Stimulant Medication and Psychotic Symptoms in Offspring of Parents With Mental Illness

Abstract

BACKGROUND: Stimulants, such as methylphenidate, are among the most commonly used medications in children and adolescents. Psychotic symptoms have been reported as rare adverse reactions to stimulants but have not been systematically inquired about in most previous studies. Family history of mental illness may increase the vulnerability to druginduced psychotic symptoms. We examined the association between stimulant use and psychotic symptoms in sons and daughters of parents with major mood and psychotic disorders.

Hallucinations and other psychotic symptoms in response to methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder: a Cochrane systematic review with meta-analysis and trial sequential analysis#

“…Five studies only included patients with comorbid disorders, including schizophrenia (64), comorbid conduct disorder or oppositional-defiant disorder (59), severe mood dysregulation (60), sleeping difficulties (58) and velocardiofacial syndrome (49). One study only included patients with parents with severe mental illness (68). In the studies, 17.4% to 100% of the patients had the ADHD combined subtype, 11.6% to 70.2% had the inattentive subtype and 0.8% to 55% had the hyperactive-impulsive subtype.…”

“…The assessment of psychotic symptoms varied across studies. Rating scales including items focusing on psychotic symptoms were used in two studies (60,68). In one of these studies, structured interviews for prodromal syndrome was also used (68).…”

“…Rating scales including items focusing on psychotic symptoms were used in two studies (60,68). In one of these studies, structured interviews for prodromal syndrome was also used (68). A structured form including any psychiatric symptomatology was used in one study (62).…”

Terminology and assessment tools of psychosis: A systematic narrative review

“…[195][196][197][198] Others only directly referred to delusions 199,200 or hallucinations. 201 Thought disorder, 97,131,145,156,161,165,167,169,184,189,[192][193][194]196,197,202 paranoia, 100,109,144,167,203 illusions, 100,144,168 ideas of reference, 118 misidentification, 122,134,157 disorganization, 123 bizarre or disorganized behavior, 156,161,165,184,185,189,191,193 psychomotor disorder, 165,184,193 behavioral changes, 159 and depersonalization and derealization 160 were also included.…”

Psychotic symptoms are associated with lower cortical folding in youth at risk for mental illness

“…30 Psychotic symptoms were assessed using the following instruments: the KSADSPL interview psychosis module and appendix, consensusrated by child and adolescent psychiatrists blind to parent psychopathology; in participants aged 3-12 years, the Structured Interview for Prodromal Syndromes (SIPS), 31 measuring attenuated psychotic symptoms; the "Funny Feel ings" interview [32][33][34] (we included only youth with symptoms rated as "definite psychotic symptom" by consensus between 2 independent raters); the Schizophrenia Proneness Instru ment, Child and Youth version (SPICY) 35 for those aged 8 years and older, to assess abnormal experiences in the domains of perception, cognition, language and affect that strongly predict the development of psychosis. 36,37 Consistent with our previous reports, 38,39 we created a di chotomous variable for the presence of psychotic symptoms captured by any one of the following: confirmed hallucina tions or delusions on KSADSPL, positive symptoms on SIPS rated ≥ 3, definite psychotic symptoms confirmed through in dependent curation, and highrisk basic symptom profiles of cognitive/perceptive disturbances on the SPICY.…”