A qualitative comparison of psychotic-like phenomena in clinical and non-clinical populations

Objectives. To explore the nature and context of psychotic-like phenomena in clinical (C) and non-clinical (NC) participants, and to investigate whether the factors involved with triggering a psychotic-like out-of-the-ordinary experience (OOE) can be distinguished from those determining its clinical consequences.

Design and methods. Qualitative data were collected by semi-structured interviews, and analysed using interpretative phenomenological analysis (IPA). Twelve participants, who reported OOEs starting in the last 5 years, were split into C and NC groups depending on whether they were involved with mental-health services as a result of their experiences. Inter-group comparisons of emergent themes were made.

Results. Inter-group similarities were found in the triggers and subjective nature of experiences, with clearer group differences in the inter-personal and background personal contexts, and how the experiences were incorporated into their lives. In particular, the inter-personal theme of validation was identified as important in distinguishing the clinical consequences of OOEs.

Conclusions. It is not the OOE itself that determines the development of a clinical condition, but rather the wider personal and interpersonal contexts that influence how this experience is subsequently integrated. Theoretical implications for the refinement of psychosis models are outlined, and clinical implications for the validation and normalization of psychotic-like phenomena are proposed.