Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK.
Tony Hillis Unit, Lambeth Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
Schizophr Bull. 2020 Feb 26;46(2):261-271. doi: 10.1093/schbul/sbz069.
Childhood psychotic symptoms have been associated with various psychiatric disorders in adulthood but their role as early markers of poor outcomes during the crucial transition to adulthood is largely unknown. Therefore, we investigated associations between age-12 psychotic symptoms and a range of mental health problems and functional outcomes at age 18.
Data were used from the Environmental Risk Longitudinal Twin Study, a nationally representative birth cohort of 2232 twins born in 1994-1995 in England and Wales, followed to age 18 with 93% retention. Childhood psychotic symptoms were assessed in structured interviews at age 12. At age 18, study members' mental health problems, functional outcomes, risky behaviors, and offending were measured using self-reports and official records.
Children with psychotic symptoms (N = 125, 5.9%) were more likely to experience a range of mental health problems in young adulthood than children without such symptoms. They were also more likely to be obese, smoke cigarettes, be lonely, be parents, and report a lower quality of life, but not more likely to commit crimes. Childhood psychotic symptoms predicted these poor outcomes over and above other emotional and behavioral problems during childhood. Nevertheless, twin analyses indicated that these associations were largely accounted for by shared family factors.
Psychotic symptoms in childhood signal risk for pervasive mental health and functional difficulties in young adulthood and thus may provide a useful screen for an array of later problems. However, early psychotic symptoms and poor outcomes may be manifestations of shared environmental and genetic risks.
儿童期精神病症状与成年后的各种精神障碍有关，但它们作为向成年期关键过渡期间不良结局的早期标志物的作用在很大程度上尚不清楚。因此，我们研究了 12 岁时的精神病症状与一系列心理健康问题和 18 岁时的功能结果之间的关联。
本研究使用了环境风险纵向双胞胎研究的数据，该研究是一项全国性的代表性出生队列研究，共有 2232 对双胞胎于 1994 年至 1995 年在英格兰和威尔士出生，在 18 岁时进行了 93%的保留随访。12 岁时通过结构化访谈评估儿童期精神病症状。在 18 岁时，通过自我报告和官方记录测量研究对象的心理健康问题、功能结果、危险行为和犯罪行为。
患有精神病症状的儿童（N=125，5.9%）比没有此类症状的儿童更有可能在成年早期经历一系列心理健康问题。他们也更有可能肥胖、吸烟、孤独、为人父母，并报告生活质量较低，但不太可能犯罪。在考虑了儿童期的其他情绪和行为问题后，儿童期的精神病症状仍然可以预测这些不良结果。然而，双胞胎分析表明，这些关联在很大程度上是由共同的家庭因素造成的。
儿童期的精神病症状预示着成年早期普遍存在心理健康和功能困难的风险，因此可能是一系列后期问题的有用筛查工具。然而，早期的精神病症状和不良结果可能是共同的环境和遗传风险的表现。
