Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T17:06:55.173Z Has data issue: false hasContentIssue false

Early adult mental health, functional and neuropsychological outcomes of young people who have reported psychotic experiences: a 10-year longitudinal study

Published online by Cambridge University Press:  27 March 2020

Eleanor Carey*
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin Trinity College Institute of Neuroscience, Dublin, Ireland
Diane Gillan
Affiliation:
Department of Psychology, Beaumont Hospital, Dublin, Ireland
Colm Healy
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Niamh Dooley
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin Trinity College Institute of Neuroscience, Dublin, Ireland
Dónal Campbell
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin Department of Psychology, Beaumont Hospital, Dublin, Ireland
Josen McGrane
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Aisling O'Neill
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin Trinity College Institute of Neuroscience, Dublin, Ireland
Helen Coughlan
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Mary Clarke
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Ian Kelleher
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin
Mary Cannon
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin Trinity College Institute of Neuroscience, Dublin, Ireland Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
*
Author for correspondence: Eleanor Carey, E-mail: eleanorcarey1@rcsi.com

Abstract

Background

Psychotic experiences (PE) are highly prevalent in childhood and are known to be associated with co-morbid mental health disorders and functional difficulties in adolescence. However, little is known about the long-term outcomes of young people who report PE.

Methods

As part of the Adolescent Brain Development Study, 211 young people were recruited in childhood (mean age 11.7 years) and underwent detailed clinical interviews, with 25% reporting PE. A 10 year follow-up study was completed and 103 participants returned (mean age 20.9 years). Structured clinical interviews for DSM-5 (SCID-5) and interviewer-rated assessments of functioning were conducted. A detailed neuropsychological battery was also administered. Analyses investigated group differences between those who had ever reported PE and controls in early adulthood.

Results

The PE group was at a significantly higher risk of meeting DSM-5 criteria for a current (OR 4.08, CI 1.16–14.29, p = 0.03) and lifetime psychiatric disorder (OR 3.27, CI 1.43–7.47, p = 0.005). They were also at a significantly higher risk of multi-morbid lifetime psychiatric disorders. Significantly lower scores on current social and global functioning measures were observed for the PE group. Overall, there were no differences in neuropsychological performance between groups apart from significantly lower scores on the Stroop Word task and the Purdue Pegboard task for the PE group.

Conclusions

Our findings suggest that reports of PE are associated with poorer mental health and functional outcomes in early adulthood, with some persisting cognitive and motor deficits. Young people who report such symptoms could be considered a target group for interventions to aid functional outcomes.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Armando, M., Nelson, B., Yung, A. R., Ross, M., Birchwood, M., Girardi, P., & Nastro, P. F. (2010). Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophrenia Research, 119, 258265.CrossRefGoogle Scholar
Blanchard, M. M., Jacobson, S., Clarke, M. C., Connor, D., Kelleher, I., Garavan, H., … Cannon, M. (2010). Language, motor and speed of processing deficits in adolescents with subclinical psychotic symptoms. Schizophrenia Research, 123, 7176.CrossRefGoogle ScholarPubMed
Bora, E., & Murray, R. M. (2013). Meta-analysis of cognitive deficits in ultra-high risk to psychosis and first-episode psychosis: Do the cognitive deficits progress over, or after, the onset of psychosis? Schizophrenia Bulletin, 40, 744755.CrossRefGoogle ScholarPubMed
Brandizzi, M., Schultze-Lutter, F., Masillo, A., Lanna, A., Curto, M., Lindau, J. F., … Gebhardt, E. (2014). Self-reported attenuated psychotic-like experiences in help-seeking adolescents and their association with age, functioning and psychopathology. Schizophrenia Research, 160, 10117.CrossRefGoogle ScholarPubMed
Calkins, M. E., Moore, T. M., Merikangas, K. R., Burstein, M., Satterthwaite, T. D., Bilker, W. B., … Qiu, H. (2014). The psychosis spectrum in a young US community sample: Findings from the Philadelphia neurodevelopmental cohort. World Psychiatry, 13, 296305.CrossRefGoogle Scholar
Calkins, M. E., Moore, T. M., Satterthwaite, T. D., Wolf, D. H., Turetsky, B. I., Roalf, D. R., & Gur, R. E. (2017). Persistence of psychosis spectrum symptoms in the Philadelphia Neurodevelopmental Cohort: a prospective two-year follow-up. World Psychiatry, 16, 6276.CrossRefGoogle ScholarPubMed
Cannon, M., Jones, P., Huttunen, M. O., Tanskanen, A., Huttunen, T., Rabe-Hesketh, S., & Murray, R. M. (1999). School performance in Finnish children and later development of schizophrenia: A population-based longitudinal study. Archives of General Psychiatry, 56, 457463.CrossRefGoogle ScholarPubMed
Carey, E., Dooley, N., Gillan, D., Healy, C., Coughlan, H., Clarke, M., … Cannon, M. (2019). Fine motor skill and processing speed deficits in young people with psychotic experiences: A longitudinal study. Schizophrenia Research, 204, 127132.CrossRefGoogle ScholarPubMed
Cornblatt, B. A., Auther, A. M., Niendam, T., Smith, C. W., Zinberg, J., Bearden, C. E., & Cannon, T. D. (2007). Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia. Schizophrenia Bulletin, 33, 688702.CrossRefGoogle ScholarPubMed
Fisher, H. L., Caspi, A., Poulton, R., Meier, M. H., Houts, R., Harrington, H., … Moffitt, T. E. (2013). Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: A birth cohort study. Psychological Medicine, 43, 20772086.CrossRefGoogle ScholarPubMed
Gschwandtner, U., Pflüger, M., Aston, J., Drewe, M., Stieglitz, R. D., & Riecher–Rössler, A. (2006). Fine motor function and neuropsychological deficits in individuals at risk for schizophrenia. European Archives of Psychiatry and Clinical Neuroscience, 256, 201206.CrossRefGoogle ScholarPubMed
Gur, R. C., Calkins, M. E., Satterthwaite, T. D., Ruparel, K., Bilker, W. B., Moore, T. M., … Gur, R. E. (2014). Neurocognitive growth charting in psychosis spectrum youths. JAMA Psychiatry, 71, 366374.CrossRefGoogle ScholarPubMed
Healy, C., Brannigan, R., Dooley, N., Coughlan, H., Clarke, M., Kelleher, I., & Cannon, M. (2019). Childhood and adolescent psychotic experiences and risk of mental disorder: A systematic review and meta-analysis. Psychological Medicine, 10, 111.Google Scholar
Healy, C., Campbell, D., Coughlan, H., Clarke, M., Kelleher, I., & Cannon, M. (2018). Childhood psychotic experiences are associated with poorer global functioning throughout adolescence and into early adulthood. Acta Psychiatrica Scandinavica, 138, 2634.CrossRefGoogle ScholarPubMed
Heinze, K., Lin, A., Nelson, B., Reniers, R. L., Upthegrove, R., Clarke, L., … Wood, S. J. (2018). The impact of psychotic experiences in the early stages of mental health problems in young people. BMC Psychiatry, 18, 214.CrossRefGoogle ScholarPubMed
Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6570.Google Scholar
Kelleher, I., & Cannon, M. (2014). SOCRATES Assessment of Perceptual Abnormalities and Unusual Thought Content.Google Scholar
Kelleher, I., Clarke, M. C., Rawdon, C., Murphy, J., & Cannon, M. (2012a). Neurocognition in the extended psychosis phenotype: Performance of a community sample of adolescents with psychotic symptoms on the MATRICS neurocognitive battery. Schizophrenia Bulletin, 39, 10181026.CrossRefGoogle Scholar
Kelleher, I., Connor, D., Clarke, M. C., Devlin, N., Harley, M., & Cannon, M. (2012b). Prevalence of psychotic symptoms in childhood and adolescence: A systematic review and meta-analysis of population-based studies. Psychological Medicine, 42, 18571863.CrossRefGoogle Scholar
Kelleher, I., Keeley, H., Corcoran, P., Lynch, F., Fitzpatrick, C., Devlin, N., … Arseneault, L. (2012c). Clinicopathological significance of psychotic experiences in non-psychotic young people: Evidence from four population-based studies. The British Journal of Psychiatry, 201, 2632.CrossRefGoogle Scholar
Kelleher, I., Wigman, J. T., Harley, M., O'Hanlon, E., Coughlan, H., Rawdon, C., … Cannon, M. (2015). Psychotic experiences in the population: Association with functioning and mental distress. Schizophrenia Research, 165, 914.CrossRefGoogle ScholarPubMed
Kim, S. J., Lee, Y. J., Jang, J. H., Lim, W., Cho, I. H., & Cho, S. J. (2012). The relationship between psychotic-like experiences and attention deficits in adolescents. Journal of Psychiatric Research, 46, 13541358.CrossRefGoogle ScholarPubMed
Kounali, D., Zammit, S., Wiles, N., Sullivan, S., Cannon, M., Stochl, J., & Lewis, G. (2014). Common versus psychopathology-specific risk factors for psychotic experiences and depression during adolescence. Psychological Medicine, 44, 25572566.CrossRefGoogle ScholarPubMed
Lin, A., Wigman, J. T. W., Nelson, B., Vollebergh, W. A., Van Os, J., Baksheev, G., … Yung, A. R. (2011). The relationship between coping and subclinical psychotic experiences in adolescents from the general population – a longitudinal study. Psychological Medicine, 41, 25352546.CrossRefGoogle ScholarPubMed
Lindgren, M., Manninen, M., Laajasalo, T., Mustonen, U., Kalska, H., Suvisaari, J., … Therman, S. (2010). The relationship between psychotic-like symptoms and neurocognitive performance in a general adolescent psychiatric sample. Schizophrenia Research, 123, 7785.CrossRefGoogle Scholar
Martín-Santiago, O., Suazo, V., Rodríguez-Lorenzana, A., de Azúa, S. R., Valcárcel, C., Díez, Á, … Molina, V. (2016). Relationship between subclinical psychotic symptoms and cognitive performance in the general population. Revista de Psiquiatría y Salud Mental (English Edition) 9, 7886.CrossRefGoogle ScholarPubMed
McGorry, P. D., Hartmann, J. A., Spooner, R., & Nelson, B. (2018). Beyond the “at risk mental state” concept: Transitioning to transdiagnostic psychiatry. World Psychiatry, 17, 133142.CrossRefGoogle ScholarPubMed
McGrath, J. J., Saha, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., Bruffaerts, R., … Florescu, S. (2015). Psychotic experiences in the general population: A cross-national analysis based on 31 261 respondents from 18 countries. JAMA Psychiatry, 72, 697705.CrossRefGoogle ScholarPubMed
Mittal, V. A., & Walther, S. (2019). As motor system pathophysiology returns to the forefront of psychosis research, clinical implications should hold center stage. Schizophrenia Bulletin, 45, 495497.CrossRefGoogle ScholarPubMed
Mollon, J., David, A. S., Morgan, C., Frissa, S., Glahn, D., Pilecka, I., … Reichenberg, A. (2016). Psychotic experiences and neuropsychological functioning in a population-based sample. JAMA Psychiatry, 73, 129138.CrossRefGoogle Scholar
Moriyama, T. S., van Os, J., Gadelha, A., Pan, P. M., Salum, G. A., Manfro, G. G., & McGuire, P. (2019). Differences between self-reported psychotic experiences, clinically relevant psychotic experiences, and attenuated psychotic symptoms in the general population. Frontiers in Psychiatry, 10, 782.CrossRefGoogle ScholarPubMed
Niarchou, M., Zammit, S., Walters, J., Lewis, G., Owen, M. J., & van den Bree, M. B. (2013). Defective processing speed and nonclinical psychotic experiences in children: Longitudinal analyses in a large birth cohort. American Journal of Psychiatry, 170, 550557.CrossRefGoogle Scholar
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry, 56, 345365.CrossRefGoogle ScholarPubMed
Saiepour, N., Najman, J. M., Ware, R., Baker, P., Clavarino, A. M., & Williams, G. M. (2019). Does attrition affect estimates of association: A longitudinal study. Journal of Psychiatric Research, 110, 127142.CrossRefGoogle ScholarPubMed
Scott, J., Welham, J., Martin, G., Bor, W., Najman, J., O'Callaghan, M., … McGrath, J. (2008). Demographic correlates of psychotic-like experiences in young Australian adults. Acta Psychiatrica Scandinavica, 118, 230237.CrossRefGoogle ScholarPubMed
Shanahan, L., Zucker, N., Copeland, W. E., Bondy, C. L., Egger, H. L., & Costello, E. J. (2015). Childhood somatic complaints predict generalized anxiety and depressive disorders during young adulthood in a community sample. Psychological Medicine, 45, 17211730.CrossRefGoogle Scholar
Strik, W., Stegmayer, K., Walther, S., & Dierks, T. (2017). Systems neuroscience of psychosis: Mapping schizophrenia symptoms onto brain systems. Neuropsychobiology, 75, 100116.CrossRefGoogle ScholarPubMed
Sullivan, S. A., Kounali, D., Cannon, M., David, A. S., Fletcher, P. C., Holmans, P., & Owen, M. J. (2020). A population-based cohort study examining the incidence and impact of psychotic experiences from childhood to adulthood, and prediction of psychotic disorder. American Journal of Psychiatry, appi-ajp.Google ScholarPubMed
Suvisaari, J., Aalto-Setälä, T., Tuulio-Henriksson, A., Härkänen, T., Saarni, S. I., Perälä, J., & Lähteenmäki, S. (2009). Mental disorders in young adulthood. Psychological Medicine, 39, 287299.CrossRefGoogle ScholarPubMed
Trotta, A., Arseneault, L., Caspi, A., Moffitt, T. E., Danese, A., Pariante, C., & Fisher, H. L. (2020). Mental health and functional outcomes in young adulthood of children with psychotic symptoms: A longitudinal cohort study. Schizophrenia Bulletin 46, 261271.Google ScholarPubMed
Van Os, J., Linscott, R. J., 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.CrossRefGoogle ScholarPubMed
Yates, K., Lång, U., Cederlöf, M., Boland, F., Taylor, P., Cannon, M., … Kelleher, I. (2019). Association of psychotic experiences with subsequent risk of suicidal ideation, suicide attempts, and suicide deaths: a systematic review and meta-analysis of longitudinal population studies. JAMA Psychiatry, 76, 180189.CrossRefGoogle ScholarPubMed
Supplementary material: File

Carey et al. supplementary material

Tables S1-S4

Download Carey et al. supplementary material(File)
File 30 KB