Abstract

PurposeTo investigate whether psychotic experiences and depressive symptoms at ages 12 and 18 years are associated with adverse life outcomes across a range of functional domains between 16 and 20 years of age.MethodsData were gathered from ALSPAC, a UK birth cohort. Individuals were assessed with the semi-structured Psychosis-Like Symptoms Interview and the Short Mood and Feeling Questionnaire at ages 12 and 18 years. Logistic regression was used to explore associations with outcomes in education, occupation, social functioning, substance use (alcohol, cannabis, smoking, and other drugs), and illegal behaviour between the ages of 16 and 20 years. All associations were adjusted for socio-demographic and childhood confounders and for comorbid psychotic experiences or depressive symptoms.ResultsPsychotic experiences and depression at age 12 were associated with poorer educational, occupational, and social outcomes between the ages of 16 and 20; these withstood adjustment for confounding. Depressive symptoms at age 12 were also associated with harmful drinking. Psychotic experiences and depression at age 18 were additionally associated with other forms of substance use and illegal behaviour. Comorbidity had little impact at age 12, but was associated with significantly worse educational, social, and substance use outcomes at age 18.ConclusionsAdolescent psychotic experiences and depression represent a risk marker for a number of later adverse outcomes, most consistently with education and employment, but also social impairment, harmful drinking, and substance use. This highlights the importance of recognizing adolescent psychopathology, so that support can be provided to try and minimize adverse outcomes.

Highlights

  • Psychotic experiences, which are usually regarded as subclinical manifestations of a psychosis continuum [1], and depression are both common during adolescence

  • In the total ALSPAC sample that completed the Psychosis-Like Symptoms Interview (PLIKSi) at age 12 years (n = 6796), 11.6% had psychotic experiences

  • Having psychotic experiences or depression at 12 years of age was associated with adverse life outcomes in early adulthood

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Summary

Introduction

Psychotic experiences, which are usually regarded as subclinical manifestations of a psychosis continuum [1], and depression are both common during adolescence. Depression becomes increasingly prevalent at this time [2], affecting 8–21% of young people by the age of 18 [2,3,4]. The prevalence of psychotic experiences, assessed using semistructured interviews rather than self-report measures, is 5–6% [5,6,7]. Unlike depression, this prevalence appears to be relatively stable during adolescence [7], with evidence suggesting that they become less common with age [8]. While there is considerable research on the mental health outcomes of adolescent depression [9,10,11], and growing research on

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