Jim van Os

• MD, PhD
• Head of Department at University Medical Center Utrecht

We propose renaming schizophrenia to Positive and Negative Symptoms Disorder (PND) to reduce stigma, enhance clarity, and align with current diagnostic criteria. The term reflects core symptom domains, is translatable, ICD compatible, and avoids misleading associations. If cognitive deficits should be part of the name, it would be Positive, Negativ...

While antipsychotic maintenance treatment effectively prevents relapse after a first psychotic episode, many remitted antipsychotic users wish to reduce or discontinue their medication, due to side effects, long‐term health concerns, stigma, or the desire to regain autonomy. Current guidelines suggest gradual tapering, but what the optimal speed of...

Purpose: To investigate sex-dependent effects of polygenic risk (PRS-SCZ) and exposome score (ES-SCZ) for schizophrenia, both independently and jointly, on distressing psychotic experiences (PEs) in early adolescents. Method: Baseline to 3-year follow-up data of the Adolescent Brain and Cognitive Development Study (ABCD) were used. PRS-SCZ and ES-S...

Clozapine is highly effective for treatment-resistant schizophrenia but is underutilized due to patient and clinician-related concerns. Little is known about the general level of patient satisfaction with clozapine and determinants thereof. We therefore explored determinants of patient satisfaction with clozapine in individuals diagnosed with schiz...

This study aimed to assess the independent and joint associations of genomic and exposomic liabilities for schizophrenia with distressing psychotic experiences (PEs) and their persistence in early adolescence. The Adolescent Brain and Cognitive Development Study data from children with European ancestry were used ( N = 5122). The primary outcome wa...

Background Psychosis-related environmental risks in autism, along with genetic overlaps between autism and psychosis, have been well-established. However, their moderating roles in the relationship between autistic traits (ATs) and psychotic experiences (PEs) remain underexplored. Methods First-wave data from 792 twins and siblings (mean age: 17.4...

Background Previous studies identified clusters of first-episode psychosis (FEP) patients based on cognition and premorbid adjustment. This study examined a range of socio-environmental risk factors associated with clusters of FEP, aiming a) to compare clusters of FEP and community controls using the Maudsley Environmental Risk Score for psychosis...

Background Recent stressful life events (SLE) are a risk factor for psychosis, but limited research has explored how SLEs affect individuals at clinical high risk (CHR) for psychosis. The current study investigated the longitudinal effects of SLEs on functioning and symptom severity in CHR individuals, where we hypothesized CHR would report more SL...

Background Multiple genetic and environmental risk factors play a role in the development of both schizophrenia-spectrum disorders and affective psychoses. How they act in combination is yet to be clarified. Methods We analyzed 573 first episode psychosis cases and 1005 controls, of European ancestry. Firstly, we tested whether the association of...

Background The association between cannabis and psychosis is established, but the role of underlying genetics is unclear. We used data from the EU-GEI case-control study and UK Biobank to examine the independent and combined effect of heavy cannabis use and schizophrenia polygenic risk score (PRS) on risk for psychosis. Methods Genome-wide associa...

Background and Hypothesis: Psychosis-related environmental risks are common in autism, with identified genetic connections to psychosis. Therefore, we hypothesized these risks may moderate the relationship between autistic traits (ATs) and psychotic experiences (PEs). Study Design: First-wave data from 792 twins and siblings in the TwinssCan Projec...

Background Cannabis use and familial vulnerability to psychosis have been associated with social cognition deficits. This study examined the potential relationship between cannabis use and cognitive biases underlying social cognition and functioning in patients with first episode psychosis (FEP), their siblings, and controls. Methods We analyzed a...

To assess the longitudinal associations of genomic and exposomic liabilities for schizophrenia, both independently and jointly, with distressing psychotic experiences (PEs) and their persistence in early adolescence. The Adolescent Brain and Cognitive Development Study data from children with European ancestry were used (n=5,122). The primary outco...

Purpose The Clinical High Risk (CHR) concept has a limited transition risk to psychotic disorders (PD). This study investigates the association between affective and negative symptoms, currently not included in the CHR concept, and the risk of transition to PD in a community-based population of 2185 participants in Turkey. Methods Participants wer...

Background Urbanicity is a well‐established risk factor for psychosis. Our recent multi‐national study found an association between urbanicity and clinical psychosis in Northern Europe but not in Southern Europe. In this study, we hypothesized that the effect of current urbanicity on variation of schizotypy would be greater in North‐western Europe...

Childhood adversity is associated with various clinical dimensions in psychosis; however, how genetic vulnerability shapes the adversity-associated psychopathological signature is yet to be studied. We studied data of 583 First Episode Psychosis (FEP) cases from the EU-GEI FEP case-control study, including Polygenic risk scores for major depressive...

Background Previous studies assessing the hypothesis that the construct of ‘aberrant salience’ is associated with psychosis and psychotic symptoms showed conflicting results. For this reason, the association between measures to index aberrant salience and subclinical psychotic symptoms in a general population sample was analysed. In addition, genet...

The rising prevalence and legalisation of cannabis worldwide have underscored the need for a comprehensive understanding of its biological impact, particularly on mental health. Epigenetic mechanisms, specifically DNA methylation, have gained increasing recognition as vital factors in the interplay between risk factors and mental health. This study...

Background: Suicide is a major cause of death among youth. Childhood trauma (CT) has emerged as a leading environmental risk factor for suicidal ideation (SI). The present study intends to understand the association between CT and SI in a sample of twins, highlighting the relevance of CT per se, regardless of genetic vulnerability. Methods: Data w...

The Diagnostic and Statistical Manual of Mental Disorders, abbreviated as the DSM, is one of mental health care’s most commonly used classification systems. While the DSM has been successful in establishing a shared language for researching and communicating about mental distress, it has its limitations as an empirical compass. In the transformatio...

This study examined and reflected on the frequency of people with psychotic symptoms and features as the target population in design studies for mental health care innovation.

UNSTRUCTURED This study examined and reflected on the frequency of people with psychotic symptoms and features as the target population in design studies for mental health care innovation.

Background: Mental health care faces challenges that not only necessitate innovation but also require the involvement of service users and people with lived experience in developing and evaluating mental health care services. As the development of digital interventions is becoming more prevalent, design approaches are increasingly finding their way...

BACKGROUND Mental health care faces challenges that not only necessitate innovation but also require the involvement of service users and people with lived experience in developing and evaluating mental health care services. As the development of digital interventions is becoming more prevalent, design approaches are increasingly finding their way...

Many have suggested different ways of conceptualizing mental health conditions in mental health services. However, eliciting the unicity of the individual experience of mental health conditions in the diagnostic process remains challenging. In this position paper, we describe the diagnostic process in psychiatry and outline three challenges for whi...

Objective Irritable bowel syndrome (IBS) has a high comorbidity with mental disorders. The present paper aims to visualise the interplay between IBS and affect (anxiety and mood) in daily life. Furthermore, this interplay may be different depending on risk factors such as childhood trauma. Methods Using momentary assessment (Experience Sampling Me...

Aims Psychosis spectrum disorder has a complex pathoetiology characterised by interacting environmental and genetic vulnerabilities. The present study aims to investigate the role of gene–environment interaction using aggregate scores of genetic (polygenic risk score for schizophrenia (PRS-SCZ)) and environment liability for schizophrenia (exposome...

Environmental and individual contextual factors profoundly influence how people regulate their emotions. The current article addresses the role of event intensity and psychopathology (an admixture of depression, anxiety, and psychoticism) on emotion regulation in response to naturally occurring events. For six days each evening, a youth sample (age...

Background There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation. Methods We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was co...

Background Despite the increasing understanding of factors that might underlie psychiatric disorders, prospectively detecting shifts from a healthy towards a symptomatic state has remained unattainable. A complex systems perspective on psychopathology implies that such symptom shifts may be foreseen by generic indicators of instability, or early wa...

Background This study attempted to replicate whether a bias in probabilistic reasoning, or ‘jumping to conclusions’(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation. Methods Data were derived from the EUGEI project,...

Background: The prevalence of psychotic experiences (PEs) is higher in low-and-middle-income-countries (LAMIC) than in high-income countries (HIC). Here, we examine whether this effect is explicable by measurement bias. Methods: A community sample from 13 countries (N = 7141) was used to examine the measurement invariance (MI) of a frequently us...

First-degree relatives of patients diagnosed with schizophrenia (SZ-FDRs) show similar patterns of brain abnormalities and cognitive alterations to patients, albeit with smaller effect sizes. First-degree relatives of patients diagnosed with bipolar disorder (BD-FDRs) show divergent patterns; on average, intracranial volume is larger compared to co...

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 we...

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...

Group comparisons of individuals with psychotic disorder and controls have shown alterations in white matter microstructure. Whether white matter microstructure and network connectivity is altered in adolescents with subclinical psychotic experiences (PE) at the lowest end of the psychosis severity spectrum is less clear. DWI scan were acquired in...

The psychosis phenotype is generally associated with altered experience of salience associated with internal or external events, giving rise to experiences such as hallucinations or delusional ideation. Psychotic experiences (PEs) and traits vary in severity, frequencyand functional impairment, and compose a wide behavioral range for the trait. Her...

Psychotic experiences (PE), below the threshold of psychotic disorder, are common in the general population. PE are associated with risk behaviors such as suicidality, non-suicidal self-injury (NSSI) and substance use. However, PE as specific or causal phenomena of these risk behaviors are still debated. We aimed to examine the longitudinal traject...

The polygenic risk score (PRS) allows for quantification of the relative contributions of genes and environment in population-based studies of mental health. We analyzed the impact of transdiagnostic schizophrenia PRS and measures of familial and environmental risk on the level of and change in general mental health (Short-Form-36 mental health) in...

Sinds de 'covid-19-maatregelen' in heel Nederland zijn aangenomen en de term ander-halve-metersamenleving nu al kans maakt op "woord van het jaar", is een groot deel van het land overgegaan op thuiswerken. Ook velen van u zijn tijdens deze periode aangewezen op het (voor een deel) werken vanuit huis. De fysieke wachtkamer is vervangen door een digi...

Many individuals with severe mental disorders have difficulties in vocational and social functioning, which are regarded the most important outcomes, together with clinical symptoms. To understand the underlying mechanisms, research is increasingly focused on factors influencing functional outcomes. One established association has been shown betwee...

Background Diagnostic categories within the psychosis spectrum are widely used in clinical practice, however psychosis may occur on a continuum. Therefore, we explored whether the continuous distribution of psychotic symptoms across categories is a function of genetic as well as environmental risk factors, such as polygenic risk scores (PRSs) and c...

Psychiatrie in crisis? De Nederlandse psychiatrie lijkt in een crisis te verkeren. De volgende factoren hebben daarop invloed gehad. De overheid heeft in korte tijd veel grote veranderingen op verschillende gebieden doorgevoerd, zoals: – afbouw van beddenaantallen; – strengere kwaliteitsbewaking; – marktwerking; – transitie van delen van de geestel...

Background: Some recent studies have challenged the direction of causality for the association between cannabis use and psychotic disorder, suggesting that cannabis use initiation is explained by common genetic variants associated with risk of schizophrenia. We used data from the European Union Gene-Environment Interaction consortium (EUGEI) case-c...

Importance The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. Objective To examine the association be...

for the EU-GEI High Risk Study Group IMPORTANCE The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. OBJ...

Meta-analyses suggest that clinical psychopathology is preceded by dimensional behavioral and cognitive phenotypes such as psychotic experiences, executive functioning, working memory and affective dysregulation that are determined by the interplay between genetic and nongenetic factors contributing to the severity of psychopathology. The liability...

Previous research in patients with psychotic disorder has shown widespread abnormalities in brain activation during reward anticipation. Research at the level of subclinical psychotic experiences in individuals unexposed to antipsychotic medication is limited with inconclusive results. Therefore, brain activation during reward anticipation was exam...

Purpose: Psychotic experiences in childhood (such as hearing voices or being suspicious) represent an important phenotype for early intervention. However, these experiences can be defined in several ways: self-reported psychotic experiences (SRPE) rely exclusively on the child’s report, clinically validated psychotic experiences (CRPE) are based on...

Background: Machine learning (ML) can distinguish cases with psychotic disorder from healthy controls based on magnetic resonance imaging (MRI) data, with reported accuracy in the range 60-100%. It is not yet clear which MRI metrics are the most informative for case-control ML. Methods: We analysed multi-modal MRI data from two independent case-con...

Introduction: White noise speech illusions index liability for psychotic disorder in case–control comparisons. In the current study, we examined i) the rate of white noise speech illusions in siblings of patients with psychotic disorder and ii) to what degree this rate would be contingent on exposure to known environmental risk factors (childhood a...

Background: The earliest stages of the pluripotent psychopathology on the pathway to psychotic disorders is represented by emotional dysregulation and subtle psychosis expression, which can be measured using the Ecological Momentary Assessment (EMA). However, it is not clear to what degree common genetic and environmental risk factors for psychosis...

Purpose Whilst childhood trauma (CT) is a known risk factor across the spectrum of psychosis expression, little is known about possible interplay with genetic liability. Methods The TwinssCan Study collected data in general population twins, focussing on expression of psychosis at the level of subthreshold psychotic experiences. A multilevel mixed...

Aims First Episode Psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predic...

Background First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes. Methods We conducted, using two different samples for discovery ( n = 336 controls and 649 siblings of patients with psychotic disorder) and replication ( n = 1208 controls...

Objective Elevated prevalence of non-affective psychotic disorders is often found in densely populated areas. This functional magnetic resonance imaging study investigates if reduced trust, a component of impaired social functioning in patients with psychotic disorder, is associated with urban upbringing. Methods In total, 39 patients (22 first ep...

Objective: TürkSch is a prospective, longitudinal study in a representative community sample (İzmir, Turkey), consisting of several data collection stages, to screen and follow-up mental health outcomes, with a special focus on the extended and transdiagnostic psychosis phenotype. The aim of the present paper is to describe the research methodology...

Background: Previous studies have suggested that culture impacts the experience of psychosis. The current study set out to extend these findings by examining cultural variation in subclinical positive psychotic experiences in students from The Netherlands, Nigeria, and Norway. Positive psychotic experiences were hypothesized to (i) be more frequen...

Aims: Athens First-Episode Psychosis (FEP) Research study, aims to explore the potential associations between multiple genetic, environmental and neurometabolic risk factors of psychotic disorders, through the clinical management of FEP patients with minimal exposure (<2 weeks) to antipsychotic treatment at entry. The goal of this paper is to intr...

Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP...

Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariab...

Background The association between schizophrenia and decreased vitamin D levels is well documented. Low maternal and postnatal vitamin D levels suggest a possible etiological mechanism. Alternatively, vitamin D deficiency in patients with schizophrenia is presumably (also) the result of disease-related factors or demographic risk factors such as ur...

Objectives: To investigate the longitudinal relationship between subclinical psychotic symptoms and social functioning in a representative general population sample of adolescents. Method: Data were derived from a routine general health screening of 1909 adolescents in a circumscribed region. Baseline measurement was in the second grade of secon...

Background: Altered structural network-connectivity has been reported in psychotic disorder but whether these alterations are associated with genetic vulnerability, and/or with phenotypic variation, has been less well examined. This study examined i) whether differences in network-connectivity exist between patients with psychotic disorder, siblin...

Extinction learning is assumed to represent a core mechanism underlying exposure therapy. Empirical evaluations of this assumption, however, are largely lacking. The current study investigated whether neural activations and self-report outcomes during extinction learning and extinction recall could specifically predict exposure therapy response in...

Background: Cognitive impairment is a clinically important feature of schizophrenia. Polygenic risk score (PRS) methods have demonstrated genetic overlap between schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), educational attainment (EA), and IQ, but very few studies have examined associations between these PRS and cognitive...

Schizophrenia is a heritable complex phenotype associated with a background risk involving multiple common genetic variants of small effect and a multitude of environmental exposures. Early twin and family studies using proxy‐genetic liability measures suggest gene‐environment interaction in the etiology of schizophrenia spectrum disorders, but the...

Background: Schizophrenia and bipolar disorder share genetic liability, and some structural brain abnormalities are common to both conditions. First-degree relatives of patients with schizophrenia (FDRs-SZ) show similar brain abnormalities to patients, albeit with smaller effect sizes. Imaging findings in first-degree relatives of patients with bi...

Objective: Stigmatization has negative consequences for people with mental health disorder diagnosis. Studies indicate that professionals have stigmatizing attitudes and behavior towards clients. Continuum beliefs are associated with less stigmatizing attitudes. The effect of a workshop to diminish stigmatizing attitudes and to enhance continuum be...

It is worrying that antidepressants are causing withdrawal effects that can be long lasting and severe and that this is not being sufficiently recognised by current clinical guidelines—and, by extension, many prescribers. NICE is now in the process of updating its depression guidelines, and we call on it and the royal colleges to revise their pract...

Background: Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and an...

Background The “jumping to conclusions” (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ. Methods 817 FEP patients and 1294 population-based controls complete...

Adverse childhood experiences (ACE), such as emotional or physical abuse, can produce a lasting effect on the individual. The aim of this study was to investigate how ACE may impact electromyography (EMG) activity of the trapezius muscle in a novel experimental stress paradigm, in a sample of 120 healthy participants. The stress paradigm consisted...

EMG data for multilevel data analyses. (SAV)

SPSS syntax third-order interaction model for early childhood ACE score. (TIF)

The ubiquity of smartphones opened up the possibility of widespread use of the Experience Sampling Method (ESM). The method is used to collect longitudinal data of participants' daily life experiences and is ideal to capture fluctuations in emotions (momentary mental states) as an indicator for later mental ill-health. In this study, ESM data of pa...

Objective Studies have shown preliminary support for mindfulness-based interventions benefitting people with dementia and their caregivers. However, most studies focus on these two groups separately. This study examined whether it would be possible and beneficial for people with dementia and their caregiver to jointly undergo an adjusted Mindfulnes...

Schizophrenia has been conceived as a disorder of brain connectivity, but it is unclear how this network phenotype is related to the underlying genetics. We used morphometric similarity analysis of MRI data as a marker of interareal cortical connectivity in three prior case–control studies of psychosis: in total, n = 185 cases and n = 227 controls....

Background Epigenetic mechanisms are emerging as potential important players that underlie the interactions between genetic and environmental risk factors in the aetiology of psychiatric disorders. Cannabis is the most widely used recreational drug and its use, with a dose relationship pattern, has consistently been associated with an increased ris...

Background The rates of non-suicidal self-injury (NSSI) and suicidal behaviors have increased markedly in youth populations worldwide; and suicide is among the leading causes of death in patients recently diagnosed with psychotic disorders. In general population samples of children and youth, well replicated findings report a strong association bet...