Adolescents who exhibit mild psychotic episodes will rarely go on to develop full blown clinical psychosis. “Longitudinal studies in general population samples, using follow-up intervals from 6 months to 8 years, have shown that, in most adolescents, psychotic experiences disappear over time and do not persist into adulthood,” said J.T. Wigman of the Department of Interdisciplinary Social Science at the University of Utrecht in the Netherlands. “However, in a minority of adolescents, subclinical psychotic experiences progress to clinical psychotic illness.” In an attempt to determine what factors contribute to the later development of psychosis in teens with subclinical psychosis, Wigman conducted a study that examined minority status, cannabis use, stress, social adaptation and attention. He used parental reports to gauge the teens’ behavior and also considered childhood trauma as a risk factor. Additionally, Wigman examined how often the teens received mental health care for their psychotic episodes, as previous research has shown this to be a significant predictor of further psychosis.
Wigman evaluated 2230 Dutch adolescents who were part of a larger study, the Tracking Adolescents’ Individual Lives Survey (TRAIL). He found that the teens who had exhibited cognitive difficulties were most likely to develop clinical levels of psychosis. Parental reports revealed that the teens who received the highest levels of care were also at risk for increased psychotic episodes. Additionally, Wigman found that childhood trauma, cannabis use and minority status significantly increased the risk for the adolescents. “The results suggest that the outcome of early developmental deviation associated with later expression of psychotic experiences is contingent on the degree of later interaction with environmental risks inducing, first, persistence of psychotic experiences and, second, progression to onset of need for care and service use.” Wigman added, “Insight into the longitudinal dynamics of risk states in representative samples may contribute to the development of targeted early intervention in psychosis.”
Wigman, J T, R. Van Winkel, Q A Raaijmkaers, J. Ormel, and F. C. Verhulst. “Evidence for a Persistent, Environment-dependent and Deteriorating Subtype of Subclinical Psychotic Experiences: a 6-year Longitudinal General Population Study.”Psychological Medicine 41.11 (2011): 2317-329. Print.
© Copyright 2011 by By Noah Rubinstein, LMFT, LMHC, therapist in Olympia, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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