6. What do Psychotic Symptoms in Childhood Mean for Neurodevelopment and Adult Mental Health Outcomes?

Abstract

Overall Abstract: Research over the past 15 years has shown that psychotic symptoms are relatively prevalent in both the clinic and the community, outside the context of psychotic disorders. Epidemiological studies have shown that 8%-17% of children and 5%-7% of adults report these symptoms, which, in the general population, are often referred to as “psychotic experiences.” Although initially conceptualized as an epidemiological complement to the clinic-based “ultra high risk” approach to psychosis, more recent research has demonstrated that psychotic experiences occur across the full spectrum of mental disorders. An important question, then, is, what does it mean when an individual reports psychotic experiences/symptoms outside the context of a psychotic disorder? This symposium will bring together researchers from Australia, Europe, and the United States to look at this question from multiple perspectives, including associations with clinical/disorder outcomes, functional outcomes, cognitive outcomes, and structural and functional brain development outcomes. James Scott will talk about an Australian cohort study of community-based 14-year-olds, followed up at both 21 years and at 30-33 years. This talk will look at the relationship between hallucinations in adolescence and mental illness outcomes in adulthood, demonstrating that hallucinatory experiences in youth predict increased risk of psychotic disorders, substance use disorders, and suicide attempt as well poor outcomes in terms of education, employment, and quality-of-life measures. Agna Bartels will talk about a Dutch cohort study of 7-to 8-year-olds, followed up 5 years and 11 years later. This talk will look not only at the persistence rate of psychotic experiences from early childhood into early adulthood but also the relationship between persistence of psychotic experiences and risk of measures of both psychopathology and trauma as well as exploring a novel network approach to understanding psychotic experiences. Ian Kelleher will discuss a Swedish cohort study of community-based 15-year-olds, followed up 3 years later at age 18. This talk will delve into different subtypes of psychotic experiences-visual and auditory hallucinations and different delusional beliefs-and whether these specifc symptom subtypes differentially predicted poor mental health outcomes, including suicidal behavior and substance use disorders. Daniel Wolf will discuss the Philadelphia Neurodevelopmental Cohort, the largest neuroimaging study to date of a community sample with psychotic experiences. This talk will explore structural and functional differences that have been detected in discrete neural circuits, including those involved in executive functioning and emotion processing, in young people with psychotic experiences, as well as the theoretical and practical implications of this.