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Childhood and adolescent psychotic experiences and risk of mental disorder: a systematic review and meta-analysis

Published online by Cambridge University Press:  15 May 2019

Colm Healy*
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Ross Brannigan
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Niamh Dooley
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Helen Coughlan
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Mary Clarke
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Ian Kelleher
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
Mary Cannon
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
*
Author for correspondence: Colm Healy, E-mail: colmhealy@rcsi.com

Abstract

Background

Psychotic experiences (PEs) are common in childhood and adolescence and their association with mental disorders is well-established. We aim to conduct a quantitative synthesis the literature on the relationship between childhood and adolescent PEs and (i) any mental disorder; and (ii) specific categories of mental disorder, while stratifying by study design.

Method

Three electronic databases (PUBMED, PsycINFO and EMBASE) were searched from inception to August 2017 for all the published literature on childhood and adolescent PEs and mental disorder (outcome) in non-help-seeking community samples. Study quality was assessed using a recognised quality assessment tool for observational studies. Two authors conducted independent data extraction. Pooled odds ratios were calculated for mental disorders using random-effects models. Additional analyses were conducted investigating different categories of mental disorder while stratifying by study design.

Results

Fourteen studies from 13 community samples (n = 29 517) were identified with 9.8% of participants reporting PEs. PEs were associated with a three-fold increased risk of any mental disorder [odds ratio (OR) 3.08, confidence interval (CI) 2.26–4.21, k = 12]. PEs were associated with four-fold increase risk of psychotic disorder (OR 3.96, CI 2.03–7.73, population-attributable-fraction: 23.2%, k = 5). In addition, PEs were associated with an increased risk of affective disorders, anxiety disorders, behavioural disorders and substance-use disorders. Few longitudinal studies have investigated childhood and adolescent PEs and subsequent non-psychotic disorders which limited a meaningful synthesis and interpretation of these results.

Conclusion

This meta-analysis confirms that PEs are prevalent in childhood and adolescent community samples and are associated with a variety of mental disorders beyond psychotic disorders. Further longitudinal research is necessary to fully determine the longitudinal relationship between PEs and non-psychotic disorders.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2019 

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