Lack of association between psychosis-like experiences and seeking help from professionals: a case-controlled study

Backgrounds: It still remains unclear whether individuals who experience attenuated psychotic symptoms are likely to seek help, whereas depressive symptoms are more likely to be associated with help-seeking behavior than these symptoms themselves. The aims of our study were to compare the profile of these symptoms between clinical and community samples and to investigate to what extent help-seeking behavior depends on the severity of psychosis-like symptoms and/or depressive symptoms.

Methods: The clinical sample consisted of help-seeking outpatients aged 16-30 years who had approached a community mental health clinic (N=750, mean age: 23.3±4.2 years, 62.4% females). The community sample was comprised of students from two universities and two high schools (N=781, mean age: 18.1±1.7 years, 59.2% females). Psychosis-like experiences were assessed using the PRIME Screen-Revised (PS-R), a self-reported screening instrument for assessing the risk of psychosis. Depressive symptoms were assessed using the Zung Self-rating Depression Scale (ZSDS), a 20-item self-reported questionnaire.

Results: Among the clinical and community samples, 27% and 10% had positive PS-R results respectively. No significant difference in the PS-R total score or the frequency of PS-R-positive items was observed between the clinical and community samples. A logistic regression analysis revealed that none of the psychosis-like experiences were significantly associated with help-seeking behavior, after controlling for the effect of depressive symptoms.

Conclusions: Our findings showed that attenuated psychotic symptoms do not contribute significantly to help-seeking behavior, suggesting that the relationships among PLEs, depressive symptoms, and help-seeking behavior should be reconsidered.