Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study

BACKGROUND

Childhood psychotic symptoms have been used as a subclinical phenotype of schizophrenia in etiological research and as a target for preventative interventions. However, recent studies have cast doubt on the specificity of these symptoms for schizophrenia, suggesting alternative outcomes such as anxiety and depression. Using a prospective longitudinal birth cohort we investigated whether childhood psychotic symptoms predicted a diagnosis of schizophrenia or other psychiatric disorders by 38 years of age.

METHOD

Participants were drawn from a birth cohort of 1037 children from Dunedin, New Zealand, who were followed prospectively to 38 years of age (96% retention rate). Structured clinical interviews were administered at age 11 to assess psychotic symptoms and study members underwent psychiatric assessments at ages 18, 21, 26, 32 and 38 to obtain past-year DSM-III-R/IV diagnoses and self-reports of attempted suicides since adolescence.

RESULTS

Psychotic symptoms at age 11 predicted elevated rates of research diagnoses of schizophrenia and posttraumatic stress disorder (PTSD) and also suicide attempts by age 38, even when controlling for gender, social class and childhood psychopathology. No significant associations were found for persistent anxiety, persistent depression, mania or persistent substance dependence. Very few of the children presenting with age-11 psychotic symptoms were free from disorder by age 38.

CONCLUSIONS

Childhood psychotic symptoms were not specific to a diagnosis of schizophrenia in adulthood and thus future studies of early symptoms should be cautious in extrapolating findings only to this clinical disorder. However, these symptoms may be useful as a marker of adult mental health problems more broadly.

Parental drinking, parent-child communication, and social skills in young adults

The goals of this study are to determine (1) if parent-child communication is associated with the level of alcoholic problems within the family and (2) if there is a relationship between problem drinking, family communication and the self-reported social skills of the young adult child. The self-reports of 338 students indicate that young adults who have memories of regular problem drinking within the family perceive less positive regard and a greater denial of or inattention to their feelings by the parents. Problem-drinking level interacted with either criticism or denial of feelings or emotional support to parents to predict primarily nonverbal social skills such as decreased emotional expressivity and increased sensitivity to the emotional cues of others. The results indicate that the effect of parental alcoholism on social skills of the young adult child must be considered in conjunction with specific types of family communication.