Associations of attention-deficit/hyperactivity and other childhood disorders with psychotic experiences and disorders in adolescence.

Abstract

Prodromal symptoms of psychosis are associated with an increased risk of transition, functional impairment, poor mental health, and unfavorable developmental prospects. Existing interventions targeting the prodrome are non-satisfactory. It may thus be more promising to attempt to identify risk factors in the premorbid phase preceding the prodrome to increase the chances of successful preventive approaches. Here, we investigate whether childhood mental disorders in general and attention-deficit/hyperactivity disorder (ADHD) specifically indicate a risk for subsequent psychotic experiences and disorders. We used a sample from the prospective Avon Longitudinal Study of Parents and Children (N=5528). When the participants were 7years old, mental disorders were assigned according to the DSM-IV. In standardized interviews, psychotic experiences were assessed at age 12 and psychotic disorders at age 18. We examined the associations of each of the childhood mental disorders alone and in combination with psychotic experiences at age 12 and psychotic disorders at age 18 using logistic regression. Compared to participants without a disorder, participants with a mental disorder had a higher risk of psychotic experiences at age 12 (OR 1.70, 95% CI 1.28-2.27) and of psychotic disorders at age 18 (OR 2.31, 95% CI 1.03-5.15). Particularly, the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR 3.26, 95% CI 1.74-6.10). As expected, childhood mental disorders are risk indicators of psychotic experiences and disorders. To improve prevention, health care professionals need to screen for psychotic experiences in children with non-psychotic disorders.