Association between childhood psychiatric disorders and psychotic experiences in adolescence: A population-based longitudinal study

Caroline Siebald,Golam M Khandaker,Stanley Zammit,Glyn Lewis,Peter B Jones

doi:10.1016/j.comppsych.2016.05.004

Abstract

BackgroundAdolescent psychotic experiences (PEs) are common, and are associated with both psychotic and non-psychotic illnesses. In order to examine psychopathological and cognitive antecedents of adolescent PEs, we have conducted a longitudinal study of common childhood psychiatric disorders and subsequent adolescent PEs in the population-based prospective ALSPAC birth cohort. MethodDepression, anxiety, attention deficit hyperactivity disorder, oppositional defiant or conduct disorder, and pervasive developmental disorder were diagnosed according to DSM-IV criteria in 8253 participants at age 8years. IQ was assessed by WISC-III also at 8years. PEs, depressive and anxiety symptoms were assessed at 13years. Logistic regression calculated odds ratio (OR) for PEs at 13years associated with psychiatric disorders at 8years. Linear regression calculated mean difference in IQ between groups with and without psychiatric disorder. Mediating effects of IQ, mood and anxiety symptoms on the psychiatric disorder-PEs relationship were examined. ResultsIn total, 599 children were assessed to have a DSM-IV psychiatric disorder at 8years (7.2%). These children compared with those without any psychiatric disorder performed worse on all measures of IQ; adjusted mean difference in total IQ −6.17 (95% CI, −7.86, −4.48). Childhood psychiatric disorders were associated with PEs subsequently in adolescence; adjusted OR 1.96 (95% CI, 1.47–2.68). The association between psychiatric disorder and subsequent PEs was partly mediated by, independently, IQ deficit at 8years and depressive and anxiety symptoms at 13years. ConclusionsThe findings indicate that adolescent PEs are associated with general cognitive ability and past and present psychopathological factors.

Highlights

Psychotic experiences (PEs) are common in the general population [1], especially during childhood and adolescence [2]
Building on our previous work we have examined psychopathological and cognitive antecedents of adolescent PEs using a broader range of childhood psychiatric disorders as predictors of subsequent PEs in early-adolescence in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort
The findings suggest that childhood psychiatric disorders diagnosed according to DSM-IV criteria at 8 years are associated with increased risk of psychotic experiences at 13 years, which persists after controlling for potential confounders such as age, sex, ethnicity, maternal social class and educational level

Summary

Introduction

Psychotic experiences (PEs) are common in the general population [1], especially during childhood and adolescence [2]. PEs in adolescence or adulthood are associated with concurrent anxiety, depression, obsessive compulsive disorder, borderline personality disorder, poor functioning, self-harm and suicidal behavior [18,19,20,21,22,23]. These findings are consistent with statistical modeling of the underlying structure of psychiatric symptoms in two birth cohorts which reveal that psychotic phenomena co-occur with depression and anxiety [24,25], and may be a marker of the severity of mental ill health in a single, unitary dimension of common mental distress in young people [25].

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Results

Conclusion