Associations of attention-deficit/hyperactivity and other childhood disorders with psychotic experiences and disorders in adolescence

Abstract

Prodromal symptoms of psychosis are associated with an increased risk of transition, functional impairment, poor mental health, and unfavorable developmental prospects. Existing interventions targeting the prodrome are non-satisfactory. It may thus be more promising to attempt to identify risk factors in the premorbid phase preceding the prodrome to increase the chances of successful preventive approaches. Here, we investigate whether childhood mental disorders in general and attention-deficit/hyperactivity disorder (ADHD) specifically indicate a risk for subsequent psychotic experiences and disorders. We used a sample from the prospective Avon Longitudinal Study of Parents and Children (N = 5528). When the participants were 7 years old, mental disorders were assigned according to the DSM-IV. In standardized interviews, psychotic experiences were assessed at age 12 and psychotic disorders at age 18. We examined the associations of each of the childhood mental disorders alone and in combination with psychotic experiences at age 12 and psychotic disorders at age 18 using logistic regression. Compared to participants without a disorder, participants with a mental disorder had a higher risk of psychotic experiences at age 12 (OR 1.70, 95 % CI 1.28-2.27) and of psychotic disorders at age 18 (OR 2.31, 95 % CI 1.03-5.15). Particularly, the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR 3.26, 95 % CI 1.74-6.10). As expected, childhood mental disorders are risk indicators of psychotic experiences and disorders. To improve prevention, health care professionals need to screen for psychotic experiences in children with non-psychotic disorders.

Psychotic‐like experiences in pre‐adolescence: what precedes the antecedent symptoms of severe mental illness?

“…Importantly, psychotic‐like experiences were also associated with emotional and behavioural difficulties earlier in childhood, including anxiety, depression, aggressive behaviour and autistic traits, at ages 3 and 6 years. This is in line with studies demonstrating that autistic symptoms, attention‐deficit/hyperactivity disorder and other DSM‐based psychiatric disorders are predictive of adolescent psychotic‐like experiences . Moreover, population‐based studies have shown that genetic vulnerability to schizophrenia also confers antecedent risk of emotional and behavioural difficulties in childhood .…”

“…Importantly, the interpretation that internalising problems mediated the associations to subsequent psychotic‐like experiences is also compatible with our data. In addition, our findings extend earlier studies that suggested a direct association between symptoms attention‐deficit/hyperactivity disorder, autism spectrum disorder, aggressive behaviour and subsequent psychotic‐like experiences . The predictive value of emotional problems might reflect a general vulnerability to overlapping networks of affective and emotional psychopathology across development, of which psychotic‐like experiences might be a common manifestation in pre‐adolescence .…”

“…Most adult psychiatric disorders, including anxiety, mood and impulse control disorders, are associated with an elevated risk of subsequent psychotic‐like experiences . Previous studies have shown that childhood autistic traits , attention‐deficit/hyperactivity disorder and other psychiatric disorders are associated with adolescent psychotic‐like experiences. However, most studies of the association between childhood psychotic‐like experiences and psychiatric comorbidity have been cross‐sectional , or investigated which future psychiatric disorders might be predicted by adolescent psychotic‐like experiences .…”

Cannabidiol Administered During Peri-Adolescence Prevents Behavioral Abnormalities in an Animal Model of Schizophrenia

“…In addition, schizophrenia patients or high-risk individuals with ADHD perform worse in neuropsychological tests, when compared to those without ADHD ( Keshavan et al, 2003 ; Oner and Munir, 2005 ; Donev et al, 2011 ). Of relevance for this work, diagnosis of ADHD in peri-adolescence is associated with the emergence of schizophrenia symptomatology later in life ( Kim-Cohen et al, 2003 ; Hennig et al, 2017 ). In this scenario, our data may also indicate that CBD displays a preventive potential for high-risk individuals with ADHD as a comorbidity or for those that develop schizophrenia and display a previous history of ADHD.…”

Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: A population-based study

“…ADHD patients had a higher risk of psychotic experiences at age 12 (OR: 1.70, 95% CI: 1.28-2.27) and of psychotic disorders at age 18 (OR: 2.31, 95% CI: 1.03-5.15). Especially the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR: 3.26, 95% CI: 1.74-6.10) [11].…”