Course of auditory vocal hallucinations in childhood: 5-year follow-up study

Abstract

follow-up study Course of auditory vocal hallucinations in childhood: 5-year permissions Reprints/ permissions@rcpsych.ac.uk write to To obtain reprints or permission to reproduce material from this paper, please to this article at You can respond http://bjp.rcpsych.org/cgi/eletter-submit/199/4/296 from Downloaded The Royal College of Psychiatrists Published by on December 13, 2011 http://bjp.rcpsych.org/ http://bjp.rcpsych.org/site/subscriptions/ go to: The British Journal of Psychiatry To subscribe to Subclinical psychotic experiences in the general population are prevalent in both children and adults, and not generally associated with persistence over time or onset of psychiatric disorder. Nevertheless, literature reviews suggest that a small number will make the transition to a clinical psychotic disorder. 1,2 In a previous study on a representative sample of 7-and 8-year-old children in The Netherlands, the prevalence of auditory vocal hallucinations was 9%. 3 Although auditory vocal hallucinations in these children were mostly of limited functional impact, a subgroup with serious suffering was considered at risk for more severe psychotic outcomes. The current study presents a 5-year follow-up of this sample (now 12 and 13 years of age) and examines the persistence and new incidence of auditory vocal hallucinations, as well as their clinical relevance in terms of problem behaviour, severity and associations with aetiological variables. In view of the baseline results and previous work in this area, it was hypothesised that: (1) severity of auditory vocal hallucinations at baseline would predict persistence; 4-6 (2) auditory vocal hallucinations would show associations with behavioural problems 7-9 and other psychotic symptoms; 10 (3) incidence and severity of auditory vocal hallucinations would be associated with environmental factors such as cannabis use 11-13 and urbanicity; 14-16 (4) baseline characteristics of auditory vocal hallucinations suggesting external attribution and higher level of intrusion would be predictive of persistence; 4-6 (5) auditory vocal hallucinations would be associated negatively with cognitive ability. 17-20 Method Procedure From the case-control sample of the first wave (n = 694, of which 347 children with auditory vocal hallucinations), parents of 605 children (87%, of which 50% with auditory vocal hallucinations) gave informed consent for follow-up. These parents were sent a notification letter by mail. Non-responders were sent a reminder followed by a second letter, if necessary. In case of persisting non-response, parents were contacted by telephone if their numbers could be traced. Seven female interviewers (six students (bachelor degree) from the Department of Orthopedagogy and one psychology graduate, all from the University of Groningen) received extensive training by A.A.B.-V., G.v.d.W. and J.A.J. in conducting the interviews. First, they were introduced to the topic of auditory hallucinations, and then, with consent, observed several therapeutic sessions of patients r...

Persisting psychotic-like experiences are associated with both externalising and internalising psychopathology in a longitudinal general population child cohort

“…Our findings are consistent with the significantly higher rates of internalising problem outcomes reported in paediatric samples with persisting PLEs (Bartels-Velthuis et al, 2011;De Loore et al, 2011;Wigman et al, 2011b). One previous longitudinal study (measuring only auditory vocal hallucination symptoms) examined the relationship between persisting PLEs and later externalising symptoms (BartelsVelthuis et al, 2011), with no significant association observed.…”

“…In our cohort, which was sampled predominately from socially-disadvantaged, inner-city communities, the observed association between persisting PLEs and externalising psychopathology contrasts with a lack of similar association indicated between auditory hallucinations and externalising psychopathology in a more socially advantaged, predominantly rural cohort (Bartels-Velthuis et al, 2011). As social disadvantage in mid-childhood confers a greater risk of HPA axis dysregulation (Chen et al, 2010) and high rates of perceived threat or family chaos (Aneshensel and Sucoff, 1996), we speculate that our cohort might be more disposed to developing along a 'TCO PLE-externalising' pathway.…”

“…c o m / l o c a t e / s c h r e s Two longitudinal studies following PLE expression from mid-childhood (8-11 years) both indicated the predictive validity of psychotic phenomena for adolescent psychopathology. However, these studies were limited by instruments that (a) did not specifically target PLEs but assessed a broader range of 'thought problems' (Wigman et al, 2011b) or (b) examined auditory hallucinatory phenomena only (Bartels-Velthuis et al, 2011). Secondly, few studies have examined whether PLEs act independently of concurrent internalising or externalising (i.e., hyperactive, aggressive, antisocial, or oppositional behaviours) psychopathology in the prediction of later psychopathology.…”

Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies

“…Bartels-Velthuis et al, (2010) found that auditory hallucinations in children aged 7 to 8 years demonstrated only a minor association with psychopathology as measured by the Child Behavior Checklist (CBCL). However, when they reassessed these children at ages 12 to 13 years, they found that psychotic symptoms, whether persistent from childhood or newly incident, were strongly predictive of CBCLrated psychopathology (Bartels-Velthuis et al, 2011).…”

Early detection and intervention of psychosis in children and adolescents: urgent need for studies

“…Furthermore, the clinical relevance of (atypical) psychotic symptoms in children and their predictive validity for a psychotic disorder is still not fully understood. While several studies confirm the transient and atypical nature of (atypical) psychotic symptoms in children with low conversion rates to psychotic disorders [24][25][26], the Dunedin birth cohort study reported that psychotic symptoms at age 11 predicted the emergence of a schizophreniform disorder at age 26, but also of an anxiety disorder [27].…”