Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence
Psychotic experiences co-occur with sleep problems, negative affect and mental disorders in preadolescence
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DOI：
10.1111/jcpp.12319
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发表时间：
2015-05-01
影响因子：
7.6
通讯作者：
Skovgaard, Anne M.
中科院分区：
文献类型：
--
作者：
Jeppesen, Pia;Clemmensen, Lars;Skovgaard, Anne M.
背景关于儿童精神病症状和经历(PE)的意义的知识仍然有限。本研究旨在通过深入的精神病理访谈和综合诊断评估，调查普通人群中青春期前儿童PE的患病率和临床意义。方法从2000年哥本哈根儿童队列中调查1632名儿童。通过使用K-SADS-PL精神症状和情感症状条目的半结构访谈来测量PE，每个症状被评分为不存在或可能存在或确定存在。发展和幸福感评估(DAWBA)被独立用于诊断DSM-IV-精神障碍。青春期发育和睡眠障碍是自我报告的。在调整性别和青春期开始时间的多变量二项回归分析中，对PE(任何终生幻觉和/或妄想)与各种心理问题和障碍的关系进行了检验。结果11~12岁PE的加权终生患病率为10.9%(CI 9.1~12.7)。大多数PE儿童(n=172)要么有可诊断的DSM-IV精神障碍(31.4%)，要么有自我报告的精神健康问题(31.4%)。随着青春期的到来，妄想的风险也会增加。无论PE是否表现为幻觉和/或妄想，随着情绪和神经发育障碍、阈值下抑郁症状、睡眠问题和睡眠不足，PE的风险增加。情感障碍和多发性精神障碍的相关性最高。结论精神经历在情感调节障碍和睡眠障碍的背景下特别普遍，随着青春期的开始而增加，代表着精神病理学的跨诊断标记。
BackgroundKnowledge on the significance of childhood psychotic symptoms and experiences (PE) is still limited. This study aimed to investigate the prevalence and clinical significance of PE in preadolescent children from the general population by use of in-depth psychopathological interviews and comprehensive diagnostic assessments.MethodsWe investigated 1,632 children from the general population-based Copenhagen Child Cohort 2000. PE were measured by semistructured interviews using the K-SADS-PL-items on psychotic and affective symptoms, each symptom scored as not present versus likely or definitely present. The Development and Well-Being Assessment (DAWBA) was used independently to diagnose DSM-IV-mental disorders. Puberty development and sleep disturbance were self-reported. The associations between PE (any lifetime hallucination and/or delusion) and various mental problems and disorders were examined by multivariable binomial regression analyses, adjusting for gender and onset of puberty.ResultsThe weighted life time prevalence of PE at age 11-12years was 10.9% (CI 9.1-12.7). The majority of children with PE (n=172) either had a diagnosable DSM-IV-mental disorder (31.4%) or self-reported mental health difficulties in absence of a diagnosis (31.4%). The risk of delusions increased with onset of puberty. The risk of PE increased with emotional and neurodevelopmental disorders, subthreshold depressive symptoms, sleep problems and lack of sleep, regardless of whether PE were expressed as hallucinations and/or delusions. The highest correlations were seen for emotional and multiple disorders.ConclusionsPsychotic experiences are particularly prevalent in the context of affective dysregulation and sleep disturbance, increase with onset of puberty and represent a trans-diagnostic marker of psychopathology.