Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Ana Catalan^{1

2}, Stefania Tognin^{1

3}, Matthew J Kempton^{1

4}, Daniel Stahl⁵, Gonzalo Salazar de Pablo^{6

7}, Barnaby Nelson^{8

9}, Christos Pantelis¹⁰, Anita Riecher-Rössler¹¹, Rodrigo Bressan¹², Neus Barrantes-Vidal¹³, Marie-Odile Krebs^{14

15}, Merete Nordentoft¹⁶, Stephan Ruhrmann¹⁷, Gabriele Sachs¹⁸, Bart P F Rutten¹⁹, Jim van Os^{1

19

20}, Lieuwe de Haan²¹, Mark van der Gaag^{22

23}; EU-GEI High Risk Study; Lucia R Valmaggia^{4

24}, Philip McGuire^{1

3

4}

Affiliations

¹ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
² Deparment of Mental Health, Biocruces Bizkaia Health Research Institute. Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain.
³ Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK.
⁴ National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK.
⁵ Department of Biostatistics and Health Informatics, King´s College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK.
⁶ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁷ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
⁸ Orygen, Parkville, Victoria, Australia.
⁹ Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
¹⁰ Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia.
¹¹ Medical Faculty, University of Basel, Basel, Switzerland.
¹² Depto Psiquiatria, LiNC - Lab Integrative Neuroscience, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
¹³ Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain.
¹⁴ INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université de Paris, Institut de Psychiatrie (CNRS GDR 3557), Paris, France.
¹⁵ Faculté de Médecine Paris Descartes, GHU Paris - Sainte-Anne, Pôle Hospitalo Universitaire PEPIT C'JAAD, Paris, France.
¹⁶ Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark.
¹⁷ Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
¹⁸ Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
¹⁹ Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.
²⁰ Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands.
²¹ Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands.
²² VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health research institute, Amsterdam, The Netherlands.
²³ Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
²⁴ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

PMID: 33019957
PMCID: PMC9226382
DOI: 10.1017/S0033291720003396

Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Ana Catalan et al. Psychol Med. 2022 Jun.

. 2022 Jun;52(8):1569-1577.

doi: 10.1017/S0033291720003396. Epub 2020 Oct 6.

Authors

Affiliations

¹ Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
² Deparment of Mental Health, Biocruces Bizkaia Health Research Institute. Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU. Plaza de Cruces 12. 48903, Barakaldo, Bizkaia, Spain.
³ Outreach and Support in South London (OASIS) service, South London and Maudsley NHS Foundation Trust, Likondon, UK.
⁴ National Institute for Health Research (NIHR) Biomedical Research Centre (BRC), London, UK.
⁵ Department of Biostatistics and Health Informatics, King´s College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK.
⁶ Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
⁷ Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
⁸ Orygen, Parkville, Victoria, Australia.
⁹ Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
¹⁰ Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia.
¹¹ Medical Faculty, University of Basel, Basel, Switzerland.
¹² Depto Psiquiatria, LiNC - Lab Integrative Neuroscience, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, Brazil.
¹³ Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver, Spanish Mental Health Research Network (CIBERSAM), Madrid, Spain.
¹⁴ INSERM, IPNP UMR S1266, Laboratoire de Physiopathologie des Maladies Psychiatriques, Université de Paris, Institut de Psychiatrie (CNRS GDR 3557), Paris, France.
¹⁵ Faculté de Médecine Paris Descartes, GHU Paris - Sainte-Anne, Pôle Hospitalo Universitaire PEPIT C'JAAD, Paris, France.
¹⁶ Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark.
¹⁷ Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
¹⁸ Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
¹⁹ Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.
²⁰ Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University Medical Centre, Utrecht, The Netherlands.
²¹ Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands.
²² VU University, Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and Amsterdam Public Mental Health research institute, Amsterdam, The Netherlands.
²³ Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands.
²⁴ Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

PMID: 33019957
PMCID: PMC9226382
DOI: 10.1017/S0033291720003396

Abstract

Background: Psychosis is associated with a reasoning bias, which manifests as a tendency to 'jump to conclusions'. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes.

Methods: In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were assessed at baseline, and after 1 and 2 years. A 'beads' task was used to assess reasoning bias. Symptoms and level of functioning were assessed using the Comprehensive Assessment of At-Risk Mental States scale (CAARMS) and the Global Assessment of Functioning (GAF), respectively. During follow up, 58 (16.1%) of the CHR group developed psychosis (CHR-T), and 245 did not (CHR-NT). Logistic regressions, multilevel mixed models, and Cox regression were used to analyse the relationship between reasoning bias and transition to psychosis and level of functioning, at each time point.

Results: There was no association between reasoning bias at baseline and the subsequent onset of psychosis. However, when assessed after the transition to psychosis, CHR-T participants showed a greater tendency to jump to conclusions than CHR-NT and HC participants (55, 17, 17%; χ2 = 8.13, p = 0.012). There was a significant association between jumping to conclusions (JTC) at baseline and a reduced level of functioning at 2-year follow-up in the CHR group after adjusting for transition, gender, ethnicity, age, and IQ.

Conclusions: In CHR participants, JTC at baseline was associated with adverse functioning at the follow-up. Interventions designed to improve JTC could be beneficial in the CHR population.

Keywords: Functioning; psychosis; transition to psychosis; ultra high-risk.

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Conflict of interest statement

None.

Figures

**Fig. 1.**
Level of JTC bias at baseline and 1- and 2-year follow-up. *significant level p < 0.05. JTC, jumping to conclusions; HC, healthy controls; CHR-T, clinical high-risk subjects who made a transition to psychosis; CHR-NT, clinical high-risk subjects who did not make transition to psychosis.

**Fig. 2.**
Relationship between JTC and level of functioning in CHR subjects. GAF means during the follow-up period. JTC, jumping to conclusions; GAF, Global Assessment of Functioning.

See this image and copyright information in PMC

References

1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.
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1. Broome, M. R., Johns, L. C., Valli, I., Woolley, J. B., Tabraham, P., Brett, C., … McGuire, P. K. (2007). Delusion formation and reasoning biases in those at clinical high risk for psychosis. The British Journal of Psychiatry, 191(S51), s38–s42. doi: 10.1192/bjp.191.51.s38 - DOI - PubMed
1. Brown, H., & Prescott, R. (2015). Applied mixed models in medicine (3rd ed.). Chichester, West Sussex: Hoboken: John Wiley & Sons Inc.

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Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Affiliations

Relationship between jumping to conclusions and clinical outcomes in people at clinical high-risk for psychosis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials