Childhood and adolescent psychotic experiences and risk of mental disorder: a systematic review and meta-analysis

Abstract

BackgroundPsychotic experiences (PEs) are common in childhood and adolescence and their association with mental disorders is well-established. We aim to conduct a quantitative synthesis the literature on the relationship between childhood and adolescent PEs and (i) any mental disorder; and (ii) specific categories of mental disorder, while stratifying by study design.MethodThree electronic databases (PUBMED, PsycINFO and EMBASE) were searched from inception to August 2017 for all the published literature on childhood and adolescent PEs and mental disorder (outcome) in non-help-seeking community samples. Study quality was assessed using a recognised quality assessment tool for observational studies. Two authors conducted independent data extraction. Pooled odds ratios were calculated for mental disorders using random-effects models. Additional analyses were conducted investigating different categories of mental disorder while stratifying by study design.ResultsFourteen studies from 13 community samples (n = 29 517) were identified with 9.8% of participants reporting PEs. PEs were associated with a three-fold increased risk of any mental disorder [odds ratio (OR) 3.08, confidence interval (CI) 2.26–4.21, k = 12]. PEs were associated with four-fold increase risk of psychotic disorder (OR 3.96, CI 2.03–7.73, population-attributable-fraction: 23.2%, k = 5). In addition, PEs were associated with an increased risk of affective disorders, anxiety disorders, behavioural disorders and substance-use disorders. Few longitudinal studies have investigated childhood and adolescent PEs and subsequent non-psychotic disorders which limited a meaningful synthesis and interpretation of these results.ConclusionThis meta-analysis confirms that PEs are prevalent in childhood and adolescent community samples and are associated with a variety of mental disorders beyond psychotic disorders. Further longitudinal research is necessary to fully determine the longitudinal relationship between PEs and non-psychotic disorders.

Mental Health and Functional Outcomes in Young Adulthood of Children With Psychotic Symptoms: A Longitudinal Cohort Study

“…However, children with psychotic symptoms were more likely to experience a higher number of mental health problems in young adulthood compared to children without such symptoms including a broad spectrum of nonpsychotic psychopathology. This is in keeping with previous studies, 7 , 11 , 55 and supports the hypothesis that early psychotic phenomena are part of a latent continuum of common mental distress. 56 In addition, childhood psychotic symptoms were also associated with a wide array of poor functional outcomes, leading to high personal and societal burden.…”

Replication of Associations With Psychotic-Like Experiences in Middle Childhood From the Adolescent Brain Cognitive Development (ABCD) Study

“…Furthermore, the current replication study found associations similar to other large cross-sectional studies of PLEs in childhood and adolescence. 20 , 22–26 The current findings underscore that robust and reliable associations between PLEs and the aforementioned factors can be found in middle childhood manifestations of non-clinical psychosis spectrum symptoms.…”

“… 14 Notably, research indicates that self-reported PLEs, even those not confirmed with clinical interview, are still clinically relevant and associated with higher rates of psychopathology 15–17 and reduced functioning. 17 , 18 Several large cross-sectional datasets over the past 2 decades have examined the correlates of PLEs, finding associations with racial/ethnic minority status, 19 internalizing symptoms, 20–22 externalizing symptoms, 20 developmental impairments, 23 and cognitive impairments, 23 , 24 including reading, 25 working memory, 26 , 27 and processing speed 28 impairments.…”

More sensitive identification of psychotic experiences in common mental disorder by primary mental healthcare services – effect on prevalence and recovery: casting the net wider

“…Studies modelling the co-occurrence of common mental disorders (CMD), such as anxiety and depression, and psychotic experiences have revealed that such experiences measure severity of a unitary, latent continuum of common mental distress 1 and correlate with increased comorbidity, suicidality and poorer treatment outcomes. [2][3][4][5][6][7][8] Psychotic experiences also predict propensity to seek treatment from mental health services for persistent mental ill health. 9 However, stringent referral thresholds prevent these individuals accessing secondary mental healthcare services and they are therefore managed in primary mental healthcare settings.…”