Persistent Hallucinations May Increase Risk of Multiple Mental Health Disorders

While more than 12% of youth report having experienced a hallucination, these hallucinations are often transitory and do not indicate that later onset of psychosis is inevitable. However, youth who experience multiple hallucinations may be at a heightened risk of a variety of mental illnesses—not only psychosis—and suicide later in life.

Those were among the takeaway messages offered by several speakers at the International Congress of Schizophrenia Research (ICOSR) in San Diego last month.

James Scott, M.D., an affiliate associate professor at the University of Queensland Centre for Clinical Research, Australia, reported results from an Australian birth cohort study that included data on the mental health outcomes of individuals aged 30 to 33 who had filled out the Youth Self-Report Questionnaire at ages 14 and 21.

A total of 455 participants (12.9% of the total sample) self-reported having hallucinations at age 14, but not at age 21, and 140 (4%) self-reported hallucinations at both 14 and 21 years of age. These data were compared with those from 490 controls who reported no history of hallucinations at either time point.

Those with hallucinations at both 14 and 21 years had close to nine times the odds of having a psychotic disorder by 30 years of age compared with controls. Those with persistent hallucinations were also 2.3 times more likely than controls to have a substance use disorder and 3.6 times more likely to have an eating disorder. Moreover, those who reported a history of hallucinations at both time points had more than seven times the risk of any lifetime suicide attempt compared with controls. They were also less likely to be employed or in job training and four times as likely to have a poor quality of life, Scott reported.

Scott said that adolescents who present with hallucinations should receive a thorough mental health assessment, including screening for the presence of current or past trauma, suicidal ideation, and substance use. Avoidance of substance use, especially cannabis, is critical, Scott said. “Most adolescents who experience hallucination are not going to progress to psychosis, and most don’t develop schizophrenia. But it’s really important to avoid cannabis use.”

Look for further coverage of ICOSR in coming editions of Psychiatric News. For related information, see the AJP article “Personalized Prediction of Psychosis: External Validation of the NAPLS-2 Psychosis Risk Calculator With the EDIPPP Project.”

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