Frequent Psychotic-Like Experiences in Youth Predict Future Psychiatric Illness

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The pattern of increasing psychotic-like experiences, minority status, trauma, and family divorce were predictive of emergent mental disorders in a cohort of Chinese youth.

A pattern of increasing psychotic-like experiences (PLEs) during adolescence predicts greater risk of developing a mental disorder, particularly psychosis, according to Chinese study results published in the Journal of Clinical Psychiatry.

PLEs are not uncommon in children and young adults and occur in 17% of children age 9 to 12 years and 7.5% of children age 13 to 18 years. These occurrences are associated with an increased risk for the development of subsequent psychosis, usually within 2 to 5 years. However, the study of PLEs has been limited.

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Wen Zhang, MD, PhD, of the Department of Psychiatry, Second Xiangya Hospital of Central South University and the Mental Health Institute of Central South University, Changsha, China, and colleagues conducted a longitudinal study of self-reported PLEs and concomitant traumatic experiences in 6198 adolescents over the course of 3 years. Patients were between age 10.0 and 17.6 years at baseline (mean age 12.9 years). They used growth mixture modeling to ascertain distinct growth trajectories in the frequency of PLEs.

The researchers discerned two clear-cut patterns: stable low levels of PLE frequency and a growing frequency of PLEs. In the latter group, 3.39% of patients transitioned to a mental disorder compared with 1.28% of the stable PLE group. In individuals with increasingly frequent PLEs, the odds ratio (OR) was 2.7 for transition to any mental health disorder, while the OR for transition to psychosis was 22.14. Other risk factors associated with transition to any psychiatric disorder were childhood trauma (OR, 1.17), family divorce (OR, 2.86), and minority ethnicity (OR, 2.91).

Study findings were limited by the self-reported nature of the data, attrition of more than a quarter of the patients over the 3-year study period, and a lack of neurobiologic or neuroimaging studies.

“The pattern of increasing PLEs predominates in predicting emergent mental [disorders], particularly psychosis, along with minority status, trauma, and family divorce, suggesting potential targets for preventive intervention,” investigators concluded.


Zhang W, Zhu Y, Sun M, et al. Longitudinal trajectories of psychotic-like experiences and their relationship to emergent mental disorders among adolescents. J Clin Psychiatry. 2019;80:4.