Social Isolation in Childhood May Predict Early Adult Psychotic Experiences

Childhood social isolation may increase the risk of having 2 or more lifetime psychotic experiences, and thus subsequent diagnosis of psychotic disorder, according to a study published in European Child & Adolescent Psychiatry.

Julia Bennett, MSPH, from the department of international health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and colleagues analyzed data from a community-based prospective cohort study in France. They queried participants as to whether or not they had psychotic experiences during young adulthood (ages 25-37 years), using a telephone-based Mini International Neuropsychiatric Interview administered from January to April 2011.

Social isolation in childhood was measured using parental responses to a 10-item questionnaire about their children’s friendships when they were 7 to 10 years of age. Demographic factors and internalizing and externalizing behaviors were also gathered through parental reports. Happiness and smoking status were self-reported. Statistical analyses included generalized ordered logistic regressions and stepwise Wald tests.

The study population (n=333; 38% male; mean age, 18 years) had a 20.7% lifetime prevalence of psychotic experiences, and 39% experienced childhood social isolation. Among participants socially isolated in childhood, 10% had 2 or more reported psychotic experiences compared with only 1% for nonisolated participants.

In analyses controlling for sex, age, and general health, individuals with childhood social isolation were more likely to report 2 or more psychotic experiences (odds ratio, 11.5; 95% CI, 2.5-52.0; P =.002).

The researchers stated that limitations of the study include reliance on a nonrepresentative sample and longitudinal analyses of a small sample size, which restricted statistical power. Furthermore, the study did not examine childhood trauma or abuse, which are critical risk factors for psychosis.

“While genetic risk factors may play a role in the onset of [psychotic experiences], extant research shows that different types of social adversity, including fairly common experiences of social isolation and peer rejection, are a more important source of risk at the population level,” the researchers wrote.

Reference

Bennett JC, Surkan PJ, Moulton LH, Fombonne E, Melchior M. Childhood social isolation and psychotic experiences in young adulthood: a community based study [published online October 8, 2019]. Eur Child Adolesc Psychiatry. doi:10.1007/s00787-019-01417-2