title: Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning.
abstract: BACKGROUND
  Recent community-based research has suggested that psychotic experiences act as markers of severity of psychopathology. There has, however, been a lack of clinic-based research. We wished to investigate, in a clinical sample of adolescents referred to a state-funded mental health service, the prevalence of (attenuated or frank) psychotic experiences and the relationship with (i) affective, anxiety and behavioural disorders, (ii) multimorbid psychopathology, (iii) global functioning, and (iv) suicidal behaviour.
  
  
  METHODS
  The investigation was a clinical case-clinical control study using semi-structured research diagnostic psychiatric assessments in 108 patients newly referred to state adolescent mental health services.
  
  
  RESULTS
  Psychotic experiences were prevalent in a wide range of (non-psychotic) disorders but were strong markers of risk in particular for multimorbid psychopathology (Z = 3.44, p = 0.001). Young people with psychopathology who reported psychotic experiences demonstrated significantly poorer socio-occupational functioning than young people with psychopathology who did not report psychotic experiences, which was not explained by multimorbidity. Psychotic experiences were strong markers of risk for suicidal behaviour. Stratified analyses showed that there was a greatly increased odds of suicide attempts in patients with a major depressive disorder [odds ratio (OR) 8.89, 95% confidence interval (CI) 1.59-49.83], anxiety disorder (OR 15.4, 95% CI 1.85-127.94) or behavioural disorder (OR 3.13, 95% CI 1.11-8.79) who also had psychotic experiences compared with patients who did not report psychotic experiences.
  
  
  CONCLUSIONS
  Psychotic experiences (attenuated or frank) are an important but under-recognized marker of risk for severe psychopathology, including multimorbidity, poor functioning and suicidal behaviour in young people who present to mental health services.
authors.affiliation: Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
authors.forename: I
authors.initials: I
authors.lastname: Kelleher
authors.affiliation: Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
authors.forename: N
authors.initials: N
authors.lastname: Devlin
authors.affiliation: Maastricht University, Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: J T W
authors.initials: JT
authors.lastname: Wigman
authors.affiliation: University College Dublin, Catherine McAuley Research Centre, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Kehoe
authors.affiliation: Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Murtagh
authors.affiliation: University College Dublin, Catherine McAuley Research Centre, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Fitzpatrick
authors.affiliation: Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.
authors.forename: M
authors.initials: M
authors.lastname: Cannon
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008605:Mental Health Services / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology*; D012306:Risk; D013405:Suicide / Q000706:statistics & numerical data*