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Psychotic experiences from preadolescence to adolescence: when should we be worried about adolescent risk behaviors?

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Abstract

Psychotic experiences (PE), below the threshold of psychotic disorder, are common in the general population. PE are associated with risk behaviors such as suicidality, non-suicidal self-injury (NSSI) and substance use. However, PE as specific or causal phenomena of these risk behaviors are still debated. We aimed to examine the longitudinal trajectories of PE from preadolescence to adolescence and their associated risk behaviors in adolescence. A total of 1138 adolescents from the Copenhagen Child Cohort 2000 were assessed for PE and risk behaviors (NSSI, suicide ideation and -attempts and substance use) at age 11 and 16 years, along with measures of general psychopathology and depressive symptoms specifically. Self-reported impact of general psychopathology tended to be associated with more PE persistence. PE were associated with all risk behaviors in cross section at both follow-ups. Persistent PE from ages 11 to 16 and incident PE at age 16 were associated with risk behaviors at age 16, whereas remitting PE from age 11 to 16 were not. After adjustment for co-occurring depressive symptoms and general psychopathology, all associations were markedly reduced. After exclusion of preadolescents who already had expressed risk behavior at age 11, PE in preadolescence did not stand out as an independent predictor of incident adolescent risk behaviors. The current study suggests that PE in preadolescence and adolescence may not play a direct causal role regarding NSSI, suicidality, and substance use. However, PE are still useful clinical markers of severity of psychopathology and associated risk behaviors.

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Acknowledgements

We thank Anja Munkholm (MD, Ph.D.), Anne Dorothee Müller (MSc.), Maja Gregersen (MSc.), and Kia Elten (MSc.) for their substantial contributions to data collection. The current project was supported by Grants from the Danish Foundations TrygFonden (J. nr. 7-10-0189, 7-11-0341 and 109903); the Lundbeckfonden (J. nr. R54-A5843). Martin K. Rimvall was funded by a Ph.D. Grant from the Mental Health Services of the Capital Region of Denmark.

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Authors and Affiliations

  1. Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark

    Martin K. Rimvall, Frank Verhulst & Pia Jeppesen

  2. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Martin K. Rimvall, Frank Verhulst & Pia Jeppesen

  3. Department of Psychiatry, University Medical Centre Utrecht, Brain Center Rudolf Magnus, Utrecht, The Netherlands

    Jim van Os

  4. Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands

    Jim van Os

  5. Department of Psychosis Studies, King’s College London, King’s Health Partners, Institute of Psychiatry, London, UK

    Jim van Os

  6. Research Unit, Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Aarhus, Denmark

    Charlotte Ulrikka Rask

  7. Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

    Charlotte Ulrikka Rask

  8. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Else Marie Olsen

  9. Centre for Clinical Research and Prevention, the Capital Region of Denmark, Copenhagen, Denmark

    Else Marie Olsen

  10. National Institute of Public Health, University of Southern Denmark, Odense, Denmark

    Anne Mette Skovgaard

  11. Center for Telepsychiatry, Mental Health Services, Region of Southern Denmark, Odense, Denmark

    Lars Clemmensen

  12. National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark

    Janne Tidselbak Larsen

  13. Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, Denmark

    Janne Tidselbak Larsen

  14. Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark

    Janne Tidselbak Larsen

  15. Department of Child Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Frank Verhulst

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  1. Martin K. Rimvall
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  2. Jim van Os
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Correspondence to Martin K. Rimvall.

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Frank Verhulst publishes the Dutch translations of ASEBA materials from which he receives remuneration. The remaining authors declare that they have no potential conflicts of interest.

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Rimvall, M.K., van Os, J., Rask, C.U. et al. Psychotic experiences from preadolescence to adolescence: when should we be worried about adolescent risk behaviors?. Eur Child Adolesc Psychiatry 29, 1251–1264 (2020). https://doi.org/10.1007/s00787-019-01439-w

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