Abstract
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Background: Childhood risk factors for the development of adult schizophrenia have proved to have only modest and non-specific effects, and most appear unrelated to the adult phenotype. This paper reports the first direct examination of the longitudinal relation between psychotic symptoms in childhood and adulthood.
Methods: Prospective data from a birth cohort (n=761) in which children were asked about delusional beliefs and hallucinatory experiences at age 11, and then followed up to age 26, were analysed. Structured diagnostic interviews were employed at both ages and self-report of schizophreniform symptoms was augmented by other data sources at age 26.
Results: Self-reported psychotic symptoms at age 11 predicted a very high risk of a schizophreniform diagnosis at age 26 (OR = 16.4, 95%CI: 3.9-67.8). In terms of attributable risk, 42% of the age-26 schizophreniform cases in the cohort had reported one or more psychotic symptoms at age 11. Age-11 psychotic symptoms did not predict mania or depression at age 26, suggesting specificity of prediction to schizophreniform disorder. The link between child and adult psychotic symptoms was not simply the result of general childhood psychopathology.
Conclusions: These findings provide the first evidence for continuity of psychotic symptoms from childhood to adulthood.