Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study
Open accessAbstract
Background: Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age. Method: Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence. Results: Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and post-traumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38. Conclusions: Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.
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Adolescents who report psychotic experiences are at greater risk of developing psychotic disorders in adulthood.
“adolescents who report psychotic experiences are at greater risk of developing psychotic disorders in adulthood (e.g. Fisher, Caspi, & Poulton, 2013).”
From The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review (2015) · cites this paper as Fisher, Caspi, & Poulton, 2013
The Results section (page not provided) reports that strong psychotic symptoms at age 11 predicted a higher risk of schizophrenia by age 38. But the Method > Analysis section reports no significant increase for weak symptoms. The claim extends this finding from children with strong symptoms to adolescents reporting psychotic experiences generally, and from schizophrenia to psychotic disorders broadly. (LLM, conf=0.87)
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- Authors
- Fisher, H. L., Caspi, A., Poulton, R., Meier, M. H., Houts, R., Harrington, H., Arseneault, L., & Moffitt, T. E.
- Affiliations
- King's College London (GB)
- Duke University (US)
- University of Otago (NZ)
- Corresponding author
- Fisher, H. L.
- ORCID
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2013-01-10
- Volume
- 43
- Issue
- 10
- Pages
- 2077-2086
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC3758773
- OpenAlex
- W2166148614
- Cited by
- 307
- References
- 4
- Citations by year
- 2026: 6 · 2025: 19 · 2024: 20 · 2023: 14 · 2022: 18 · 2021: 24 · 2020: 22 · 2019: 27 · 2018: 30 · 2017: 31 · 2016: 21 · 2015: 43 · 2014: 22 · 2013: 10
- FWCI
- 22.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institutes of Health
- Medical Research Council (MR/K00381X/1)
- National Institute on Aging (R01AG032282)
- National Institute on Drug Abuse (P30DA023026)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD061298)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- schizophrenia, predictive validity, post-traumatic stress disorder, suicide attempts, persistent anxiety, dysthymia, mania, substance dependence, Dunedin birth cohort
- MeSH terms
- Adolescent, Adult, Child, Humans, New Zealand, Predictive Value of Tests, Prospective Studies, Psychotic Disorders, Schizophrenia, Stress Disorders, Post-Traumatic, Suicide, Attempted, Comorbidity, Young Adult
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