Adolescent Psychotic Experiences and Adverse Mental Health Outcomes in Young Adulthood in a General Population Sample

Objective: To estimate the risk of incident depressive, anxiety, psychotic disorders, and suicide attempts associated with adolescent psychotic experiences. Methods: A nested case-control design was used within the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth-cohort study that recruited expectant mothers from 1991 to 1992. Participants were 8822 offspring of ALSPAC mothers who completed the Psychosis-like Symptoms Questionnaire, which assessed Psychotic Experiences (PEs). Depressive disorders were assessed using the Short Mood and Feelings Questionnaire, anxiety disorders using the generalized anxiety disorder (GAD) Assessment and the Clinical Interview Schedule-Revised, and psychotic disorders using the PLIKS structured interviews. Risk of incident depressive disorder, GAD, psychotic disorder, and suicide attempts were compared between participants who had ever versus never reported a PE and those who reported persistent versus transient PEs. Results: Adolescent PEs were associated with increased risk for incident depressive disorder (adjusted hazard ratio [aHR] = 1.62, 95% confidence interval [CI] = 1.42–1.84), GAD (aHR 1.23, 95% CI = 1.03–1.47), psychotic disorder (adjusted odds ratio [aOR] = 5.08, 95% CI = 2.02–12.79), and suicide attempts (aHR = 2.11, 95% CI; 1.70–2.62). Persistent PEs (compared with transient) were associated with increased risk for depressive disorder (aHR = 1.81, 95% CI = 1.55–2.12), GAD (aHR = 1.34, 95% CI = 1.07–1.68), and psychotic disorder (aOR = 7.39, 95% CI = 2.43–22.19) but not suicide attempts. Conclusion: Adolescent PEs are a risk factor for multiple mental disorders and suicide attempts, with persistent PEs conferring greater risk. Identifying interventions for adolescents who report PEs, particularly persistent PEs, could lessen the burden of multiple mental health disorders and suicide attempts.