Children who report PEs have persistently poorer functioning through to early adulthood. The longitudinal association between childhood PEs and global functioning highlights the underlying global vulnerability in children reporting PEs, beyond what can be explained by mental disorder.
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.
Comparison was made among the electroencephalograms of eleven patients with psychotic reactions after the use of cannabis, twenty-nine patients admitted with a diagnosis of schizophrenia, ten for neurological consultations and eleven cannabis users with no apparent psychiatric implications. It was found that there was a greater increase in the EEG abnormalities of cannabis users than in the rest. It is therefore suggested that the drug may be a factor in creating the EEG abnormalities as well as contributing to the psychotic reactions observed, especially when the other factors which could create similar EEG abnormalities have been ruled out.
BackgroundPsychotic experiences (PEs) are relatively common in childhood and early adolescence, being present in 17% of children aged 9 to 12 (Kelleher et al., 2012). Research suggests that young people who experience PEs are more vulnerable to psychopathology later in life, despite PEs being transient in 78.7% of cases (Zammit et al., 2013). While childhood PEs are associated with poorer functioning (Kelleher et al., 2015), it has not yet been established whether the impact of PEs on functioning persists into later life.Methods52 participants from a prospective cohort study (retention rate: 60.4%) of Irish young people were included on the basis that they had completed a clinical interview at all three data-collection time points (T1 mean age: 11.69; T2: 15.80; T3 18.80). Following each interview, participants were scored on the Global Assessment of Functioning (GAF) scale, and given a Current (C-GAF) score and a Most Severe Past (MSP-GAF) score. Fixed-effects repeated-measures models were used to compare the scores of those with a history of PEs at T1 (n=18) to those without (n=34), accounting for age, gender, and childhood functioning. Secondary analyses investigated whether differences in functioning were evident in those who reported transient PEs (only at T1; n=12).ResultsOverall, participants who had reported childhood PEs (T1) received significantly lower C-GAF scores (F = 31.553, p < .001) and MSP-GAF scores (F = 79.377, p < .001) than those without PEs. Simple effects analysis indicated that deficits in the PE group were evident at each time point for both C-GAF scores (T1: p = .001; T2: p <.001; T3: p = .002) and MSP-GAF scores (T1: p < .001; T2: p = .001; T3: p < .001), indicating poorer functioning from childhood, through adolescence, into early adulthood. There was no significant effect of the co-variates.When the analysis was restricted to a comparison of participants who reported PEs at T1 only (i.e. transient PEs) and those with no history of PEs, the PE group had poorer functioning scoring than their peers across the three time points (C-GAF: F = 17.709, p < .001; MSP-GAF: F= 32.247, p < .001).DiscussionThe analysis provides longitudinal evidence that the presentation of PEs is associated with persistent poor global functioning throughout adolescence and into early adulthood, even when the phenomena are transient. PEs appear to be a marker for vulnerability that extends beyond mental disorder. These results tentatively suggest a causal link between PEs and poorer functioning later in life, as the difference in functioning between the groups in early adulthood was still evident after accounting for childhood functioning. Moreover, the disparity between the groups is clinically relevant, with the PE group scoring one to two categories lower than their peers on the GAF scale even into early adulthood. Childhood PEs are an excellent prognostic marker for future functioning and providing targeted early intervention for these individuals may reduce the likelihood of developing a significant cl...
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