title: The longitudinal association between psychotic experiences, depression and suicidal behaviour in a population sample of adolescents.
abstract: OBJECTIVE
  Whilst psychotic experiences are associated with suicidal behaviour in a number of studies the value of psychotic experiences for the prediction of suicidal behaviour and the role of depressive symptoms in this relationship is not clear. We examined the association between psychotic experiences and subsequent suicidal behaviour and examine the role of depressive symptoms in this relationship.
  
  
  METHODS
  Psychotic experiences and depressive symptoms at age 12 and 16 years, and suicidal behaviour at age 16 years were assessed in participants (prospective analysis n = 3171; cross-sectional analysis n = 3952) from a population-based cohort.
  
  
  RESULTS
  Psychotic experiences (OR 1.75 95 % CI 1.20, 2.54) and depression (OR 3.97 95 % CI 2.56, 6.15) at 12 years were independently associated with suicidal behaviour at 16 years after adjustment for confounding. There was no evidence that the relationship between psychotic experiences and suicidal behaviour was stronger in participants who were also depressive. A ROC analysis showed that adding information on psychotic experiences to measures of depressive symptoms had hardly any effect on improving prediction of suicidal behaviour (AUC increased from 0.64 to 0.65). Whereas adding a measure of depressive symptoms to the measure of psychotic experiences improved prediction substantially (AUC 0.56-0.65).
  
  
  CONCLUSIONS
  Psychotic experiences and depression are independently associated with suicidal behaviour although the association with depression is substantially stronger. Psychotic experiences alone are not a strong predictor of later suicidal behaviour and add little to predicting the risk of suicidal behaviour over and above the information provided by depressive symptoms.
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK. sarah.sullivan@bristol.ac.uk.|CLAHRC West, School of Social and Community Medicine, University of Bristol, Bristol, UK. sarah.sullivan@bristol.ac.uk.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Sullivan
authors.affiliation: Mental Health Sciences Unit, University College London, London, UK.
authors.forename: Glyn
authors.initials: G
authors.lastname: Lewis
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
authors.affiliation: Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Cannon
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Becky
authors.initials: B
authors.lastname: Mars
authors.affiliation: Centre for Academic Mental Health, School of Social and Community Medicine, University of Bristol, Bristol, UK.|Institute of Psychological Medicine and Clinical Neurosciences, University of Cardiff, Cardiff, UK.
authors.forename: Stan
authors.initials: S
authors.lastname: Zammit
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011618:Psychotic Disorders / Q000523:psychology*; D012306:Risk; D059020:Suicidal Ideation
keywords: Depressive symptoms; Epidemiology; Psychotic experiences; Suicidal behaviour