Persisting psychotic-like experiences as predictors of externalising and internalising psychopathology in a longitudinal general population child cohort

Background: Persisting psychotic-like experiences (PLEs) are associated with an increased risk of internalising symptoms in adolescence. Whether this association holds similarly for externalising symptoms, and from mid-child- hood, remains unclear. This study investigated prospectively the association of PLE persistence with internalising and externalising psychopathology in a community sample of children followed from age 9–11 years. Methods: 8,099 children (mean age 10.4 years) completed questionnaires assessing PLEs, externalising, and internalising symptoms. A subsample of 547 children completed reassessment, on average, two years later. Results: Two-thirds (66%) of children reported PLEs at baseline. Approximately two years later, PLEs persisted in 39%. After adjustment for previous psychopathology and other potential confounds, children with persisting PLEs were at higher risk for internalising (odds ratio [OR] = 1.94; 95% confidence interval [95% CI] 1.13–3.34) and externalising (OR = 1.97; 95% CI 1.19–3.26) psychopathology than children whose PLEs remitted, and relative to children who never presented PLEs. Conclusions: Persistent PLEs from mid-childhood are associated with later internalising and externalising psychopathology in the general population, whereas transitory PLEs may be part of a spectrum of normative childhood development. Interventions that target persistent PLEs may contribute to a reduction in common childhood psychopatholog