Clinical presentation of psychotic experiences in patients with common mental disorders attending the UK primary care improving access to psychological therapies (IAPT) Programme

作者：Anna Wiedemann, Jan Štochl, Debra A Russo, Ushma Patel, Polly‐Anna Ashford, Naima Samreen Ali, Peter B. Jones, Jesús Pérez · 发表于：Journal of Affective Disorders · 年份：2023 · DOI：10.1016/j.jad.2023.10.073 · 被引用次数：9 · 研究领域：Schizophrenia research and treatment、Mental Health and Psychiatry、Mental Health Treatment and Access

BACKGROUND: Improving Access to Psychological Therapies (IAPT) services address anxiety and depression in primary care, with psychotic disorders typically excluded. Our previous research found 1 in 4 patients report distressing psychotic experiences (PE) alongside common mental disorders, yet little is known about their clinical presentation and impact on recovery. METHODS: We used the Community Assessment of Psychic Experiences - Positive Scale (CAPE-P15) to assess the clinical presentation and symptomatic profile of PE within IAPT settings across three National Health Service (NHS) trusts, serving a diverse population in Southern England. We identified different classes based on the reported PE frequencies using latent class analysis. RESULTS: A total of 2042 IAPT patients completed the CAPE-P15. The mean age was 39.8 (±15.3) years. We identified five distinct classes of symptom profiles, findings that PE were common, especially self-referential and persecutory ideas. Prevalence and intensity increased across classes, extending to bizarre experiences and perceptual abnormalities in the fifth and least common class. Perceptual abnormalities were a strong indicator of symptom severity, with patients being the least likely to achieve recovery by the end of treatment. LIMITATIONS: Data were collected during a service evaluation. Replication of these findings across other IAPT services could prove beneficial. We did not collect information on negative PE. CONCLUSIONS: Patients s...