Martin K. Rimvall1,2, Jim van Os3,4,5, Charlotte Ulrikka Rask6,7, Else Marie Olsen8,9, Lars Clemmensen1, Anne Mette Skovgaard8,10, Frank Verhulst1,2, Pia Jeppesen1,2; 1Child and Adolescent Mental Health Services, Capital Region of Denmark, 2Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark, 3Department of Psychiatry and Psychology at Maastricht University Medical Centre, Maastricht, The Netherlands, 4Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands, 5Institute of Psychology and Neuroscience, Department of Child and Adolescent Psychiatry, King's College London, UK, 6Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Denmark, 7Child and Adolescent Psychiatric Centre Risskov, Aarhus University Hospital, Denmark, 8Department of Public Health, University of Copenhagen, Denmark, 9Centre for Clinical Research and Prevention, Capital Region of Denmark, 10National Institute of Public Health, University of Southern Denmark, Denmark
Subclinical psychotic experiences are common in the general population in adolescence, and indicate an increased risk of developing psychotic disorders later in life. Suicide is one of the most common causes of death in adolescence and young adulthood, and non-suicidal self-injury (NSSI) as well as suicidal ideation and behaviors are highly associated with psychotic experiences in adolescence. The current study examines the association between psychotic experiences and NSSI and suicidal ideation in pre-adolescents from the general population. A total of 1631 11-12-year old children from the Copenhagen Child Cohort 2000 were interviewed by trained professionals using the sections on psychotic and affective symptoms of the Kiddie-Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version. During their lifetime, 172 children (10.5%) had experienced psychotic experiences, 24 (1.5%) reported NSSI, and 55 (3.4%) reported suicidal ideation. PE were strongly associated with NSSI (OR 10.8 95%CI 4.7-24.4) and suicidal ideation (OR 9.5 95% CI 5.5-16.6). Adjustment for depressed mood, irritability and anhedonia reduced the associations, but still held significance: NSSI OR 5.3 (95%CI 2.2-12.7) and suicidal ideation 5.0 (95%CI 2.7-9.0). Only 6 individuals confided that they had attempted suicide. We found that psychotic experiences are significantly associated with NSSI and suicidal ideation already in pre-adolescence. Longitudinal studies of the Copenhagen Child Cohort 2000 will investigate the possible causal role of psychotic experiences and other clinical correlates which could guide future interventions to decrease NSSI and suicidal behavior in youngsters vulnerable to psychosis.
