Burton Isaiah J, Tibbo Philip G, Ponto Nicole, Crocker Candice E
Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J Lane Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J Lane Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Early Psychosis Intervention Nova Scotia (EPINS), Nova Scotia Health Authority, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 6287 Alumni Crescent, 3rd Floor Life Sciences Centre, Halifax, NS, B3H 4R2, Canada.
Psychiatry Res. 2024 Dec;342:116207. doi: 10.1016/j.psychres.2024.116207. Epub 2024 Sep 21.
Psychotic-like experiences (PLEs) are common in the general population. Child and adolescent PLEs are the most prevalent and linked with future psychotic disorders. Significant heterogeneity in PLE assessment has obscured its clinical utility to identify psychosis-prone trajectories and improve clinical outcomes. This meta-analysis aimed to assess i) PLE prevalence in children and adolescents and ii) their relationship with subsequent psychotic disorder while exploring sources of heterogeneity. PubMed, Embase, PsycINFO, and CINAHL databases were searched in August 2023 for population-based longitudinal studies that assessed child or adolescent PLEs and early adulthood psychotic outcomes. Six studies were included (n = 16,560), showing a pooled PLE prevalence of 17.3 %. Child and adolescent PLEs were associated with an increased risk of psychotic disorder in early adulthood (unadjusted OR = 3.80, 95 % CI: 2.31-6.26), with a population attributable fraction of 32.6 %. Significant heterogeneity in the strength of this relationship (I = 70 %, p = .01) was related to assessment type (self-report vs. interview). This review contends that interview-based PLE assessments could more accurately identify children or adolescents on a path towards psychosis and are better suited for psychotic risk identification. Further research is needed to elucidate interactions between PLEs and other psychotic risk factors.
类精神病性体验（PLEs）在普通人群中很常见。儿童和青少年的PLEs最为普遍，且与未来的精神障碍有关。PLE评估中存在的显著异质性掩盖了其在识别易患精神病轨迹和改善临床结果方面的临床效用。这项荟萃分析旨在评估：i）儿童和青少年中PLEs的患病率；ii）它们与随后发生的精神障碍之间的关系，同时探索异质性的来源。2023年8月，对PubMed、Embase、PsycINFO和CINAHL数据库进行了检索，以查找基于人群的纵向研究，这些研究评估了儿童或青少年的PLEs以及成年早期的精神病结局。纳入了六项研究（n = 16,560），汇总的PLE患病率为17.3%。儿童和青少年的PLEs与成年早期患精神障碍的风险增加相关（未调整的OR = 3.80，95% CI：2.31 - 6.26），人群归因分数为32.6%。这种关系强度的显著异质性（I² = 70%，p = 0.01）与评估类型（自我报告与访谈）有关。本综述认为，基于访谈的PLE评估可以更准确地识别处于精神病发病路径上的儿童或青少年，并且更适合用于识别精神病风险。需要进一步的研究来阐明PLEs与其他精神病风险因素之间的相互作用。
