Developmental Pathways and Clinical Outcomes of Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder: A Prospective, Longitudinal Cohort Study - The Danish High Risk and Resilience Study, VIA 11

Maja Gregersen; Jens Richardt Møllegaard Jepsen; Sinnika Birkehøj Rohd; Anne Søndergaard; Julie Marie Brandt; Ditte Ellersgaard; Carsten Hjorthøj; Jessica Ohland; Mette Falkenberg Krantz; Martin Wilms; Anna Krogh Andreassen; Lotte Veddum; Christina Bruun Knudsen; Aja Neergaard Greve; Vibeke Bliksted; Ole Mors; Lars Clemmensen; Merete Nordentoft; Nicoline Hemager; Anne Amalie Elgaard Thorup

doi:10.1176/appi.ajp.21101076

Developmental Pathways and Clinical Outcomes of Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder: A Prospective, Longitudinal Cohort Study - The Danish High Risk and Resilience Study, VIA 11

Am J Psychiatry. 2022 Sep;179(9):628-639. doi: 10.1176/appi.ajp.21101076.

Authors

Maja Gregersen¹, Jens Richardt Møllegaard Jepsen¹, Sinnika Birkehøj Rohd¹, Anne Søndergaard¹, Julie Marie Brandt¹, Ditte Ellersgaard¹, Carsten Hjorthøj¹, Jessica Ohland¹, Mette Falkenberg Krantz¹, Martin Wilms¹, Anna Krogh Andreassen¹, Lotte Veddum¹, Christina Bruun Knudsen¹, Aja Neergaard Greve¹, Vibeke Bliksted¹, Ole Mors¹, Lars Clemmensen¹, Merete Nordentoft¹, Nicoline Hemager¹, Anne Amalie Elgaard Thorup¹

Affiliation

¹ Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors).

PMID: 36048497
DOI: 10.1176/appi.ajp.21101076

Abstract

Objective: Psychotic experiences are common in children and adolescents and are associated with concurrent and subsequent psychopathology. Most findings originate from general population studies, whereas little is known of the clinical outcomes of psychotic experiences in children and adolescents at familial high risk of psychosis. We examined the prevalence of psychotic experiences in middle childhood and whether early childhood psychotic experiences and developmental pathways of psychotic experiences predicted mental disorders in middle childhood in children at familial high risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and a population-based control group.

Methods: In a longitudinal population-based cohort study children at FHR-SZ (N=170), FHR-BP (N=103), and the control group (N=174) were assessed for psychotic experiences and axis I disorders with face-to-face interviews in early and middle childhood (at 7 and 11 years of age).

Results: Psychotic experiences were more prevalent in children at FHR-SZ (31.8%, odds ratio 2.1, 95% CI 1.3-3.4) than in the control group (18.4%) in middle childhood. Early childhood psychotic experiences predicted mental disorders in middle childhood after adjusting for early childhood disorders and familial risk (odds ratio 2.0, 95% CI 1.2-3.1). Having three or more psychotic experiences increased odds the most (odds ratio 2.5, 95% CI 1.1-5.7). Persistent psychotic experiences were associated with increased odds of middle childhood disorders (odds ratio 4.1, 95% CI 2.1-8.4). Psychotic experiences were nondifferentially associated with mental disorders across the three familial risk groups.

Conclusions: Early childhood psychotic experiences predict mental disorders in middle childhood. Psychotic experiences index vulnerability for psychopathology nondifferentially in children at familial high risk and the control group. Psychotic experiences should be included in mental health screenings including children at familial high risk.

Keywords: Bipolar and Related Disorders; Child/Adolescent Psychiatry; Schizophrenia Spectrum and Other Psychotic Disorders.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Bipolar Disorder* / diagnosis
Bipolar Disorder* / epidemiology
Bipolar Disorder* / genetics
Child
Child, Preschool
Cohort Studies
Denmark / epidemiology
Genetic Predisposition to Disease
Humans
Longitudinal Studies
Mental Disorders* / psychology
Prospective Studies
Psychotic Disorders* / diagnosis
Psychotic Disorders* / epidemiology
Psychotic Disorders* / psychology
Schizophrenia* / diagnosis
Schizophrenia* / epidemiology
Schizophrenia* / genetics