Persistent psychotic-like experiences (PLEs) that are distressing are associated with impairment in children in areas including cognitive ability and psychopathology, according to a study published online in Molecular Psychiatry.

“Although we know some children have PLEs, it has remained unclear which will go on to develop psychotic disorders later in life,” said study author Shelli Avenevoli, PhD, deputy director of the National Institute of Mental Health. “This study shows that [youth] who have persistent, distressing PLEs face significant challenges during development, suggesting the value of early intervention for all children with these experiences, regardless of whether they go on to develop psychotic disorders.”

Psychotic-like experiences, such as mild perceptual abnormalities or delusional thoughts, affect more than 17% of youth ages 9 through 12, researchers explained. The study looked at the extent such experiences are associated with risk factors for psychosis.

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The investigation used data from three waves of Adolescent Brain Cognitive Development study to categorize 9- and 10-year-olds with PLEs into 4 groups: persistent distressing PLEs (272 children), transient distressing PLEs (298 children), persistent nondistressing PLEs (221 children), and transient nondistressing PLEs (536 children). Participants were assessed at 3 points over about 2 years.

According to the study, children with distressing and persistent PLEs showed the greatest functional impairments and mental health service utilization, and had greater bipolar, externalizing, and internalizing symptoms than children in the other groups. They also had larger deficits in fluid cognition, including working memory and receptive language, and experienced more significant environmental adversity, such as higher overall deprivation levels and more adverse childhood experiences, than their counterparts in other groups.

Whether persistent or transient, distressing PLEs were also associated with delayed developmental milestone achievement, lower cortical and subcortical brain volume, and differences in brain network connectivity compared with nondistressing PLEs, researchers reported.

“These novel longitudinal data underscore that it is often only in the context of distress,” researcher wrote, “that persistent PLEs were related to impairments.”

References

Karcher NR, Loewy RL, Savill M, et al. Persistent and distressing psychotic-like experiences using Adolescent Brain Cognitive Development study data. Mol Psychiatry. Published online November 16, 2021. doi: 10.1038/s41380-021-01373-x

Persistent, distressing psychotic-like experiences associated with impairment in youth. News release. NIH/National Institute of Mental Health; November 17, 2021. Accessed November 19, 2021.