Speech Illusions in People at Clinical High Risk for Psychosis Linked to Clinical Outcome

Emily J. Hird, Noriyuki Ohmuro, Paul Allen, Peter Moseley, Matthew J. Kempton, Gemma Modinos, Gabriele Sachs, Mark Van Der Gaag, Lieuwe De Haan, Ary Gadelha, Rodrigo Bressan, Neus Barrantes-Vidal, Stephan Ruhrmann, Ana Catalan, Philip McGuire, Lucia R. Valmaggia, Maria Calem, Stefania Tognin, Eva Velthorst, Tamar C. KraanDaniella S. Van Dam, Nadine Burger, Barnaby Nelson, Patrick McGorry, Günter Paul Amminger, Christos Pantelis, Athena Politis, Joanne Goodall, Anita Riecher-Rössler, Stefan Borgwardt, Charlotte Rapp, Sarah Ittig, Erich Studerus, Renata Smieskova, Elisa Brietzke, Graccielle Asevedo, Elson Asevedo, Andre Zugman, Tecelli Domínguez-Martínez, Pilar Torrecilla, Thomas R. Kwapil, Manel Monsonet, Lídia Hinojosa, Mathilde Kazes, Claire Daban, Julie Bourgin, Olivier Gay, Celia Mam-Lam-Fook, Marie Odile Krebs, Dorte Nordholm, Lasse Randers, Kristine Krakauer, Louise Glenthøj, Birte Glenthøj, Merete Nordentoft, Dominika Gebhard, Julia Arnhold, Joachim Klosterkötter, Iris Lasser, Bernadette Winklbaur, Philippe A. Delespaul, Bart P. Rutten, Jim Van Os

Research output: Contribution to journalArticlepeer-review


Background and hypothesis: Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. Study design: At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. Study results: CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P =. 007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P =. 043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P =. 029). Conclusions: In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.

Original languageEnglish (US)
Pages (from-to)339-349
Number of pages11
JournalSchizophrenia Bulletin
Issue number2
StatePublished - Mar 1 2023
Externally publishedYes


  • remission
  • signal-detection
  • transition
  • uncertainty
  • white noise task

ASJC Scopus subject areas

  • Psychiatry and Mental health


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