DSM outcomes of psychotic experiences and associated risk factors: 6-year follow-up study in a community-based sample

Umut Kirli, Tolga Binbay, Marjan Drukker, Hayriye Elbi, Bulent Kayahan, Duygu Keskin Gokcelli, Ferda Ozkinay, Huseyin Onay, Koksal Alptekin, Jim van Os

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Psychotic experiences (PEs) may predict a range of common, non-psychotic disorders as well as psychotic disorders. In this representative, general population-based cohort study, both psychotic and non-psychotic disorder outcomes of PE were analysed, as were potential moderators.

METHODS: Addresses were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011). Participants were interviewed with the Composite International Diagnostic Interview (CIDI) both at baseline and at 6-year follow-up. Participants with PE at baseline were clinically re-interviewed with the SCID-I at follow-up. The role of socio-demographics, characteristics of PE, co-occurrence of mood disorders and family history of mental disorders were tested in the association between baseline PE and follow-up diagnosis.

RESULTS: In the participants with baseline PE, the psychotic disorder diagnosis rate at follow up was 7.0% - much lower than the rates of DSM-IV mood disorders without psychotic features (42.8%) and other non-psychotic disorders (24.1%). Within the group with baseline PE, female sex, lower socio-economic status, co-occurrence of mood disorders, family history of a mental disorder and persistence of PE predicted any follow-up DSM diagnosis. Furthermore, onset of psychotic v. non-psychotic disorder was predicted by younger age (15-30 years), co-presence of delusional and hallucinatory PE and family history of severe mental illness.

CONCLUSION: The outcome of PE appears to be a consequence of baseline severity of multidimensional psychopathology and familial risk. It may be useful to consider PE as a risk indicator that has trans-diagnostic value.

Original languageEnglish
Pages (from-to)1346-1356
Number of pages11
JournalPsychological Medicine
Issue number8
Early online date13 Aug 2018
Publication statusPublished - Jun 2019


  • type of psychotic experiences
  • non-psychotic disorders
  • persistence of psychotic experiences
  • mood disorders
  • psychotic experiences
  • family history of mental disorders
  • Community-based population
  • psychotic disorders
  • follow-up study
  • socio-demographic factors


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