Early adult mental health, functional and neuropsychological outcomes of young people who have reported psychotic experiences: a 10-year longitudinal study

Abstract

Background Psychotic experiences (PE) are highly prevalent in childhood and are known to be associated with co-morbid mental health disorders and functional difficulties in adolescence. However, little is known about the long-term outcomes of young people who report PE. Methods As part of the Adolescent Brain Development Study, 211 young people were recruited in childhood (mean age 11.7 years) and underwent detailed clinical interviews, with 25% reporting PE. A 10 year follow-up study was completed and 103 participants returned (mean age 20.9 years). Structured clinical interviews for DSM-5 (SCID-5) and interviewer-rated assessments of functioning were conducted. A detailed neuropsychological battery was also administered. Analyses investigated group differences between those who had ever reported PE and controls in early adulthood. Results The PE group was at a significantly higher risk of meeting DSM-5 criteria for a current (OR 4.08, CI 1.16–14.29, p = 0.03) and lifetime psychiatric disorder (OR 3.27, CI 1.43–7.47, p = 0.005). They were also at a significantly higher risk of multi-morbid lifetime psychiatric disorders. Significantly lower scores on current social and global functioning measures were observed for the PE group. Overall, there were no differences in neuropsychological performance between groups apart from significantly lower scores on the Stroop Word task and the Purdue Pegboard task for the PE group. Conclusions Our findings suggest that reports of PE are associated with poorer mental health and functional outcomes in early adulthood, with some persisting cognitive and motor deficits. Young people who report such symptoms could be considered a target group for interventions to aid functional outcomes.

Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8–18 years

“…Alongside neurocognitive functioning, early delays in language development and other developmental milestones have been found to distinguish those who later receive a psychosis-spectrum diagnoses from non-clinical controls [12]. Similar developmental markers are identified in samples of children and young adolescents reporting PLEs, including language processing difficulties [22], early speech and/or motor delays [23], and current fine motor skill difficulties [19,20]. This literature therefore indicates that there may be subtle developmental lags among youth reporting PLEs and further investigation is now needed to test these associations in other groups, including young people reporting PLEs with associated impairment/distress.…”

“…There is some evidence for relationships between lower IQ, reading ability and working memory with PLEs in general population and hospital samples of children as young as 8 years of age and adolescents [15][16][17][18]. In recent prospective work [19,20] in general population samples of youth, robust associations have been found between working memory and processing speed difficulties with PLEs, with some evidence that these difficulties persist into adulthood for young people who report PLEs, even when the PLEs are transient [20]. The general population literature seems to show a more robust link between domains of cognitive functioning and PLEs that are associated with impairment/distress [21] that will be important to investigate in other samples of youth.…”

Psychosis-like experiences and cognition in young adults: an observational and Mendelian randomisation study

“…Although common in early life, onset of PLEs may occur throughout the lifespan 2 . Early PLEs enhance the risk not only for later developing psychotic disorders, but also for other mental health conditions, including anxiety, affective, behavioural and substance use disorders 1 , and broader functional and social deficits 5 .…”

Psychotic experiences as a health indicator: A provisional framework

“…Psychotic experiences are associated with multiple psychiatric disorders, including mood, anxiety, and alcohol/substance use disorders (DeVylder et al, 2014). These associations are apparent early in life and may reflect overall poor social and global functioning (Carey et al, 2020). Additionally, psychotic experiences are associated with physical health conditions (Moreno et al, 2013; Oh et al, 2018b; Scott et al, 2018), including the subsequent onset of arthritis, back/neck pain, frequent/severe headache, other chronic pain, heart disease, high blood pressure, diabetes, and peptic ulcers (Scott et al, 2018).…”