Psychotic experiences from preadolescence to adolescence: when should we be worried about adolescent risk behaviors?
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Psychotic experiences from preadolescence to adolescence: when should we be worried about adolescent risk behaviors? Martin K. Rimvall1,2 · Jim van Os3,4,5 · Charlotte Ulrikka Rask6,7 · Else Marie Olsen8,9 · Anne Mette Skovgaard10 · Lars Clemmensen11 · Janne Tidselbak Larsen12,13,14 · Frank Verhulst1,2,15 · Pia Jeppesen1,2 Received: 29 March 2019 / Accepted: 11 November 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Psychotic experiences (PE), below the threshold of psychotic disorder, are common in the general population. PE are associated with risk behaviors such as suicidality, non-suicidal self-injury (NSSI) and substance use. However, PE as specific or causal phenomena of these risk behaviors are still debated. We aimed to examine the longitudinal trajectories of PE from preadolescence to adolescence and their associated risk behaviors in adolescence. A total of 1138 adolescents from the Copenhagen Child Cohort 2000 were assessed for PE and risk behaviors (NSSI, suicide ideation and -attempts and substance use) at age 11 and 16 years, along with measures of general psychopathology and depressive symptoms specifically. Selfreported impact of general psychopathology tended to be associated with more PE persistence. PE were associated with all risk behaviors in cross section at both follow-ups. Persistent PE from ages 11 to 16 and incident PE at age 16 were associated with risk behaviors at age 16, whereas remitting PE from age 11 to 16 were not. After adjustment for co-occurring depressive symptoms and general psychopathology, all associations were markedly reduced. After exclusion of preadolescents who already had expressed risk behavior at age 11, PE in preadolescence did not stand out as an independent predictor of incident adolescent risk behaviors. The current study suggests that PE in preadolescence and adolescence may not play a direct causal role regarding NSSI, suicidality, and substance use. However, PE are still useful clinical markers of severity of psychopathology and associated risk behaviors. Keywords Psychotic experiences · Suicidality · Non-suicidal self-harm · Substance use · Risk behaviors · Epidemiology · Longitudinal
Background Psychosis can be observed with markedly varying clinical manifestations, ranging from subclinical positive symptoms, often referred to as psychotic experiences (PE), to clinical psychotic disorders [1]. PE are common in the general population with meta-analytic prevalence estimates around 7% in adults, and up to 20% in children [2]. PE in childhood are often transient [3], and throughout adolescence, longitudinal studies have found decreasing prevalence estimates with higher age [4–6]. The rates are highly dependent on Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00787-019-01439-w) contains supplementary material, which is available to authorized users. * Martin K. Rimvall [email protected] Extended author information available on the last page of the
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