Epidemiological findings of psychosis

Untill recently schizophrenia was considered as mainly a genetic disease. More knowledge on genes and environment shows that there is an interplay of genes and environment that can result in certain symptoms and difficulties. On this page you find information about recent research.

General: Heritability of psychosis and social factors

Richard Bentall (University of Liverpool, UK); Title of lecture: “From social risk factors to psychotic symptoms see YouTube

And Richard Bentall clip 2

Latest developments Anne Thorup on IEPA Familial Risk Studies  -Why are they still relevant? The Danish High Risk and Resilience Study, Status, Results and Perpectives

Anne shows that also with children, born out of parents with severe mental illness,  adversity plays a role and tells about very early intervention

One thesis and more general articles from epidemiologic researchers:

Gene-Environment Interactions in Schizophrenia: Review of Epidemiological Findings and Future Directions, Jim van Os, Bart PF Rutten, and Richie Poulton see full text

A recent very informative thesis of Judith Allardyce on the epidemiology of schizophrenia: Epidemiological studies of Schizophrenia see thesis

A continuity of symptoms in society

There is no clear line between those who are sane and those who are mad, argues schizophrenia researcher Robin Murray, he considers schizophrenia as the end of a spectrum. Especially worthwhile are the epidemiological findings he talks about. See You Tube Psychiatrists have for many years regarded conditions such as anxiety or depression as being at the extreme end of a normal distribution of the characteristic. In contrast, traditional psychiatric classification considers disorders such as schizophrenia as discrete conditions qualitatively quite distinct from normality. However, recent surveys have suggested that minor psychotic symptoms are relatively common amongst the general population, and that they are increased by the same factors as increase the risk of schizophrenia. Furthermore, other studies indicate that those diagnosed as psychotic are in many ways rational. This new evidence suggests that a continuum of liability to psychosis exists, and that the mad are saner than is often thought while the normal are not so sane as we commonly assume.

Psychotic like experiences in young adolescence, a large study

Psychotic-like experiences in a community sample of 8000 children aged 9 to 11 years: an item response theory analysis, K. R. Laurens, M. J. Hobbs, M. Sunderland, M. J. Green and G. L. Mould see abstract

The risk of cannabis

Robin Murray on the risk of cannabis, King's College London: The links between cannabis and psychosis, Professor Murray talks about general research in King’s college first, after 15 minutes very informative on his research on cannabis and psychosis see You Tube

Especially cannabis with highTHC is risky 

Skunk-like cannabis' increases risk of psychosis, study suggests see you tube

Communication in the family

In the sixties there was a view that psychosis was produced by the family, than there was a swing to the opinion that ‘’schizophrenia’’ was anything but the fault of the family. It is now more clear that families can do something to prevent vulnerable children from becoming psychotic:

One of the first very careful prospective study is from Tienari et al. Adoptees with a biological parent with a schizophrenia spectrum disorder could be protected for getting psychotic by a family with a healthy communication style: Genotype-environment interaction in schizophrenia-spectrum disorder, Long-term follow-up study of Finnish adoptees, Pekka Tienari, Lyman C. Wynne, Anneli Sorri, Ilpo Lahti, Kristian Läksy, Juha Moring, Mikko Naarala, Pentti Nieminen, Karl-Erik Wahlberg See full text

The importance of the quality of parental communication style has been confirmed: Parental Communication and Psychosis: A Meta-analysis Paulo de Sousa, Filippo Varese, 2 William Sellwood, and Richard P. Bentall. See full text

Jeri Doane investigated communication deviance and found that it predicted psychosis in vulnerable adolescents. There is no free full text article. Parental Communication Deviance and Affective Style. Predictors of Subsequent Schizophrenia Spectrum Disorders in Vulnerable Adolescents, Jeri A. Doane, PhD; Kathryn L. West, PhD; Michael J. Goldstein, PhD; Eliot H. Rodnick, PhD; James E. Jones, PhD Arch Gen Psychiatry. 1981;38(6):679-685. See abstract

More on communication deviance, and its relationship with other family patrons: Intrafamilial Interactive Behavior, Parental Communication Deviance, and Risk for Schizophrenia Julia M. Lewis, Eliot H. Rodnick, and Michael J. Goldstein, University of California, Los Angeles see article

What families can do to prevent psychosis?

Family can learn to have a more supportive, more clear communication style by a consistent family intervention with includes teaching problem solving and communication skills! See

A Randomized Trial of Family Focused Therapy With Populations at Clinical High Risk for Psychosis: Effects on Interactional Behavior Mary P. O’Brien, David J. Miklowitz, Kristin A. Candan, Catherine Marshall, Isabel Domingues, Barbara C. Walsh, Jamie L. Zinberg, Sandra D. De Silva, Kristen A. Woodberry, and Tyrone D. Cannon see full text

Psychosis and trauma general

John Read argues that many people with psychotic symptoms had traumatic experiences in youth see You Tube

further reading of John Read: Models of Madness see frontpage of book

A meta-analysis:

Childhood Adversities Increase the Risk of Psychosis: A Meta-analysis of Patient-Control, Prospective- and Cross-sectional Cohort Studies Filippo Varese Feikje Smeets, Marjan Drukker, Ritsaert Lieverse, Tineke Lataster, Wolfgang Viechtbauer, John Read, Jim van Os and Richard P. Bentall see full text

A prospective study:

Childhood Trauma and Psychosis in a Prospective Cohort Study: Cause, Effect, and Directionality Ian Kelleher, , M.D., Ph.D., Helen Keeley, , M.D., Paul Corcoran, , Ph.D., Hugh Ramsay, , M.D., Camilla Wasserman, , M.A., Vladimir Carli, , M.D., Ph.D., Marco Sarchiapone, , M.D., Christina Hoven, , Dr.P.H., Danuta Wasserman, , M.D., Ph.D., Mary Cannon, , M.D., Ph.D. see full text

A neurodevelopment model:

The traumagenic neurodevelopmental model of psychosis revisited, John Read, Roar Fosse, Andrew Moskowitz & Bruce Perry see full text

Separation from one parent during childhood and other adversities

Social Disadvantage: Cause or Consequence of Impending Psychosis? Simona A. Stilo et al From the abstract: Long term separation from, and death of, a parent before the age of 17 years were both strongly associated with a 2- to 3-fold-increased odds of psychosis. Cases were also significantly more likely to report 2 or more markers of adult social disadvantage than healthy controls (OR = 9.03) at the time of the first presentation with psychosis, independent of a number of confounders. When we repeated these analyses for long-standing adult social disadvantage, we found that the strength of the association decreased but still remained significant for 1 year (OR = 5.67) and 5 years (OR = 2.57) prior to the first contact. Conclusions: Social disadvantage indexes exposure to factors operating prior to onset that increase the risk of psychosis, both during childhood and adulthood. See full text

Modelling the Interplay between Childhood and Adult Adversity in Pathways to Psychosis Initial Evidence from the ÆSOP Study Craig Morgan, PhD et al. From the abstract Building on previous analyses of the AESOP sample, we sought to move beyond identification of single environmental risk factors to examine whether markers of childhood adversity combine with other socio-environmental factors to increase risk of psychosis by testing path (mediation) models and synergistic effects. Three primary findings emerged: (1) there was strong evidence that the effect of separation from (but not death of) a parent on risk of psychosis was partially mediated through subsequent poor educational attainment and social disadvantage and, more tentatively, low self-esteem; (2) there was strong evidence that separation (but not death) interacted synergistically, on an additive scale, with disadvantage to increase risk; and (3) there was no evidence that the mediation or interaction effects varied by ethnicity. The evidence for both mediated and synergistic effects is suggestive of mediated synergy (i.e., of separation from a parent both increasing likelihood of, and interacting with, subsequent social disadvantage). It is notable, moreover, that similar effects were not observed for loss of a parent during childhood. This, of course, may be due to a lack of power given parental loss is relatively rare and therefore needs to be interpreted cautiously. This noted, it raises the possibility that specific factors may have specific effects and operate through different paths and mechanisms, and this merits further consideration in future research. See full text

Psychosis and bullying

Bullying during childhood, whether as a victim or a perpetrator, may increase the risk of developing psychotic experiences in early adulthood, new research suggests.

A community-based study of more than 4700 participants from the United Kingdom showed that those who were bullied at the age of 10 years were more than twice as likely to suffer from episodes of psychosis by the age of 18 as those who were never bullied. Interestingly, children who reported doing the bullying themselves were almost 5 times more likely to have psychotic experiences by the age of 18 years. See full text and Pdf

Why are children bullying? Read this on Empowering parents page. The Secret Life of Bullies: Why They Do It—and How to Stop Them See website

KnowBullying: Put the power to prevent bullying in your hand an app for parents to prevent bullying from SAMSHA KnowBullying empowers parents, caregivers, and educators with the tools they need to start the conversation with their children about bullying. KnowBullying, a 2014 recipient of the Bronze Award in the Mobile category from the Web Health Awards, describes strategies to prevent bullying and explains how to recognize warning signs that a child is bullying, witnessing bullying, or being bullied. Includes a section for educators. See link to app

Psychosis and migration

Schizophrenia among ethnic minorities – a ground breaking thesis from Wim Veling , Dutch epidemiologic researcher. Copy paste in your browser: repub.eur.nl/pub/11610/080312_Veling,%20Willem%20Anne.pdf for downloading his thesis. Moroccan first and secondary migrants had till 8 times more chance to develop psychosis than native persons!

Why have migrants more risk to develop a psychotic disorder, one explanation is the social defeat hypothesis from : Jean-Paul Selten and Elizabeth Cantor-Graae see Pdf

Look for the differences found in cohort of North African migrant group in Israel! Incidence of Schizophrenia Among Second-Generation Immigrants in the Jerusalem Perinatal Cohort Cheryl Corcoran Mary Perrin, Susan Harlap, Lisa Deutsch, Shmuel Fennig, Orly Manor, Daniella Nahon, David Kimhy, Dolores Malaspina and Ezra Susser see full text


Psychosis and fragmented neighborhoods 

When you grow up in a neighborhood where people don’t vote you have more risk of getting a psychosis!

Social fragmentation, deprivation and urbanicity: relation to first-admission rates for psychoses J. Allardyce, e.o. See Pdf

A more recent study confirms this relationship:

Neighborhood-level socio-environmental factors and incidence of first episode psychosis by place at onset in rural Ireland: The Cavan–Monaghan First Episode Psychosis Study Sami Omer, James B. Kirkbride, Dennis G. Pringle Vincent Russell, Eadbhard O'Callaghan and John L. Waddington See full text

Psychosis risk elevated when mother endures severe stress during the first months of pregnancy

Exposure to trauma in the first month in the womb may increase risk for psychosis.

Higher Risk of Offspring Schizophrenia Following Antenatal Maternal Exposure to Severe Adverse Life Events, Ali S. Khashan see full text article

An overview: Offspring psychopathology following preconception, prenatal, and postnatal maternal bereavement stress, Quetzal A. Class e.a. see full text

Lessons learned for public health policy

Translating the epidemiology of psychosis into public mental health: evidence, challenges and future prospects James Kirkbride, Jeremy W Coid, Craig Morgan, Paul Fearon, Paola Dazzan, Min Yang, Tuhina Lloyd, Glynn L Harrison, Robin M Murray, and Peter B Jones see full text

The Prevention of Schizophrenia—What Can We Learn From Eco-Epidemiology? James B. Kirkbride and Peter B. Jones see full text

Latest developments: Max Birchwood on IEPA conference''From childhoodadversity to first episode psychosis'' go to virtual conference and then to 25.50  minutes after beginning. 


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ISPS Journal


The ISPS Journal Psychosis accepts personal and institutional subscriptions. All Individual Members of ISPS and members of regional ISPS groups receive quarterly issues of the journal as a membership benefit.

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