Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Hellerup, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Eur Child Adolesc Psychiatry. 2020 Sep;29(9):1251-1264. doi: 10.1007/s00787-019-01439-w. Epub 2019 Nov 15.
Psychotic experiences (PE), below the threshold of psychotic disorder, are common in the general population. PE are associated with risk behaviors such as suicidality, non-suicidal self-injury (NSSI) and substance use. However, PE as specific or causal phenomena of these risk behaviors are still debated. We aimed to examine the longitudinal trajectories of PE from preadolescence to adolescence and their associated risk behaviors in adolescence. A total of 1138 adolescents from the Copenhagen Child Cohort 2000 were assessed for PE and risk behaviors (NSSI, suicide ideation and -attempts and substance use) at age 11 and 16 years, along with measures of general psychopathology and depressive symptoms specifically. Self-reported impact of general psychopathology tended to be associated with more PE persistence. PE were associated with all risk behaviors in cross section at both follow-ups. Persistent PE from ages 11 to 16 and incident PE at age 16 were associated with risk behaviors at age 16, whereas remitting PE from age 11 to 16 were not. After adjustment for co-occurring depressive symptoms and general psychopathology, all associations were markedly reduced. After exclusion of preadolescents who already had expressed risk behavior at age 11, PE in preadolescence did not stand out as an independent predictor of incident adolescent risk behaviors. The current study suggests that PE in preadolescence and adolescence may not play a direct causal role regarding NSSI, suicidality, and substance use. However, PE are still useful clinical markers of severity of psychopathology and associated risk behaviors.
精神病性体验（PE），低于精神病障碍的阈值，在普通人群中很常见。PE 与自杀、非自杀性自伤（NSSI）和物质使用等风险行为有关。然而，PE 作为这些风险行为的特定或因果现象仍存在争议。我们旨在研究从青春期前到青春期的 PE 的纵向轨迹及其在青春期的相关风险行为。共有 1138 名来自哥本哈根儿童队列 2000 的青少年在 11 岁和 16 岁时评估了 PE 和风险行为（NSSI、自杀意念和尝试以及物质使用），同时还评估了一般精神病理学和特定的抑郁症状。一般精神病理学的自我报告影响往往与更多的 PE 持续存在相关。PE 在两个随访中都与所有风险行为在横断面相关。从 11 岁到 16 岁的持续 PE 和 16 岁的新发性 PE 与 16 岁时的风险行为相关，而从 11 岁到 16 岁的缓解性 PE 则没有。在调整共存的抑郁症状和一般精神病理学后，所有关联都明显减少。排除在 11 岁时已经表现出风险行为的青春期前儿童后，青春期前的 PE 并没有成为青少年风险行为的独立预测因素。本研究表明，青春期前和青春期的 PE 可能在 NSSI、自杀和物质使用方面没有直接的因果作用。然而，PE 仍然是精神病理学严重程度和相关风险行为的有用临床标志物。
