OBJECTIVE The authors investigated the incidence, course, and outcome of psychotic experiences from childhood through early adulthood in the general population and examined prediction of psychotic disorder. METHODS This was a population-based cohort study using the semistructured Psychosis-Like Symptoms Interview at ages 12, 18, and 24 (N=7,900 with any data). Incidence rates were estimated using flexible parametric modeling, and positive predictive values (PPVs), sensitivity, specificity, and area under the curve were estimated for prediction. RESULTS The incidence rate of psychotic experiences increased between ages 13 and 24, peaking during late adolescence. Of 3,866 participants interviewed at age 24, 313 (8.1%, 95% CI=7.2, 9.0) had a definite psychotic experience since age 12. A total of 109 individuals (2.8%) met criteria for a psychotic disorder up to age 24, of whom 70% had sought professional help. Prediction of current psychotic disorder at age 24 (N=47, 1.2%), by both self-report and interviewer-rated measures of psychotic experiences at age 18 (PPVs, 2.9% and 10.0%, respectively), was improved by incorporating information on frequency and distress (PPVs, 13.3% and 20.0%, respectively), although sensitivities were low. The PPV of an at-risk mental state at age 18 predicting incident disorder at ages 18-24 was 21.1% (95% CI=6.1, 45.6) (sensitivity, 14.3%, 95% CI=4.0, 32.7). CONCLUSIONS The study results show a peak in incidence of psychotic experiences during late adolescence as well as an unmet need for care in young people with psychotic disorders. Because of the low sensitivity, targeting individuals in non-help-seeking samples based only on more severe symptom cutoff thresholds will likely have little impact on population levels of first-episode psychosis.

中文翻译：

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一项基于人群的队列研究，探讨从童年到成年的精神病经历的发生率和影响，以及精神病的预测。

目的 作者调查了一般人群从童年到成年早期精神病经历的发生率、病程和结果，并检验了精神病的预测。方法 这是一项基于人群的队列研究，使用 12、18 和 24 岁的半结构化精神病样症状访谈（N=7,900 人，有任何数据）。使用灵活的参数模型估计发病率，并估计阳性预测值（PPV）、敏感性、特异性和曲线下面积以进行预测。结果 13 岁至 24 岁之间精神病经历的发生率增加，在青春期后期达到顶峰。在 24 岁接受采访的 3,866 名参与者中，有 313 人（8.1%，95% CI=7.2，9.0）自 12 岁起就有明确的精神病经历。共有 109 人（2.8%）在 24 岁之前符合精神病标准，其中 70% 曾寻求专业帮助。通过整合信息，通过自我报告和访谈者评估 18 岁时精神病经历的测量（PPV 分别为 2.9% 和 10.0%），对 24 岁时当前精神病的预测（N=47，1.2%）得到了改善尽管敏感性较低，但频率和痛苦（PPV 分别为 13.3% 和 20.0%）。18 岁时处于危险精神状态的 PPV 预测 18-24 岁时发生障碍的概率为 21.1% (95% CI=6.1, 45.6)（敏感性为 14.3%, 95% CI=4.0, 32.7）。结论 研究结果显示，青春期后期精神病经历的发生率达到高峰，并且患有精神病的年轻人的护理需求未得到满足。由于敏感性较低，仅根据更严重的症状截止阈值来针对非寻求帮助样本中的个体，可能对首发精神病的人群水平影响不大。