Open AccessAssessment of Psychotic Symptoms in Individuals Exposed to Very High or Extreme Altitude: A Field Study
Author(s) -
Katharina Hüfner,
Fabio Caramazza,
Agnieszka Elzbieta Stawinoga,
Evelyn R. Pircher Nöckler,
Paolo FusarPoli,
Sanjeeb Sudarshan Bhandari,
Buddha Basnyat,
Monika Brodmann Maeder,
Giacomo Strapazzon,
Iztok Tomazin,
Barbara SpernerUnterweger,
Hermann Brugger
Publication year - 2021
Publication title -
high altitude medicine and biology
Language(s) - English
Resource type - Journals
eISSN - 1557-8682
pISSN - 1527-0297
DOI - 10.1089/ham.2020.0210
Subject(s) - psychosis , effects of high altitude on humans , altitude (triangle) , altitude sickness , psychiatry , schizophrenia (object oriented programming) , psychology , medicine , geometry , mathematics , anatomy
Hüfner, Katharina, Fabio Caramazza, Agnieszka E. Stawinoga, Evelyn R. Pircher Nöckler, Paolo Fusar-Poli, Sanjeeb S. Bhandari, Buddha Basnyat, Monika Brodmann Maeder, Giacomo Strapazzon, Iztok Tomazin, Barbara Sperner-Unterweger, and Hermann Brugger. Assessment of psychotic symptoms in individuals exposed to very high or extreme altitude: A field study. High Alt Med Biol. 22:369-378, 2021. Background: Symptoms of psychosis such as hallucinations can occur at high or extreme altitude and have been linked to accidents on the mountain. No data are available on how to assess such symptoms in the field and what their prevalence or predisposing factors might be. Methods: In this field study at Everest Base Camp (5,365 m) in Nepal, 99 participants of organized expeditions underwent 279 assessments: The High Altitude Psychosis Questionnaire (HAPSY-Q), the Prodromal Questionnaire, 16-items (PQ-16), and the Mini International Neuropsychiatric Interview (M.I.N.I., psychosis section) were collected together with further clinical data. Statistical analysis was done for each phase, that is, altitude range of the climb, and overall data. Results: One of 97 climbers fulfilled the M.I.N.I. diagnostic criteria for psychosis during one acclimatization climb. At least one endorsed item on the HAPSY-Q and the PQ-16, indicating the presence of symptoms of psychosis in the absence of a psychotic disorders, were identified in 10/97 (10.3%) and 18/87 (20.7%) participants respectively. The scores of the HAPSY-Q and the PQ-16 were correlated ( r = 0.268, p < 0.001). Odds ratio analysis identified an increased risk for accidents in individuals with endorsed items on the HAPSY-Q. Conclusions: The diagnosis of high altitude psychosis is rare in climbers during organized expeditions. Nevertheless, subdiagnostic symptoms of psychosis occurred in a significant proportion of climbers. Future research is needed to validate these pilot findings.