Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study.
BACKGROUND
Birth cohort studies have shown that individuals who develop non-affective psychoses display subtle deviations in behaviour during childhood and adolescence. We had the opportunity to examine the widely used Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) to explore the antecedents of non-affective psychosis.


METHODS
Based on a birth cohort of 3801 young adults, psychopathology was assessed at years 5 and 14 using the CBCL and/or the YSR. Screen-positive non-affective psychosis (SP-NAP) was assessed at year 21 by using the Composite International Diagnostic Interview (CIDI) or a self-report checklist. The association between childhood symptoms and SP-NAP was examined using logistic regression.


RESULTS
Of the cohort, 60 subjects were classified as SP-NAP. In males, SP-NAP was associated with higher scores: (a) on year 5 CBCL 'Total', 'Aggression' and 'Social, Attention and Thought' scores; (b) on year 14 CBCL 'Social', 'Attention' and 'Delinquency' scores, and (c) YSR 'Total' and many YSR subscores. These associations were less clear for females. Hallucinations at year 14 were associated with SP-NAP for both sexes. Boys with high 'Total' scores at both years 5 and 14 were at greatest risk of SP-NAP (a 5-fold risk), followed by boys and girls whose 'Social, Attention and Thought' scores either increased or remained high from years 5 to 14 (3- to 13-fold risk).


CONCLUSIONS
Individuals who screen positive for non-affective psychosis show increased psychopathology during childhood and adolescence. The psychopathological trajectory of children who go on to develop schizophrenia anticipates the heterogeneity associated with the full clinical syndrome.
Welham
J
J
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia.
Scott
J
J
Williams
G
G
Najman
J
J
Bor
W
W
O'Callaghan
M
M
McGrath
J
J
D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000374:Aggression / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis*; D012569:Schizotypal Personality Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D012917:Social Adjustment; D013223:Statistics as Topic; D055815:Young Adult