The Impact of Age on the Prevalence and Clinical Relevance of Attenuated Psychotic Symptoms in Patients of an Early Detection Service

Abstract

Introduction

Compared to 16–40-year-olds, 8–15-year-olds of the community reported higher frequencies of perceptual and lesser clinical significance of non-perceptual attenuated psychotic symptoms (APS).

Objectives/aims

We examined if a similar age effect is present in a clinical never-psychotic sample (n = 133) referred to a specialized service for clinical suspicion of developing psychosis.

Methods

APS and brief intermittent psychotic symptoms (BIPS) were assessed using items P1-3 and P5 (non-perceptual) and P4 (perceptual) of the structured interview for psychosis-risk syndromes, current axis-I disorders with the mini-international neuropsychiatric interview and psychosocial functioning with the Social and Occupational Functioning Assessment Scale (score < 71 indicative of at least some difficulty in social, occupational, or school functioning).

Results

Overall, 64% reported APS (61%) or BIPS (7%); any perceptual APS/BIPS was reported by 43% and any non-perceptual APS/BIPS by 44%. In correspondence to the results of the community study, perceptual but not non-perceptual APS/BIPS were significantly more frequent in younger age groups below the age of 16 (8–12 yrs: OR = 4.7 (1.1–19.5); 13–15 yrs: OR = 2.7 (0.9–7.7); 20–24-year-olds as reference group). An age effect of APS/BIPS on presence of any current axis-I disorder (59%) or functional difficulties (67%) could not be detected. Yet, when APS onset requirements were met, the likelihood of a psychiatric diagnosis increased significantly with advancing age.

Conclusion

Overall, the replicated age effect on perceptual APS in this clinical sample highlights the need to examine ways to distinguish clinically relevant perceptual APS from perceptual aberrations likely remitting over the course of adolescence.

Disclosure of interest

The authors have not supplied their declaration of competing interest.