Adverse life outcomes associated with adolescent psychotic experiences and depressive symptoms

Abstract

Purpose: To investigate whether psychotic experiences and depressive symptoms at ages 12 and 18 years are associated with adverse life outcomes across a range of functional domains between 16 and 20 years of age.

Methods: Data were gathered from ALSPAC, a UK birth cohort. Individuals were assessed with the semi-structured Psychosis-Like Symptoms Interview and the Short Mood and Feeling Questionnaire at ages 12 and 18 years. Logistic regression was used to explore associations with outcomes in education, occupation, social functioning, substance use (alcohol, cannabis, smoking, and other drugs), and illegal behaviour between the ages of 16 and 20 years. All associations were adjusted for socio-demographic and childhood confounders and for comorbid psychotic experiences or depressive symptoms.

Results: Psychotic experiences and depression at age 12 were associated with poorer educational, occupational, and social outcomes between the ages of 16 and 20; these withstood adjustment for confounding. Depressive symptoms at age 12 were also associated with harmful drinking. Psychotic experiences and depression at age 18 were additionally associated with other forms of substance use and illegal behaviour. Comorbidity had little impact at age 12, but was associated with significantly worse educational, social, and substance use outcomes at age 18.

Conclusions: Adolescent psychotic experiences and depression represent a risk marker for a number of later adverse outcomes, most consistently with education and employment, but also social impairment, harmful drinking, and substance use. This highlights the importance of recognizing adolescent psychopathology, so that support can be provided to try and minimize adverse outcomes.

Keywords: ALSPAC; Adolescent; Depression; Psychosis; Social.

Fig. 1

Flow chart of cohort and study participants

Fig. 2

Odds ratios and 95% confidence intervals for psychosocial outcomes between ages 18–20 in relation with the presence of ‘neither depression nor PEs’, ‘PEs only’, and ‘depression only’ at 18 years. Having ‘both PEs and depression’ was used as the baseline reference group, meaning that OR < 1 indicates having ‘both’ was detrimental. Associations have been adjusted for confounders (gender, social class, housing, maternal education, IQ at 8, and total SDQ score at 8)