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Front Psychiatry. 2019 Sep 25;10:676. doi: 10.3389/fpsyt.2019.00676. eCollection 2019.

White Noise Speech Illusions: A Trait-Dependent Risk Marker for Psychotic Disorder?

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Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands.
Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
GGNet Mental Health, Apeldoorn, Netherlands.
MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom.
Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey.
Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey.
Department of Neuroscience, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey.
Ankara University Brain Research Center, Ankara, Turkey.
Department of Psychology, Middle East Technical University, Ankara, Turkey.
Turkish Federation of Schizophrenia Associations, Ankara, Turkey.
Güven Çayyolu Healthcare Campus, Ankara, Turkey.
Atatürk Research and Training Hospital Psychiatry Clinic, Ankara, Turkey.
Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Psychiatry CCS, Belgrade, Serbia.
Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia.
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Biomedical Research Networking Centre in Mental Health (CIBERSAM), Madrid, Spain.
Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
Mental Health Services of Principado de Asturias, Oviedo, Spain.
Department of Psychiatry, Hospital Clínico Universitario de Valencia, School of Medicine, Universidad de Valencia, Valencia, Spain.
Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain.
Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.
Fundación Publica Galega de Medicina Xenómica (SERGAS), Universidad de Santiago de Compostela, CIBERER, Santiago de Compostela, Spain.
Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain.
Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey.
Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, United Kingdom.


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 adversity and recent life events) and level of known endophenotypic dimensions of psychotic disorder [psychotic experiences assessed with the Community Assessment of Psychic Experiences (CAPE) scale and cognitive ability]. Methods: The white noise task was used as an experimental paradigm to elicit and measure speech illusions in 1,014 patients with psychotic disorders, 1,157 siblings, and 1,507 healthy participants. We examined associations between speech illusions and increasing familial risk (control -> sibling -> patient), modeled as both a linear and a categorical effect, and associations between speech illusions and level of childhood adversities and life events as well as with CAPE scores and cognitive ability scores. Results: While a positive association was found between white noise speech illusions across hypothesized increasing levels of familial risk (controls -> siblings -> patients) [odds ratio (OR) linear 1.11, 95% confidence interval (CI) 1.02-1.21, p = 0.019], there was no evidence for a categorical association with sibling status (OR 0.93, 95% CI 0.79-1.09, p = 0.360). The association between speech illusions and linear familial risk was greater if scores on the CAPE positive scale were higher (p interaction = 0.003; ORlow CAPE positive scale 0.96, 95% CI 0.85-1.07; ORhigh CAPE positive scale 1.26, 95% CI 1.09-1.46); cognitive ability was lower (p interaction < 0.001; ORhigh cognitive ability 0.94, 95% CI 0.84-1.05; ORlow cognitive ability 1.43, 95% CI 1.23-1.68); and exposure to childhood adversity was higher (p interaction < 0.001; ORlow adversity 0.92, 95% CI 0.82-1.04; ORhigh adversity 1.31, 95% CI 1.13-1.52). A similar, although less marked, pattern was seen for categorical patient-control and sibling-control comparisons. Exposure to recent life events did not modify the association between white noise and familial risk (p interaction = 0.232). Conclusion: The association between white noise speech illusions and familial risk is contingent on additional evidence of endophenotypic expression and of exposure to childhood adversity. Therefore, speech illusions may represent a trait-dependent risk marker.


Community Assessment of Psychic Experiences; childhood adversity; cognitive ability; life events; psychotic disorder; white noise speech illusions

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