Persisting psychotic-like experiences are associated with both externalising and internalising psychopathology in a longitudinal general population child cohort

Abstract Background Persisting psychotic-like experiences (PLEs) are associated with an increased risk of internalising symptoms in adolescence. Whether this association holds similarly for externalising symptoms, and from mid-childhood, is unclear. This prospective study investigated the extent to which PLE persistence was associated with internalising and externalising psychopathology in a community sample of children aged 9–11 years at study commencement. Methods 8099 children (mean age 10.4 years) completed questionnaires assessing PLEs, externalising and internalising symptoms. A subsample of 547 children completed reassessment, on average, two years later. Results Two-thirds (66%) of children reported PLEs at baseline. Approximately two years later, PLEs persisted in 39% of those children. After adjustment for previous psychopathology and other potential confounds, children with persisting PLEs were at higher risk for internalising (odds ratio [OR] = 1.94; 95% confidence interval [CI] 1.13–3.34) and externalising (OR = 1.97; 95% CI 1.19–3.26) psychopathology than children whose PLEs remitted; and, than children who never presented PLEs. Conclusions Persistent PLEs from mid-childhood are associated with later internalising and externalising psychopathology in the general population, whereas transitory PLEs may be part of a spectrum of normative childhood development. Interventions that target persistent PLEs may contribute to a reduction in common childhood psychopathology.