT, Walker EF, Woods SW, Addington J (2022) Family history of psychosis in youth at clinical high risk: a replication study. Psychiatry Res 24(311):114480

    Article  Google Scholar 

  14. Chan CT, Abdin E, Subramaniam M, Tay SA, Lim LK, Verma S (2019) Two-year clinical and functional outcomes of an Asian cohort at ultra-high risk of psychosis. Front Psychiatry 25(9):758

    Article  Google Scholar 

  15. Fusar-Poli P, Tantardini M, De Simone S, Ramella-Cravaro V, Oliver D, Kingdon J, Kotlicka-Antczak M, Valmaggia L, Lee J, Millan MJ, Galderisi S, Balottin U, Ricca V, McGuire P (2017) Deconstructing vulnerability for psychosis: Meta-analysis of environmental risk factors for psychosis in subjects at ultra high-risk. Eur Psychiatry 40:65–75

    Article  CAS  Google Scholar 

  16. Fusar-Poli P, Rocchetti M, Sardella A, Avila A, Brandizzi M, Caverzasi E, Politi P, Ruhrmann S, McGuire P (2015) Disorder, not just state of risk: meta-analysis of functioning and quality of life in people at high risk of psychosis. Br J Psychiatry 207(3):198–206

    Article  Google Scholar 

  17. Velthorst E, Nelson B, Wiltink S, de Haan L, Wood SJ, Lin A, Yung AR (2013) Transition to first episode psychosis in ultra high risk populations: does baseline functioning hold the key? Schizophr Res 143(1):132–137

    Article  Google Scholar 

  18. Davies C, Segre G, Estradé A, Radua J, De Micheli A, Provenzani U, Oliver D, Salazar de Pablo G, Ramella-Cravaro V, Besozzi M, Dazzan P, Miele M, Caputo G, Spallarossa C, Crossland G, Ilyas A, Spada G, Politi P, Murray RM, McGuire P, Fusar-Poli P (2020) Prenatal and perinatal risk and protective factors for psychosis: a systematic review and meta-analysis. Lancet Psychiatry 7(5):399–410

  19. Mamah D, Musau A, Mutiso VN, Owoso A, Abdallah AB, Cottler LB, Striley CW, Walker EF, Ndetei DM (2016) Characterizing psychosis risk traits in Africa: a longitudinal study of Kenyan adolescents. Schizophr Res 176(2–3):340–348

    Article  Google Scholar 

  20. Adewuya AO, Ola BA, Coker O, Atilola O, Olugbile O, Fasawe A, Idris O, Oladipo OE, Adewumi T, Asmal L, Emsley R (2022) The one-month prevalence and correlates of psychotic-like experiences in the general adult population in Nigeria. Curr Psychol 24:1–1

    Google Scholar 

  21. National Bureau of Statistics (2014) Lagos Household Survey. Central Office of Statistics (COS) Lagos State Government

  22. Adewuya AO, Atilola O, Ola BA, Coker OA, Zachariah MP, Olugbile O, Fasawe A, Idris O (2018) Current prevalence, comorbidity and associated factors for symptoms of depression and generalised anxiety in the Lagos State Mental Health Survey (LSMHS). Nigeria Compr Psychiatry 81:60–65

    Article  Google Scholar 

  23. Adewuya AO, Ola BA, Coker O, Atilola O, Olugbile O, Ajomale T, Fasawe A, Idris O (2021) Descriptive epidemiology of alcohol use in the Lagos State Mental Health Survey (LSMHS), Nigeria. Int J Ment Heal Addict 19(5):1787–1798

    Article  Google Scholar 

  24. Kish L (1985) Survey sampling. Wiley, New York

    Google Scholar 

  25. Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613

    Article  CAS  Google Scholar 

  26. Spitzer RL, Kroenke K, Williams JB, Löwe B (2006) A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 166(10):1092–1097

    Article  Google Scholar 

  27. Kroenke K, Spitzer RL, Williams JB (2002) The PHQ-15: validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med 64(2):258–266

    Article  Google Scholar 

  28. Adewuya AO, Ola BA, Afolabi OO (2006) Validity of the patient health questionnaire (PHQ-9) as a screening tool for depression amongst Nigerian university students. J Affect Disord 96(1–2):89–93

    Article  Google Scholar 

  29. Sheehan DV, Lecrubier Y, Sheehan KH et al (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59 Suppl 20, 22–57

  30. Ustün TB, Chatterji S, Kostanjsek N et al & WHO/NIH Joint Project (2010) Developing the World Health Organization Disability Assessment Schedule 2.0. Bulletin of the World Health Organization 88(11):815–823

  31. Loewy RL, Pearson R, Vinogradov S, Bearden CE, Cannon TD (2011) Psychosis risk screening with the Prodromal Questionnaire—brief version (PQ-B). Schizophr Res 129(1):42–46

    Article  Google Scholar 

  32. Okewole AO, Ajogbon D, Adeniji AA et al (2015) Psychosis risk screening among secondary school students in Abeokuta, Nigeria: validity of the Prodromal Questionnaire - Brief Version (PQ-B). Schizophr Res 164(1–3):281–282

    Article  CAS  Google Scholar 

  33. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, Barale F, Caverzasi E, McGuire P (2012) Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69(3):220–229

    Article  Google Scholar 

  34. Schmidt SJ, Schultze-Lutter F, Schimmelmann BG, Maric NP, Salokangas RK, Riecher-Rössler A, van der Gaag M, Meneghelli A, Nordentoft M, Marshall M, Morrison A, Raballo A, Klosterkötter J, Ruhrmann S (2015) EPA guidance on the early intervention in clinical high risk states of psychoses. Eur Psychiatry 30(3):388–404

    Article  CAS  Google Scholar 

  35. Fusar-Poli P, Cappucciati M, Rutigliano G, Lee TY, Beverly Q, Bonoldi I, Lelli J, Kaar SJ, Gago E, Rocchetti M, Patel R, Bhavsar V, Tognin S, Badger S, Calem M, Lim K, Kwon JS, Perez J, McGuire P (2016) Towards a standard psychometric diagnostic interview for subjects at ultra high risk of psychosis: CAARMS versus SIPS. Psychiatry J 2016:7146341

    Article  CAS  Google Scholar 

  36. Temesgen WA, Chien WT, Bressington D (2019) Factors influencing subjective recovery of people with recent-onset psychosis: a cross-sectional study in a low-income Sub-Saharan country. Psychiatry Res 274:421–429

    Article  Google Scholar 

  37. Kolliakou A, Joseph C, Ismail K, Atakan Z, Murray RM (2011) Why do patients with psychosis use cannabis and are they ready to change their use? Int J Dev Neurosci 29(3):335–346

    Article  Google Scholar 

  38. Gage SH, Zammit S, Hickman M (2013) Stronger evidence is needed before accepting that cannabis plays an important role in the aetiology of schizophrenia in the population. F1000 Med Rep 5

  39. Chadwick B, Miller ML, Hurd YL (2013) Cannabis use during adolescent development: susceptibility to psychiatric illness. Front Psychiatry 14(4):129

    Google Scholar 

  40. Zhang T, Xu L, Tang Y, Li H, Tang X, Cui H, Wei Y, Wang Y, Hu Q, Liu X, Li C, Lu Z, McCarley RW, Seidman LJ, Wang J; SHARP (ShangHai At Risk for Psychosis) Study Group (2019) Prediction of psychosis in prodrome: development and validation of a simple, personalized risk calculator. Psychol Med 49(12):1990–1998

  41. Georgopoulos G, Stowkowy J, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon DH, Addington J (2019) The role of a family history of psychosis for youth at clinical high risk of psychosis. Early Interv Psychiatry 13(2):251–256

    Article  Google Scholar 

  42. Kristensen K, Cadenhead KS (2007) Cannabis abuse and risk for psychosis in a prodromal sample. Psychiatry Res 151(1–2):151–154

    Article  Google Scholar 

  43. Ciarleglio AJ, Brucato G, Masucci MD, Altschuler R, Colibazzi T, Corcoran CM, Crump FM, Horga G, Lehembre-Shiah E, Leong W, Schobel SA, Wall MM, Yang LH, Lieberman JA, Girgis RR (2019) A predictive model for conversion to psychosis in clinical high-risk patients. Psychol Med 49(7):1128–1137

    Article  Google Scholar 

  44. Fusar-Poli P, Nelson B, Valmaggia L, Yung AR, McGuire PK (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophr Bull 40(1):120–131

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from the Ministry of Health, Lagos State, Nigeria (Award number LSS001). The Lagos State Government had no other contribution to the article.

Author information

Authors and Affiliations

  1. Department of Behavioral Medicine, Lagos State University College of Medicine, 1-5, Oba Akinjobi Way, GRA, Ikeja, Lagos, Nigeria

    Abiodun O. Adewuya

  2. Centre for Mental Health Research and Initiative, Lagos, Nigeria

    Abiodun O. Adewuya, Olabisi E. Oladipo & Tomilola Imarah

  3. Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa

    Laila Asmal & Robin Emsley

Authors
  1. Abiodun O. Adewuya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Olabisi E. Oladipo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomilola Imarah
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Laila Asmal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robin Emsley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Abiodun O. Adewuya.

Ethics declarations

Conflict of interest

The authors declare that they have no known competing financial interest or personal relationships that could have appeared to influence the work reported in this paper.

Ethics approval

Approval was obtained from the ethics committees of Lagos State University Teaching Hospital (LASUTH) and Stellenbosch University (SU). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Adewuya, A.O., Oladipo, O.E., Imarah, T. et al. The 3-year progression of clinically significant psychotic-like experiences in a general adult population in Lagos, Nigeria. Soc Psychiatry Psychiatr Epidemiol 58, 91–103 (2023). https://doi.org/10.1007/s00127-022-02358-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-022-02358-z

Keywords

Search

Navigation