Skip to main content Accessibility help

Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies

  • I. Kelleher (a1), D. Connor (a1), M. C. Clarke (a1), N. Devlin (a1) (a2), M. Harley (a1) (a2) and M. Cannon (a1) (a3)...



Psychotic symptoms occur more frequently in the general population than psychotic disorder and index risk for psychopathology. Multiple studies have reported on the prevalence of these symptoms using self-report questionnaires or clinical interviews but there is a lack of consensus about the prevalence of psychotic symptoms among children and adolescents.


We conducted a systematic review of all published literature on psychotic symptom prevalence in two age groups, children aged 9–12 years and adolescents aged 13–18 years, searching through electronic databases PubMed, Ovid Medline, PsycINFO and EMBASE up to June 2011, and extracted prevalence rates.


We identified 19 population studies that reported on psychotic symptom prevalence among children and adolescents. The median prevalence of psychotic symptoms was 17% among children aged 9–12 years and 7.5% among adolescents aged 13–18 years.


Psychotic symptoms are relatively common in young people, especially in childhood. Prevalence is higher in younger (9–12 years) compared to older (13–18 years) children.


Corresponding author

*Address for correspondence: Dr I. Kelleher or Professor M. Cannon, Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland. (Email: (Email:


Hide All
Addington, J, Cornblatt, BA, Cadenhead, KS, Cannon, TD, McGlashan, TH, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, Woods, SW, Heinssen, R (2011). At clinical high risk for psychosis: outcome for nonconverters. American Journal of Psychiatry 168, 800805.
Alemany, S, Arias, B, Aguilera, M, Villa, H, Moya, J, Ibanez, MI, Vossen, H, Gasto, C, Ortet, G, Fananas, L (2011). Childhood abuse, the BDNF-Val66Met polymorphism and adult psychotic-like experiences. British Journal of Psychiatry 199, 3842.
Barragan, M, Laurens, KR, Navarro, JB, Obiols, JE (2011). Psychotic-like experiences and depressive symptoms in a community sample of adolescents. European Psychiatry 26, 396401.
Bartels-Velthuis, AA, Jenner, JA, van de Willige, G, van Os, J, Wiersma, D (2010). Prevalence and correlates of auditory vocal hallucinations in middle childhood. British Journal of Psychiatry 196, 4146.
Bartels-Velthuis, AA, van de Willige, G, Jenner, JA, van Os, J, Wiersma, D (2011). Course of auditory vocal hallucinations in childhood: 5-year follow-up study. British Journal of Psychiatry. Published online: 27 June 2011. doi:10.1192/bjp.bp.110.086918.
Blanchard, MM, Jacobson, S, Clarke, MC, Connor, D, Kelleher, I, Garavan, H, Harley, M, Cannon, M (2010). Language, motor and speed of processing deficits in adolescents with subclinical psychotic symptoms. Schizophrenia Research 123, 7176.
Cullen, AE, Dickson, H, West, SA, Morris, RG, Mould, GL, Hodgins, S, Murray, RM, Laurens, KR (2010). Neurocognitive performance in children aged 9-12 years who present putative antecedents of schizophrenia. Schizophrenia Research 121, 1523.
De Loore, E, Gunther, N, Drukker, M, Feron, F, Sabbe, B, Deboutte, D, van Os, J, Myin-Germeys, I (2011). Persistence and outcome of auditory hallucinations in adolescence: a longitudinal general population study of 1800 individuals. Schizophrenia Research 127, 252256.
Dhossche, D, Ferdinand, R, Van der Ende, J, Hofstra, MB, Verhulst, F (2002). Diagnostic outcome of self-reported hallucinations in a community sample of adolescents. Psychological Medicine 32, 619627.
Dominguez, MD, Wichers, M, Lieb, R, Wittchen, HU, van Os, J (2011). Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophrenia Bulletin 37, 8493.
Hanssen, M, Peeters, F, Krabbendam, L, Radstake, S, Verdoux, H, van Os, J (2003). How psychotic are individuals with non-psychotic disorders? Social Psychiatry and Psychiatric Epidemiology 38, 149154.
Horwood, J, Salvi, G, Thomas, K, Duffy, L, Gunnell, D, Hollis, C, Lewis, G, Menezes, P, Thompson, A, Wolke, D, Zammit, S, Harrison, G (2008). IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort. British Journal of Psychiatry 193, 185191.
Jacobson, S, Kelleher, I, Harley, M, Murtagh, A, Clarke, M, Blanchard, M, Connolly, C, O'Hanlon, E, Garavan, H, Cannon, M (2010). Structural and functional brain correlates of subclinical psychotic symptoms in 11–13 year old schoolchildren. NeuroImage 49, 18751885.
Johns, LC, Cannon, M, Singleton, N, Murray, RM, Farrell, M, Brugha, T, Bebbington, P, Jenkins, R, Meltzer, H (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. British Journal of Psychiatry 185, 298305.
Kelleher, I, Cannon, M (2011). Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychological Medicine 41, 16.
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C, Cannon, M (2008). Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378382.
Kelleher, I, Harley, M, Murtagh, A, Cannon, M (2011 a). Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview. Schizophrenia Bulletin 37, 362369.
Kelleher, I, Jenner, JA, Cannon, M (2010). Psychotic symptoms in the general population – an evolutionary perspective. British Journal of Psychiatry 197, 167169.
Kelleher, I, Keeley, H, Corcoran, P, Lynch, F, Fitzpatrick, C, Devlin, N, Molloy, C, Roddy, S, Clarke, MC, Harley, M, Arseneault, L, Wasserman, C, Carli, V, Sarchiapone, M, Hoven, CW, Wasserman, C, Cannon, M (in press). What is the clinicopathological significance of psychotic symptoms in non-psychotic young people? Evidence from 4 population studies. British Journal of Psychiatry.
Kelleher, I, Murtagh, A, Molloy, C, Roddy, S, Clarke, MC, Harley, M, Cannon, M (2011 b). Identification and characterization of prodromal risk syndromes in young adolescents in the community: a population-based clinical interview study. Schizophrenia Bulletin. Published online: 17 November 2011. doi:10.1093/schbul/sbr164.
Kinoshita, Y, Shimodera, S, Nishida, A, Kinoshita, K, Watanabe, N, Oshima, N, Akechi, T, Sasaki, T, Inoue, S, Furukawa, TA, Okazaki, Y (2011). Psychotic-like experiences are associated with violent behavior in adolescents. Schizophrenia Research 126, 245251.
Lataster, T, van Os, J, Drukker, M, Henquet, C, Feron, F, Gunther, N, Myin-Germeys, I (2006). Childhood victimisation and developmental expression of non-clinical delusional ideation and hallucinatory experiences: victimisation and non-clinical psychotic experiences. Social Psychiatry and Psychiatric Epidemiology 41, 423428.
Laurens, KR, Hobbs, MJ, Sunderland, M, Green, MJ, Mould, GL (2011). Psychotic-like experiences in a community sample of 8000 children aged 9 to 11 years: an item response theory analysis. Psychological Medicine. Published online: 17 October 2011. doi: 10.1017/S0033291711002108.
Laurens, KR, Hodgins, S, Mould, GL, West, SA, Schoenberg, PL, Murray, RM, Taylor, EA (2010). Error-related processing dysfunction in children aged 9 to 12 years presenting putative antecedents of schizophrenia. Biological Psychiatry 67, 238245.
Lencz, T, Smith, CW, Auther, A, Correll, CU, Cornblatt, B (2004). Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophrenia Research 68, 3748.
Linscott, RJ, van Os, J (2010). Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annual Review of Clinical Psychology 6, 391419.
Mackie, CJ, Castellanos-Ryan, N, Conrod, PJ (2011). Developmental trajectories of psychotic-like experiences across adolescence: impact of victimization and substance use. Psychological Medicine 41, 4758.
MacManus, D, Laurens, KR, Walker, EF, Brasfield, JL, Riaz, M, Hodgins, S (2012). Movement abnormalities and psychotic-like experiences in childhood: markers of developing schizophrenia? Psychological Medicine 42, 99–109.
Mittal, VA, Dean, DJ, Pelletier, A, Caligiuri, M (2011). Associations between spontaneous movement abnormalities and psychotic-like experiences in the general population. Schizophrenia Research 132, 194196.
Nishida, A, Tanii, H, Nishimura, Y, Kajiki, N, Inoue, K, Okada, M, Sasaki, T, Okazaki, Y (2008). Associations between psychotic-like experiences and mental health status and other psychopathologies among Japanese early teens. Schizophrenia Research 99, 125133.
Polanczyk, G, Moffitt, TE, Arseneault, L, Cannon, M, Ambler, A, Keefe, RS, Houts, R, Odgers, CL, Caspi, A (2010). Etiological and clinical features of childhood psychotic symptoms: results from a birth cohort. Archives of General Psychiatry 67, 328338.
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 10531058.
Rossler, W, Hengartner, MP, Ajdacic-Gross, V, Haker, H, Gamma, A, Angst, J (2011). Sub-clinical psychosis symptoms in young adults are risk factors for subsequent common mental disorders. Schizophrenia Research 131, 1823.
Saha, S, Chant, D, McGrath, J (2008). Meta-analyses of the incidence and prevalence of schizophrenia: conceptual and methodological issues. International Journal of Methods in Psychiatric Research 17, 5561.
Scott, J, Martin, G, Bor, W, Sawyer, M, Clark, J, McGrath, J (2009 a). The prevalence and correlates of hallucinations in Australian adolescents: results from a national survey. Schizophrenia Research 107, 179185.
Scott, J, Martin, G, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, Aird, R, McGrath, J (2009 b). Psychopathology during childhood and adolescence predicts delusional-like experiences in adults: a 21-year birth cohort study. American Journal of Psychiatry 166, 567574.
Shea, BJ, Grimshaw, JM, Wells, GA, Boers, M, Andersson, N, Hamel, C, Porter, AC, Tugwell, P, Moher, D, Bouter, LM (2007). Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology 15, 10.
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179195.
Varghese, D, Scott, J, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, McGrath, J (2011). Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophrenia Bulletin 37, 389393.
Welham, J, Scott, J, Williams, G, Najman, J, Bor, W, O'Callaghan, M, McGrath, J (2009). Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study. Psychological Medicine 39, 625634.
Wigman, JT, Vollebergh, WA, Raaijmakers, QA, Iedema, J, van Dorsselaer, S, Ormel, J, Verhulst, FC, van Os, J (2011). The structure of the extended psychosis phenotype in early adolescence – a cross-sample replication. Schizophrenia Bulletin 37, 850860.
Yoshizumi, T, Murase, S, Honjo, S, Kaneko, H, Murakami, T (2004). Hallucinatory experiences in a community sample of Japanese children. Journal of the American Academy of Child and Adolescent Psychiatry 43, 10301036.
Yung, AR, Nelson, B, Baker, K, Buckby, JA, Baksheev, G, Cosgrave, EM (2009). Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia. Australian and New Zealand Journal of Psychiatry 43, 118128.


Type Description Title
Supplementary materials

Kelleher Supplementary Material
Supplementary Material – AMSTAR

 Word (56 KB)
56 KB


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed