With or without a history of general psychopathology, psychotic experiences in preadolescence were strongly and independently associated with health anxiety (HA) and functional somatic symptoms (FSS), according to study results published in the Journal of Child Psychology and Psychiatry.
The investigators of this large cohort study sought to estimate the associations between psychotic experiences and the presence of HA and FSS in a general population of preadolescents and whether these associations remained after adjusting for general psychopathology.
The study population included 1572 children aged 11 or 12 years from the Copenhagen Child Cohort 2000. The presence of psychotic experiences was assessed dichotomously (‘not present’ vs ‘likely/definitely present’) using the psychosis section of the Kiddie Schedule of Affective Disorders and Schizophrenia Present and Lifetime Version. HA and FSS were assessed using self-reported questionnaires and the Childhood Illness Attitude Scale and the Children’s Somatization Inventory, respectively. Additional variables, including general psychopathology, emotional disorders, chronic somatic illnesses, and measures on puberty, were assessed to mitigate potential confounding.
Of 1572 participating children, 156 (9.9%) reported having psychotic experiences. In univariate analyses, psychotic experiences were associated with the top 10% of symptom scores for both HA (odds ratio [OR] 3.19; 95% CI, 2.12-4.79) and FSS (OR 4.61; 95% CI, 3.08-6.89). In multivariate analyses, this association remained significant but was reduced for HA (OR 2.15; 95% CI, 1.36-3.41; P =.001) and FSS (OR 3.31; 95% CI, 2.11-5.18; P <.001). Chronic somatic illness, gender, or onset of puberty did not influence the associations. Secondary analyses of 3 dimensions of HA (fears, help-seeking, and symptom impact) indicated that psychotic experiences were significantly associated with health-related fears (OR 3.01; 95% CI, 1.98-4.59) and daily impact of symptoms (OR 5.01; 95% CI, 3.38-7.51) but not with parental help-seeking behaviors (OR 1.17; 95% CI, 0.67-2.06).
After adjusting for general psychopathology, associations between psychotic experiences and the presence of HA and functional somatic symptoms remained significantly high among a preadolescent population. Children who presented psychotic experiences also reported more health-related fears and greater impact on daily functioning without corresponding help-seeking behaviors, indicating an opportunity for early intervention.
Multiple authors declare potential conflicts. Please see original reference for a full list of authors’ disclosures.
Rimvall MK, Jespersen CP, Clemmensen L, et al. Psychotic experiences are associated with health anxiety and functional somatic symptoms in preadolescence [published online October 5, 2018]. J Child Psychol Psyc. doi:10.1111/jcpp.12986