Psychotic Experiences and Risk of Suicidality in Adolescents: Examining the Impact of Auditory Hallucinations in Longitudinal Study From a Large Nationwide Birth Cohort.

BACKGROUND AND HYPOTHESIS: Psychotic experiences (PE) in childhood have been linked to suicidal ideation (SI) and suicide attempt (SA), usually in cross-sectional studies. We aimed to examine longitudinal associations of PE with suicidality in adolescents.

STUDY

DESIGN

The study cohort was based on The Danish National Birth Cohort (DNBC). The 11 (DNBC-11) and 18 (DNBC-18) year-follow-up included questions on PE while adolescents were asked about lifetime SI and SA at DNBC-18. DNBC data was linked with individual-level-data from Danish Registers enabling further information on hospital contacts for SA. Multinomial logistic regression models were applied and adjusted for social and mental well-being factors. Inverse probability weighting was applied to account for sample selection.

STUDY

RESULTS

Out of 26 723 participants 3118 (11.7%) reported at least one PE at DNBC-11 and (11.2%) at DNBC-18. Those reporting at least one PE had increased risk of SI (RRR = 1.91, 95% CI, 1.76-2.08) and SA (RRR = 3.37, 95% CI, 2.81-4.04) compared to children without PE. Greater number of concurrent PE was associated with increased risk of suicidality. Youths reporting PE at both age 11 and 18 had higher risk of SI (RRR = 4.00, 95% CI, 3.41-4.70) and SA (RRR = 12.92, 95% CI, 10.07-16.58) compared with youth reporting no PE. In cross-sectional analyses auditory hallucinations such as "hearing mean voices" was associated with a marked greater risk of SA (RRR = 66.15, 95% CI, 46.78-93.53) compared to youths without auditory hallucinations.

CONCLUSIONS

This large longitudinal study documents that young people who report PE in pre-adolescent years, and especially auditory hallucinations with negative comments are associated with increased risk of suicidality in teenage years.