Psychotic experiences and future school performance in childhood: a population‐based cohort study

Abstract

Background: Psychotic experiences are common in childhood and an important risk indicator of adverse mental health outcomes. However, little is known about the association of psychotic experiences with functional outcomes in childhood, particularly regarding school performance. The aim of the present study was to examine whether psychotic experiences were prospectively related to school performance in childhood. Methods: This study was embedded in the population-based Generation R Study (N = 2,362). Psychotic experiences were assessed using selfreports on hallucinations at age 10 years. School performance was assessed using a standardized national school performance test at age 12 years. We considered the total school performance score, as well as language and mathematics subscales. Analyses were adjusted for sociodemographic characteristics, maternal nonverbal IQ, nonverbal IQ at age 6 years and co-occurring psychopathology at age 10 years. Results: Psychotic experiences were prospectively associated with poorer school performance scores (B = À0.61, 95% CI [À0.98;À0.25], p = .001), as well as poorer language (B percentile rank score = À2.00, 95% CI [À3.20;À0.79], p = .001) and mathematical ability (B percentile rank score = À1.75, 95% CI [À2.99;À0.51], p = .006). These associations remained after additional adjustment for nonverbal IQ at age 6 years (B = À0.51, 95% CI [À0.86;À0.16], p = .005), and co-occurring internalizing (B = À0.40, 95% CI [À0.77;À0.03], p = .036) and externalizing problems (B = À0.40, 95% CI [À0.75;À0.04], p = .029), but not attention problems (B = À0.10, 95% CI [À0.47;0.26], p = .57). Conclusions: Children with psychotic experiences had lower school performance scores than their nonaffected peers. The finding was independent of sociodemographic characteristics, intelligence and co-occurring internalizing and externalizing problems, but not attention problems. This study suggests that psychotic experiences are associated with childhood functional impairments, although the relatively small effects and the role of attention problems warrant further exploration.

Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8–18 years

“…However, in the context of our study limitations, future research in other clinical groups is needed to assess the feasibility of adapting existing interventions for young people reporting distressing PLEs. These prevention and early intervention efforts may have important implications for considering the wider societal consequences of PLEs, particularly given emerging evidence of associations between PLEs, poorer educational achievements [26][27][28][29] and later vocational status [30].…”

“…This can inform recommendations for therapeutic targets within existing psychological interventions, both clinically and, potentially, in educational or public health settings. This may have important implications for considering the wider societal consequences for youth reporting distressing PLEs, particularly given growing evidence of associations between PLEs, poorer educational achievements [26][27][28][29] and later vocational status [30].…”

Peer‐reported bullying, rejection and hallucinatory experiences in childhood

“…Each item referred to the preceding 6 months and was rated on a three‐point scale: “not at all” (0), “a bit” (1), or “clearly” (2). We classified the sum score into the following categories: no (0 points), mild (a score of 1 point on at least one of the items), and moderate‐to‐severe (a score of 2 points on at least one of the items) hallucinatory experiences, in line with our previous work 6,7 …”

“…Psychotic experiences are thought to exist on the lower end of a psychosis continuum, which proposes that the psychosis phenotype is expressed along a spectrum of increasing severity, persistence, and impairment 5 . Youth who report psychotic experiences often suffer from other mental health problems and are more likely to function poorly 6‐9 . While psychotic experiences are associated with increased risk for later psychotic disorders, most individuals who report psychotic experiences do not go on to develop a psychotic disorder 10‐12 .…”

“…5 Youth who report psychotic experiences often suffer from other mental health problems and are more likely to function poorly. [6][7][8][9] While psychotic experiences are associated with increased risk for later psychotic disorders, most individuals who report psychotic experiences do not go on to develop a psychotic disorder. [10][11][12] Rather, psychotic experiences seem to represent a trans-diagnostic marker of psychopathology, which is reflected by a range of negative health outcomes associated with psychotic experiences, including mood disorders, mental healthcare use, and suicidal behavior.…”