Heterogeneity in assessing the risk of developing a psychotic disorder given a previous subclinical psychotic-like experience in children and adolescents: A systematic review and meta-analysis

•Child and adolescent PLEs increase the risk of psychosis onset by young adulthood.•A third of psychotic disorder diagnoses are attributed to child or adolescent PLEs.•Interview-based assessments of PLEs better identify psychosis prone trajectories.•Further work is needed to improve and standardize...

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Veröffentlicht in:Psychiatry research 2024-12, Vol.342, p.116207, Article 116207
Hauptverfasser: Burton, Isaiah J, Tibbo, Philip G, Ponto, Nicole, Crocker, Candice E
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Sprache:eng
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Zusammenfassung:•Child and adolescent PLEs increase the risk of psychosis onset by young adulthood.•A third of psychotic disorder diagnoses are attributed to child or adolescent PLEs.•Interview-based assessments of PLEs better identify psychosis prone trajectories.•Further work is needed to improve and standardize the assessment of PLEs. Psychotic-like experiences (PLEs) are common in the general population. Child and adolescent PLEs are the most prevalent and linked with future psychotic disorders. Significant heterogeneity in PLE assessment has obscured its clinical utility to identify psychosis-prone trajectories and improve clinical outcomes. This meta-analysis aimed to assess i) PLE prevalence in children and adolescents and ii) their relationship with subsequent psychotic disorder while exploring sources of heterogeneity. PubMed, Embase, PsycINFO, and CINAHL databases were searched in August 2023 for population-based longitudinal studies that assessed child or adolescent PLEs and early adulthood psychotic outcomes. Six studies were included (n = 16,560), showing a pooled PLE prevalence of 17.3 %. Child and adolescent PLEs were associated with an increased risk of psychotic disorder in early adulthood (unadjusted OR = 3.80, 95 % CI: 2.31–6.26), with a population attributable fraction of 32.6 %. Significant heterogeneity in the strength of this relationship (I2 = 70 %, p = .01) was related to assessment type (self-report vs. interview). This review contends that interview-based PLE assessments could more accurately identify children or adolescents on a path towards psychosis and are better suited for psychotic risk identification. Further research is needed to elucidate interactions between PLEs and other psychotic risk factors.
ISSN:0165-1781
1872-7123
1872-7123
DOI:10.1016/j.psychres.2024.116207