Specificity of Predictors for “Psychosis” and “Neurosis”: A Comparison in a 50-Year Follow-Up of the Unselected Lundby Community Population

Mats Bogren and Cecilia Mattisson

Affiliation : Department of Clinical Sciences, Division of Psychiatry, the Lundby Study, Lund University Hospital, Lund, Sweden

ABSTRACT

Premorbid anomalies related to personality and behavior may confer an increased risk of developing psychosis. Prospective studies have found that social anxiety, social adjustment problems, deviance in emotional reactivity, high neuroticism, low extraversion, psychoticism, features of schizotypy, neurocognitive impairment, and anhedonia are associated with an increased risk of developing schizophrenia spectrum disorders.

As some of these factors—e.g., anxiety, neuroticism, and psychoticism—have also been found to be associated with depression, however, it is possible that such deviances related to personality and behavior may reflect an increased risk of developing any mental disorder, thus raising the question whether there are any premorbid traits that are specifically related to psychosis. We studied whether certain clusters of premorbid behavioral and personality-related signs and symptoms were predictors of “nonaffective and/or affective psychosis” and “neurosis,” respectively, in a 50-year prospective study of a complete general community population (n = 3563).

Although we found that most personality-related predictors are probably shared between “psychosis” and “neurosis” outcomes, the result also suggested that premorbid proneness to anxiety, impairment in experiencing pleasure, affective flattening, cluster A resembling traits, hypersensitiveness, and distractibility may be more strongly related to the risk of developing “psychosis” than “neurosis.” Furthermore, impairments in experiencing pleasure and affective flattening may show some superior specificity for the risk of developing “psychosis” in comparison with “neurosis,” which accords with the hypothesis that psychosis proneness may be related to a salience disorder.


Correspondence: Mats Bogren, Department of Clinical Sciences, Division of Psychiatry, the Lundby Study, Lund University Hospital, St Lars,
SE-221 85 Lund, Sweden. Tel: +46 46 174321 ; Fax: +46 46 174647; e-mail: [email protected]

 

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