Etiological and Clinical Features of Childhood Psychotic Symptoms

Abstract

Context It has been reported that childhood psychotic symptoms are common in the general population and may signal neurodevelopmental processes that lead to schizophrenia. However, it is not clear whether these symptoms are associated with the same extensive risk factors established for adult schizophrenia. Objective To examine the construct validity of children’s self-reported psychotic symptoms by testing whether these symptoms share the risk factors and clinical features of adult schizophrenia. Design Prospective, longitudinal cohort study of a nationally representative birth cohort in Great Britain. Participants A total of 2232 twelve-year-old children followed up since age 5 years (retention, 96%). Main Outcome Measure Children’s self-reported hallucinations and delusions. Results Children’s psychotic symptoms are familial and heritable and are associated with social risk factors (eg, urbanicity); cognitive impairments at age 5; home-rearing risk factors (eg, maternal expressed emotion); behavioral, emotional, and educational problems at age 5; and comorbid conditions, including self-harm. Conclusions The results provide a comprehensive picture of the construct validity of children’s self-reported psychotic symptoms. For researchers, the findings indicate that children who have psychotic symptoms can be recruited for neuroscience research to determine the pathogenesis of schizophrenia. For clinicians, the findings indicate that psychotic symptoms in childhood are often a marker of an impaired developmental process and should be actively assessed.

Persisting psychotic-like experiences are associated with both externalising and internalising psychopathology in a longitudinal general population child cohort

“…The sample was drawn predominantly from deprived inner-city London (Laurens et al, 2007(Laurens et al, , 2008(Laurens et al, , 2012 and exceeds the prevalence of PLEs described in other pre-adolescent samples (range 6-17%, Poulton et al, 2000;Polanczyk et al, 2010;Wigman et al, 2011b). This elevated prevalence may relate to the demographics of this sample: the residing adult community has an elevated incidence of schizophrenia (Kirkbride et al, 2006) in addition to a self-reported PLE prevalence of 20% (Morgan et al, 2009).…”

“…Subclinical psychotic symptoms or psychotic-like experiences (PLEs) in childhood and adolescence are associated with concurrent emotional and behavioural difficulties (Laurens et al, 2007(Laurens et al, , 2012Nishida et al, 2008;Scott et al, 2009;Armando et al, 2010;Bartels-Velthuis et al, 2010;Polanczyk et al, 2010;Barragan et al, 2011;Kelleher et al, 2012b). PLEs that persist into adulthood increase risk for social dysfunction (Rossler et al, 2007), affective disturbance (van Rossum et al, 2011), substance misuse (Dhossche et al, 2002), and psychotic disorder .…”

Predicting Risk and the Emergence of Schizophrenia

“…Researchers have argued that work on this extended psychosis phenotype may provide valuable insights into the etiology of clinical psychotic disorder. 154,155 Neurocognitive research has only recently begun on this population but some of the cognitive differences that are characteristic of the prodrome and first-episode psychosis have already been shown to also occur in this population. In particular, deficits in processing speed have been found pronounced in this group.…”

Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies

“…More recently, evidence has been emerging that the clinical significance of psychotic symptoms extends beyond psychosis, with a number of research groups finding that young people who endorse questionnaire items on psychotic symptoms are also more likely to endorse symptoms of non-psychotic psychopathology, especially symptoms of depression (Hanssen et al, 2003, Johns et al, 2004, Kelleher et al, In Press, Nishida et al, 2008, Polanczyk et al, 2010, Scott et al, 2009b, Varghese et al, 2011, Wigman et al, 2011, Yung et al, 2009.…”