6.1 Hallucinations in Adolescents and Risk of Mental Disorders and Psychosocial Impairment in Adulthood: A Birth Cohort Study

Abstract

Background: Hallucinations are common in adolescents. Given the high prevalence of hallucinations, it is important to determine if they are asso-ciated with adverse mental health and psychosocial outcomes in adulthood. This study compared the mental health outcomes of participants (aged 30-33) in the Mater-University of Queensland Study of Pregnancy (MUSP) who reported hallucinations at (a) 14 years only and (b) 14 and 21 years versus cohort members without hallucinations. Method(s): Participants (n = 333) were aged between 30 and 33 years and (a) reported hallucinations on the Youth Self Report Questionnaire at 14 and/or the Young Adult Self Report Questionnaire at 21 years and (b) controls (n = 321) who did not report hallucinations. Lifetime diagnoses of mental disorders were ascertained by the Structured Clinical Interview for DSM Disorders (DSM IV-TR) administered by clinical psychologists. Suicidal behavior was measured by self-report. We identifed participants not engaged in education or employment (NEET) using the Activity and Participation Questionnaire (APQ6). Quality of Life was measured using the assessment of quality-of-life scale (AQoL). Result(s): Hallucinations at 14 years were not only associated with an increased risk of mental disorders, NEET, or poorer quality of life in adulthood. Hallucinations reported at both 14 and 21 years were associated with life time diagnoses of psychotic disorders (odds ratio [OR], 8.84; 95% confdence interval [CI]: 1.61-48.43 and substance use disorders (OR, 2.34; 95% CI: 1.36-4.07) and also strongly associated with life time suicide attempts (OR, 7.11; 95% CI: 2.68-18.83). Those with hallucinations at 14 and 21 years were more likely to be not engaged in employment or training (OR 2.47; 95% CI 1.18-5.16) and had more than 4 times the odds of experiencing a poor quality of life (OR 4.27; 95% CI 1.63, 11.17). Conclusion(s): Most adolescents who experience hallucinations do not have an increased rate of mental disorder or psychosocial impairment in adulthood, however those with hallucinations experienced at more than one point in time are at increased risk of suicidal behavior, psychotic and nonpsychotic psychopathology, and social disadvantage with impaired quality of life.