Child and Adolescent Mental Health Center, Mental Health Services, Capital Region of Denmark, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Schizophr Bull. 2021 Apr 29;47(3):682-691. doi: 10.1093/schbul/sbaa175.
Psychotic experiences (PEs) are common in the general population in preadolescence. The implications of PEs on socioeconomic outcomes, including educational attainment, are scarcely described. We aimed to estimate how preadolescent PEs were associated with later healthcare costs, school performance, and health-related quality of life (HRQoL) in adolescence. A total of 1607 preadolescents from the general population Copenhagen Child Cohort 2000 were assessed for PEs at age 11-12 years and followed up over 5 years using register-based data on mental and somatic healthcare costs, and school performance at age 16. Furthermore, HRQoL was assessed for a subsample of the children at age 16-17. We adjusted for perinatal and family sociodemographic adversities, prior parental mental illness and healthcare use, child IQ-estimate at age 11-12, and parent-rated general psychopathology of their child. PEs were associated with slightly poorer school performance. However, preadolescents with PEs more often reported HRQoL within the lowest 10th percentile (OR = 2.74 [95% CI 1.71-4.37]). Preadolescents who reported PEs had higher average total healthcare costs over the following 5 years. The costs for individuals with PEs were higher for mental healthcare services across primary to tertiary care, but not for somatic care. After adjustments, PEs remained independently associated with higher costs and poorer HRQoL, but not with poorer school performance. In conclusion, PEs are important in mental health screening of preadolescents and identify a group of young people with increased healthcare service-use throughout adolescence and who report poorer HRQoL in adolescence, over and above parent-rated general psychopathology of their child.
在青春期前，精神体验（PEs）在普通人群中很常见。PEs 对社会经济结果的影响，包括教育程度，几乎没有描述。我们旨在估计青春期前的 PEs 如何与青少年时期的后期医疗保健成本、学校表现和健康相关的生活质量（HRQoL）相关。共有 1607 名来自普通人群的青春期前儿童在 11-12 岁时接受了 PEs 评估，并通过基于登记的关于精神和躯体保健成本以及 16 岁时学校表现的数据进行了 5 年以上的随访。此外，对儿童的子样本进行了 HRQoL 评估。我们调整了围产期和家庭社会人口统计学逆境、父母先前的精神疾病和医疗保健使用、11-12 岁时的儿童 IQ 估计以及父母对其孩子一般精神病理学的评价。PEs 与较差的学校表现略有相关。然而，有 PEs 的青春期前儿童更经常报告 HRQoL 在最低的第 10 个百分位数内（OR=2.74 [95%CI 1.71-4.37]）。在接下来的 5 年中，报告有 PEs 的青春期前儿童的平均总医疗保健成本更高。PEs 的个体在从初级保健到三级保健的精神保健服务方面的费用更高，但在躯体保健方面并非如此。调整后，PEs 仍然与更高的成本和更差的 HRQoL 独立相关，但与较差的学校表现无关。总之，PEs 在青春期前的心理健康筛查中很重要，它确定了一组在整个青春期内增加医疗服务使用的年轻人，并且在青春期报告了更差的 HRQoL，超过了对其孩子的父母一般精神病理学的评价。
