Dumas Louise-Emilie, Bonnard-Couton Valérie, Golse Bernard, Askénazy Florence
Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France.
Service universitaire de psychiatrie de l'enfance et de l'adolescence (SUPEA), hôpitaux pédiatriques de Nice, CHU Lenval, 57, avenue de la Californie, 06200 Nice, France; CoBTeK laboratory, université Côte d'Azur, 10, rue Molière, 06100 Nice, France.
Encephale. 2022 Oct;48(5):546-554. doi: 10.1016/j.encep.2021.06.010. Epub 2021 Oct 5.
Auditory-verbal hallucinatory experiences (AVH) represent a prevalence of 12% in the general pediatric population. They are most often considered as a transient and benign developmental phenomenon, associated with mood and anxiety disorders. The persistence of AVHs for several years and into adolescence would represent a poor prognosis of progression into a psychiatric disorder, and more particularly psychotic disorder. The alteration of social and emotional cognitive markers are described as prodromal of this unfavorable progression which should be considered within the continuum between subclinical and clinical signs of the "psychosis phenotype". The objective of this study was to assess these markers in children and adolescents with AVH and their correlation with the presence and persistence of hallucinations.
Multicenter prospective case-control study, longitudinal over 6months. Patients were included based on the presence of HAV on clinical examination. Forty subjects aged 8 to 16years from a clinical pediatric population were included. They were divided into two groups according to the Diagnostic Interview Schedule for Children-Child version (DISC-C): a group with AVH ("AVH+"), and a group without HAV ("AVH-"). A diagnosis of schizophrenia spectrum disorder was a non-inclusion criterion according to the criteria of DSM-5 (K-SADS-PL). This group was matched to the control group without AVH (AVH-) according to sex, age (±6months) and associated psychiatric diagnoses assessed by the MINI-Kid. The marker of social cognition was assessed with the NEPSY II test. The emotional marker was assessed with the self-questionnaires: EED IV, which highlights the emotions currently being felt by the subject, and the BAVQ-R, which categorizes the child's emotions in reaction to AVH.
No significant link was found between the social and emotional cognition markers and the presence of AVH at T0. At 6months, 50% of subjects in the AVH+ group suffered from persistent AVH and 18% progressed to a diagnosis of schizophrenia spectrum disorder. The persistence of AVH was not significantly correlated with the marker of social cognition, but it was significantly correlated with the presence of negative emotions (sadness, fear, hostility and anger) and inversely correlated with emotions of joy.
In this study, AVH experiences in the pediatric population are not linked to markers of social cognition, but negative emotions appear as early markers of AVH persistence.
NCT02567500.
听觉言语幻觉体验（AVH）在普通儿科人群中的患病率为12%。它们通常被认为是一种短暂的良性发育现象，与情绪和焦虑障碍有关。AVH持续数年直至青春期可能预示着发展为精神疾病，尤其是精神病性障碍的预后不良。社会和情感认知标志物的改变被描述为这种不良进展的前驱症状，应在“精神病性表型”的亚临床和临床症状连续体中予以考虑。本研究的目的是评估有AVH的儿童和青少年中的这些标志物，以及它们与幻觉的存在和持续时间的相关性。
多中心前瞻性病例对照研究，为期6个月的纵向研究。根据临床检查中是否存在HAV纳入患者。纳入了40名来自临床儿科人群的8至16岁受试者。根据儿童诊断访谈量表-儿童版（DISC-C）将他们分为两组：有AVH的组（“AVH+”）和无HAV的组（“AVH-”）。根据DSM-5（K-SADS-PL）标准，精神分裂症谱系障碍的诊断为非纳入标准。该组根据性别、年龄（±6个月）以及由MINI-Kid评估的相关精神科诊断与无AVH的对照组（AVH-）进行匹配。社会认知标志物通过NEPSY II测试进行评估。情绪标志物通过自我问卷进行评估：EED IV突出受试者当前感受到的情绪，BAVQ-R对儿童对AVH的反应情绪进行分类。
在T0时，未发现社会和情感认知标志物与AVH存在之间有显著关联。6个月时，AVH+组中50%的受试者患有持续性AVH，18%进展为精神分裂症谱系障碍的诊断。AVH的持续时间与社会认知标志物无显著相关性，但与负面情绪（悲伤、恐惧、敌意和愤怒）的存在显著相关，与喜悦情绪呈负相关。
在本研究中，儿科人群中的AVH体验与社会认知标志物无关，但负面情绪似乎是AVH持续存在的早期标志物。
NCT02567500。
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