Adolescent psychotic experiences lack uniformity

Oct 3 2013

By Lucy Piper, Senior medwireNews Reporter

Psychotic experiences in adolescence appear to be quite distinct and vary widely from individual to individual, study findings indicate.

“One individual may experience frequent paranoid thoughts without many other experiences, another might experience hallucinations and cognitive disorganization,” the study researchers explain.

This supports the proposal that psychotic experiences in adolescents in the general population should be considered “multiple, distinct, quantitative traits,” rather than a categorical phenotype, suggests the team, led by Angelica Ronald (Birkbeck, University of London, UK).

Further research will determine whether these “distinct traits become more coherent over time,” they add.

The researchers developed a Specific Psychotic Experiences Questionnaire (SPEQ) to assess the key types of psychotic experiences associated with psychosis – paranoia, hallucinations, cognitive disorganization, grandiosity, anhedonia, and parent-rated negative symptoms – in 4743 pairs of 16-year-old twins.

Overall, 5.9% to 23.2% of adolescents reported having hallucination experiences at least monthly, while 1% to 23% reported experiencing paranoia at least weekly.

The other psychotic experiences were not assessed in terms of frequency, but 20.2% to 51.3% of adolescents responded “yes” to cognitive disorganization, while grandiosity items were endorsed by 7.1% to 31.0% and anhedonia and parent-rated negative symptoms by 1.7% to 37.6% and 10.4% to 33.1%, respectively.

The researchers note in Schizophrenia Bulletin that 5.7% of adolescents reported being quite or very distressed by cognitive disorganization and 4.2% by paranoia.

These rates of reported distress are low relative to the high frequencies of reported psychotic experiences, the researchers note, saying “a proportion of adolescents have psychotic experiences but remain healthy and do not seek clinical help.”

The SPEQ showed good internal consistency and the domains were stable when retested across an average of 9 months, but correlations between SPEQ subscales were low to moderate at best.

There was evidence of gender differences, with girls scoring highest on paranoia, hallucinations, and cognitive disorganization, whereas boys scored highest on grandiosity, anhedonia, and parent-rated negative symptoms.

All SPEQ domains, except for grandiosity, correlated significantly with traits of anxiety, depression, and neuroticism, which the researchers suggest may “act as risk factors for, or exacerbate, psychotic experiences.”

They urge for further research on psychotic experiences, both those occurring with and without distress, in order to determine possible resilience factors and enhance the management of such experiences in adolescents.

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.