Psychotic experiences in childhood predict use of mental health service, psychotropic drugs

Childhood psychotic experiences are significantly associated with the use of mental health service and psychotropic medications during adolescence, a study has found.

Psychotic experiences at ages 11–12 years predicted the receipt of a psychiatric diagnosis in child and adolescent mental health services before ages 16–17 years (adjusted hazard ratio [aHR], 3.13, 95 percent confidence interval [CI], 1.93–5.07) among children who had not been previously diagnosed and after adjusting for sociodemographic and perinatal adversities and IQ.

Such risk was elevated if the child met the criteria for a co-occurring mental disorder (not diagnosed in mental health settings) at baseline relative to no psychotic experiences or diagnosis at baseline (aHR, 7.85, 95 percent CI, 3.94–15.63). However, just by having psychotic experiences alone already showed a significantly higher risk of later psychiatric diagnoses (aHR, 2.76, 95 percent CI, 1.48–5.13).

A similar trend was observed for treatment with psychotropic medications during adolescence.

“The study findings provide strong evidence that psychotic experiences in preadolescence index a transdiagnostic vulnerability for diagnosed psychopathology in adolescence,” the authors said.

A longitudinal register-based follow-up study of the Copenhagen Child Cohort 2000 was conducted, which included 1,632 children aged 11–12 years who were assessed for psychotic experiences in face-to-face interviews. Participants were also evaluated for mental disorders and IQ.

Data on perinatal and sociodemographic characteristics, psychiatric disorders diagnosed at child and adolescent mental health services, and prescribed psychotropic medications through ages 16–17 years were sourced from national registries.

“Psychotic experiences affect more than 10 percent of children and often co-occur with nonpsychotic mental disorders,” the authors noted.