Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Hamburg, Germany.
Department of Special Needs Education and Rehabilitation, University of Oldenburg, Oldenburg, Germany.
Eur Child Adolesc Psychiatry. 2017 Apr;26(4):421-431. doi: 10.1007/s00787-016-0904-8. Epub 2016 Sep 13.
Prodromal symptoms of psychosis are associated with an increased risk of transition, functional impairment, poor mental health, and unfavorable developmental prospects. Existing interventions targeting the prodrome are non-satisfactory. It may thus be more promising to attempt to identify risk factors in the premorbid phase preceding the prodrome to increase the chances of successful preventive approaches. Here, we investigate whether childhood mental disorders in general and attention-deficit/hyperactivity disorder (ADHD) specifically indicate a risk for subsequent psychotic experiences and disorders. We used a sample from the prospective Avon Longitudinal Study of Parents and Children (N = 5528). When the participants were 7 years old, mental disorders were assigned according to the DSM-IV. In standardized interviews, psychotic experiences were assessed at age 12 and psychotic disorders at age 18. We examined the associations of each of the childhood mental disorders alone and in combination with psychotic experiences at age 12 and psychotic disorders at age 18 using logistic regression. Compared to participants without a disorder, participants with a mental disorder had a higher risk of psychotic experiences at age 12 (OR 1.70, 95 % CI 1.28-2.27) and of psychotic disorders at age 18 (OR 2.31, 95 % CI 1.03-5.15). Particularly, the ADHD combined subtype at age 7 was strongly associated with psychotic experiences at age 12 (OR 3.26, 95 % CI 1.74-6.10). As expected, childhood mental disorders are risk indicators of psychotic experiences and disorders. To improve prevention, health care professionals need to screen for psychotic experiences in children with non-psychotic disorders.
精神病前驱症状与转变风险增加、功能障碍、心理健康不良和不利的发展前景有关。针对前驱症状的现有干预措施并不令人满意。因此,尝试在前驱期,即在精神病前驱症状之前的发病前期识别风险因素,可能更有希望提高预防方法成功的机会。在这里,我们研究了一般儿童精神障碍,特别是注意缺陷多动障碍(ADHD)是否表明随后出现精神病体验和障碍的风险。我们使用了前瞻性父母和儿童纵向研究(Avon Longitudinal Study of Parents and Children,ALSPAC)的样本(N=5528)。当参与者 7 岁时,根据 DSM-IV 分配精神障碍。在标准化访谈中,12 岁时评估精神病体验,18 岁时评估精神病障碍。我们使用逻辑回归检查了每种儿童精神障碍单独以及与 12 岁时的精神病体验和 18 岁时的精神病障碍相结合的关联。与无疾病的参与者相比,患有精神障碍的参与者在 12 岁时出现精神病体验的风险更高(OR 1.70,95%CI 1.28-2.27),18 岁时出现精神病障碍的风险更高(OR 2.31,95%CI 1.03-5.15)。特别是,7 岁时的 ADHD 合并亚型与 12 岁时的精神病体验密切相关(OR 3.26,95%CI 1.74-6.10)。正如预期的那样,儿童精神障碍是精神病体验和障碍的风险指标。为了改善预防,医疗保健专业人员需要对非精神病障碍的儿童进行精神病体验筛查。