Wednesday, January 8, 2020

Psychotic Experience In Adolescence Associated With Psychotic Disorder as Young Adults

The majority of young people diagnosed with a psychotic disorder by age 24 have had a psychotic-like experience at age 12 or later, yet many have never sought professional help, according to a report in AJP in Advance.

Sarah A. Sullivan, Ph.D., of the University of Bristol, United Kingdom, and colleagues analyzed data on 3,866 adults aged 24 years who had been assessed at age 12, 18, and 24 as part of the Avon Longitudinal Birth Study. The researchers inquired about psychotic experiences using the Psychosis-Like Symptoms Interview.

Participants were diagnosed as having a psychotic disorder at age 24 if they had a definite psychotic experience not attributable to the effects of sleep or fever; if they had a psychotic experience regularly (at least once a month) over the previous six months; and if they rated the experience as either very distressing or having a very negative impact on their social or occupational functioning and/or if the experience led them to seek help from a professional source.

Of the total sample, 313 young people (8.1%) had had a definite psychotic experience, and 177 (4.6%) had had a suspected psychotic experience at age 12 or later. Of those with a definite psychotic experience, 268 (6.9%) had experienced a hallucination, and 91 (2.4%) a delusion. Forty-six individuals (1.2%) had experienced both.

One-hundred and nine 
participants met criteria for a psychotic disorder at age 24. Participants who had had a definite psychotic experience at age 12 were 6.8 times as likely to have a psychotic disorder at age 24 as those who did not.

“30% of participants who met our criteria for a psychotic disorder had not sought professional help for their experiences, indicating a significant and important unmet public health need in adolescents and young adults in the general population,” Sullivan and colleagues wrote.

“The use of individual-level interventions to reduce the individual and population health burden of psychotic illnesses requires identification of individuals at high risk,” they wrote. “Our study demonstrates that approximately 60% of those who met criteria for a psychotic disorder at age 24 had a self-reported psychotic experience at age 12, indicating that onset of odd or unusual experiences, even if they do not meet interviewer-rated criteria for being psychotic, are present from childhood in the majority of people who develop a psychotic disorder by their mid-20s.”

For related information, see the Psychiatric News article “Evidence Supporting Early Psychosis Treatment Grows as Programs Gain Ground in Communities.”

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