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Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study

Published online by Cambridge University Press:  10 January 2013

H. L. Fisher ,
A. Caspi ,
R. Poulton ,
M. H. Meier ,
R. Houts ,
H. Harrington ,
L. Arseneault  and
T. E. Moffitt
H. L. Fisher*
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
A. Caspi
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK Departments of Psychology and Neuroscience, Duke University, Durham, NC, USA Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
R. Poulton
Affiliation:
Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
M. H. Meier
Affiliation:
Departments of Psychology and Neuroscience, Duke University, Durham, NC, USA Duke Transdisciplinary Prevention Research Center, Center for Child and Family Policy, Duke University, Durham, NC, USA
R. Houts
Affiliation:
Departments of Psychology and Neuroscience, Duke University, Durham, NC, USA Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
H. Harrington
Affiliation:
Departments of Psychology and Neuroscience, Duke University, Durham, NC, USA Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
L. Arseneault
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
T. E. Moffitt
Affiliation:
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK Departments of Psychology and Neuroscience, Duke University, Durham, NC, USA Psychiatry and Behavioral Sciences, Duke University Medical School, Durham, NC, USA Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
*
*Address for correspondence: Dr H. L. Fisher, MRC Social, Genetic and Developmental Psychiatry Centre, PO80, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. (Email: helen.2.fisher@kcl.ac.uk)
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Abstract

Background

Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age.

Method

Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence.

Results

Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and post-traumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38.

Conclusions

Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.

Keywords

Childhoodlongitudinalpost-traumatic stress disorderpsychosissuicide
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2077 - 2086
Copyright
Copyright © Cambridge University Press 2013 

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References

Anderson, JC, Williams, S, McGee, R, Silva, PA (1987). DSM-III disorders in preadolescent children: prevalence in a large sample from the general population. Archives of General Psychiatry 44, 69–76.CrossRefGoogle Scholar
APA (1987). Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. American Psychiatric Publishing: Arlington, VA.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. American Psychiatric Publishing: Arlington, VA.Google Scholar
Brewin, CR, Andrews, B, Valentine, JD (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology 68, 748–766.CrossRefGoogle ScholarPubMed
Costello, A, Edelbrock, C, Kalas, R, Kessler, M, Klaric, S (1982). NIMH Diagnostic Interview for Children: Child Version. National Institute of Mental Health: Rockville, MD.Google Scholar
Dutta, R, Murray, RM, Allardyce, J, Jones, PB, Boydell, JE (2012). Mortality in first-contact psychosis patients in the UK: a cohort study. Psychological Medicine 42, 1649–1661.CrossRefGoogle ScholarPubMed
Elley, WB, Irving, JC (1976). Revised socio-economic index for New Zealand. New Zealand Journal of Educational Studies 7, 153–167.Google Scholar
Fisher, HL, Jones, PB, Fearon, P, Craig, TK, Dazzan, P, Morgan, K, Hutchinson, G, Doody, GA, McGuffin, P, Leff, J, Murray, RM, Morgan, C (2010). The varying impact of type, timing and frequency of exposure to childhood adversity on its association with adult psychotic disorder. Psychological Medicine 40, 1967–1978.CrossRefGoogle ScholarPubMed
Fusar-Poli, P, Bonoldi, I, Yung, AR, Borgwardt, S, Kempton, MJ, Valmaggia, L, Barale, F, Caverzasi, E, McGuire, P (2012). Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry 69, 220–229.CrossRefGoogle ScholarPubMed
Hafner, H, Maurer, K, Loffler, W, Reicher-Rosller, A (1993). The influence of age and sex on the onset and early course of schizophrenia. British Journal of Psychiatry 16, 280–286.Google Scholar
Kelleher, I, Cannon, M (2011). Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychological Medicine 41, 1–6.CrossRefGoogle Scholar
Kelleher, I, Connor, D, Clarke, MC, Devlin, N, Harley, M, Cannon, M (2012 a). Prevalence of psychotic symptoms in childhood and adolescence: a systematic review and meta-analysis of population-based studies. Psychological Medicine 42, 1857–1863.CrossRefGoogle ScholarPubMed
Kelleher, I, Keeley, H, Corcoran, P, Lynch, F, Fitzpatrick, C, Devlin, N, Molloy, C, Roddy, S, Clarke, MC, Harley, M, Arseneault, L, Wasserman, C, Carli, V, Sarchiapone, M, Hoven, C, Wasserman, D, Cannon, M (2012 b). Clinicopathological significance of psychotic experiences in non-psychotic young people: evidence from four population-based studies. British Journal of Psychiatry 201, 26–32.CrossRefGoogle ScholarPubMed
Kelleher, I, Lynch, F, Harley, M, Molloy, C, Roddy, S, Fitzpatrick, C, Cannon, M (2012 c). Psychotic symptoms in adolescence index risk for suicidal behavior: findings from 2 population-based case-control clinical interview studies. Archives of General Psychiatry. Published online: 29 October 2012. doi: 10.1001/archgenpsychiatry.2012.164.CrossRefGoogle ScholarPubMed
Kelleher, I, Murtagh, A, Molloy, C, Roddy, S, Clarke, MC, Harley, M, Cannon, M (2012 d). Identification and characterization of prodromal risk syndromes in young adolescents in the community: a population-based clinical interview study. Schizophrenia Bulletin 38, 239–246.CrossRefGoogle ScholarPubMed
Laurens, KR, Hodgins, S, Maughan, B, Murray, RM, Rutter, ML, Taylor, EA (2007). Community screening for psychotic-like experiences and other putative antecedents of schizophrenia in children aged 9–12 years. Schizophrenia Research 90, 130–146.CrossRefGoogle ScholarPubMed
Laurens, KR, West, SA, Murray, RM, Hodgins, S (2008). Psychotic-like experiences and other antecedents of schizophrenia in children aged 9–12 years: a comparison of ethnic and migrant groups in the United Kingdom. Psychological Medicine 38, 1103–1111.CrossRefGoogle Scholar
Lin, A, Nelson, B, Yung, AR (2012). ‘At-risk’ for psychosis research: where are we heading? Epidemiology and Psychiatric Sciences. Published online: 30 July 2012. doi: 10.1017/S2045796012000388.CrossRefGoogle ScholarPubMed
Maddox, L, Jolley, S, Laurens, KR, Hirsch, C, Hodgins, S, Browning, S, Bravery, L, Bracegirdle, K, Smith, P, Kuipers, E (2012). Cognitive behavioural therapy for unusual experiences in children: a case series. Behavioral and Cognitive Psychotherapy. Published online: 5 July 2012. doi: 10.1017/S1352465812000343.Google ScholarPubMed
Ministry of Health (2012). Suicide Facts: Deaths and Intentional Self-harm Hospitalisations 2010. Ministry of Health: Wellington, New Zealand.Google Scholar
Morrison, AP, French, P, Walford, L, Lewis, SW, Kilcommons, A, Green, J, Parker, S, Bentall, RP (2004). Cognitive therapy for the prevention of psychosis in people at ultra-high risk: randomized controlled trial. British Journal of Psychiatry 185, 291–297.CrossRefGoogle Scholar
Murray, GK, Jones, PB (2012). Psychotic symptoms in young people without psychotic illness: mechanisms and meaning. British Journal of Psychiatry 201, 4–6.CrossRefGoogle ScholarPubMed
Murray, RM, Jones, PB, Susser, ES, van Os, J, Cannon, M (2003). The Epidemiology of Schizophrenia. Cambridge University Press: Cambridge, UK.Google Scholar
Perälä, J, Suvisaari, J, Saarni, SI, Kuoppasalmi, K, Isometsä, E, Pirkola, S, Partonen, T, Tuulio-Henriksson, A, Hintikka, J, Kieseppä, T, Härkänen, T, Koskinen, S, Lönnqvist, J (2007). Lifetime prevalence of psychotic and bipolar I disorders in a general population. Archives of General Psychiatry 64, 19–28.CrossRefGoogle ScholarPubMed
Polanczyk, G, Moffitt, TE, Arseneault, L, Cannon, M, Ambler, A, Keefe, RS, Houts, R, Odgers, CL, Caspi, A (2010). Childhood psychotic symptoms share etiological and clinical features with adult schizophrenia: results from a representative birth cohort. Archives of General Psychiatry 67, 328–338.CrossRefGoogle Scholar
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Resick, PA, Miller, MW (2009). Posttraumatic stress disorder: anxiety or traumatic stress disorder? Journal of Traumatic Stress 22, 384–390.CrossRefGoogle ScholarPubMed
Robins, LN, Cottler, L, Bucholz, KK, Compton, W (1995). Diagnostic Interview Schedule for DSM-IV. Washington University School of Medicine: St Louis, MO.Google Scholar
Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS (1981). National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Archives of General Psychiatry 38, 381–389.CrossRefGoogle ScholarPubMed
Schäfer, I, Fisher, HL (2011). Childhood trauma and posttraumatic stress disorder in patients with psychosis: clinical challenges and emerging treatments. Current Opinion in Psychiatry 24, 514–518.CrossRefGoogle ScholarPubMed
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179–195.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, van Os, J, Bentall, RP (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671.CrossRefGoogle ScholarPubMed
Weich, S, McBride, O, Hussey, D, Exeter, D, Brugha, T, McManus, S (2011). Latent class analysis of co-morbidity in the Adult Psychiatric Morbidity Survey in England 2007: implications for DSM-5 and ICD-11. Psychological Medicine 41, 2201–2212.CrossRefGoogle ScholarPubMed
Welham, J, Scott, J, Williams, G, Najman, J, Bor, W, O'Callaghan, M, McGrath, J (2009). Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study. Psychological Medicine 39, 625–634.CrossRefGoogle ScholarPubMed
Werbeloff, N, Drukker, M, Dohrenwend, BP, Levav, I, Yoffe, R, van Os, J, Davidson, M, Weiser, M (2012). Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Archives of General Psychiatry 69, 467–475.CrossRefGoogle ScholarPubMed
Yung, AR, Phillips, LJ, Yuen, HP, McGorry, PD (2004). Risk factors for psychosis in an ultra high-risk group: psychopathology and clinical features. Schizophrenia Research 67, 131–142.CrossRefGoogle Scholar