School of Education, Guangzhou University, Guangzhou, China; Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
Brain Res. 2024 Jun 1;1832:148853. doi: 10.1016/j.brainres.2024.148853. Epub 2024 Mar 6.
Children who experience persistent psychotic-like experiences (PLEs) are at a higher risk of developing psychotic disorder later in life. The developmental trajectories of PLEs are influenced by various factors. Therefore, it is important to identify early characteristics that can distinguish and predict between different developmental trajectories of PLEs.
Using PLEs scores from the Adolescent Brain Cognitive Development (ABCD) data across three waves, we categorized participants into five distinct PLEs trajectories groups: persistent group (n = 47), remitting group (n = 185), increasing group (n = 117), remittent group (n = 21), and no PLEs group (n = 4,476). We utilized linear mixed-effect models and generalized linear mixed-effect models to examine the differences in baseline characteristics, including psychological and behavioral problems, suicidality, trauma experiences, developmental milestones, cognitive function, physical health, family income, family history of mental illness, and brain structureamong these PLEs trajectory groups.
We found that psychological and behavioral problems (such as DSM-oriented scales/externalizing/ADHD/social/attention/thought problems) assessed by the Child Behavior Checklist (CBCL) were associated with all PLEs groups. The persistent PLEs group had greater ADHD/social/thought problems and suicidal behavior compared to the remitting PLEs group. Comparing with the no PLEs group, poor cognitive function, abnormal brain structure (such as temporal lobe and supramarginal gyrus), more trauma experiences, and lower family income were found in only one of the PLEs groups, but not all PLEs groups.
The development of PLEs is accompanied by changes in many domains, implying a dynamic and complex developmental process. Given that psychological and behavioral problems can predict the emergence of PLEs at any time and can be regarded as risk factors for persistent PLEs, thereby enabling early precisely interventions, it is important to place greater emphasis on assessing psychological and behavioral problems.
经历持续精神病样体验（PLE）的儿童在以后的生活中患精神病的风险更高。PLE 的发展轨迹受到各种因素的影响。因此，识别能够区分和预测不同 PLE 发展轨迹的早期特征非常重要。
我们使用来自青少年大脑认知发展（ABCD）研究的三个时间点的 PLE 评分，将参与者分为五个不同的 PLE 轨迹组：持续组（n=47）、缓解组（n=185）、递增组（n=117）、缓解组（n=21）和无 PLE 组（n=4476）。我们利用线性混合效应模型和广义线性混合效应模型，比较这些 PLE 轨迹组之间的基线特征差异，包括心理和行为问题、自杀意念、创伤经历、发育里程碑、认知功能、身体健康、家庭收入、精神疾病家族史和大脑结构。
我们发现，通过儿童行为检查表（CBCL）评估的心理和行为问题（如 DSM 定向量表/外化/ADHD/社会/注意力/思维问题）与所有 PLE 组相关。与缓解组相比，持续 PLE 组的 ADHD/社会/思维问题和自杀行为更为严重。与无 PLE 组相比，仅在一个 PLE 组中发现认知功能较差、大脑结构异常（如颞叶和缘上回）、创伤经历较多和家庭收入较低，但并非所有 PLE 组都存在这些问题。
PLE 的发展伴随着许多领域的变化，这意味着这是一个动态而复杂的发展过程。鉴于心理和行为问题可以预测任何时候 PLE 的出现，并可以被视为持续 PLE 的风险因素，从而能够进行早期的精确干预，因此，更加重视评估心理和行为问题非常重要。
