Precursors and correlates of transient and persistent longitudinal profiles of psychotic experiences from late childhood through early adulthood

Alexandros Rammos, Sarah A Sullivan, Daphne Kounali, Hannah J Jones, Gemma Hammerton, Lindsey A Hines, Glyn Lewis, Peter B Jones, Mary Cannon, Andrew Thompson, Dieter Wolke, Jon Heron, Stanley Zammit

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BACKGROUND: Psychotic experiences are reported by 5-10% of young people, although only a minority persist and develop into psychotic disorders. It is unclear what characteristics differentiate those with transient psychotic experiences from those with persistent psychotic experiences that are more likely to be of clinical relevance.

AIMS: To investigate how longitudinal profiles of psychotic experiences, created from assessments at three different time points, are influenced by early life and co-occurring factors.

METHOD: Using data from 8045 individuals from a birth cohort study, longitudinal profiles of psychotic experiences based on semi-structured interviews conducted at 12, 18 and 24 years were defined. Environmental, cognitive, psychopathological and genetic determinants of these profiles were investigated, along with concurrent changes in psychopathology and cognition.

RESULTS: Following multiple imputations, the distribution of longitudinal profiles of psychotic experiences was none (65.7%), transient (24.1%), low-frequency persistent (8.4%) and high-frequency persistent (1.7%). Individuals with high-frequency persistent psychotic experiences were more likely to report traumatic experiences, other psychopathology, a more externalised locus of control, reduced emotional stability and conscientious personality traits in childhood, compared with those with transient psychotic experiences. These characteristics also differed between those who had any psychotic experiences and those who did not.

CONCLUSIONS: These findings indicate that the same risk factors are associated with incidence as with persistence of psychotic experiences. Thus, it might be that the severity of exposure, rather than the presence of specific disease-modifying factors, is most likely to determine whether psychotic experiences are transient or persist, and potentially develop into a clinical disorder over time.

Original languageEnglish
Pages (from-to)330-338
Number of pages9
JournalThe British Journal of Psychiatry
Issue number6
Early online date6 Oct 2021
Publication statusPublished - 30 Jun 2022

Bibliographical note

The UK Medical Research Council (MRC) and Wellcome Trust (grant number 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. A comprehensive list of grant funding is available on the ALSPAC website ( grant-acknowledgements.pdf); this research was specifically funded by MRC grant MR/ M006727/1.S.Z., H.J.J., D.K. and S.A.S. acknowledge support from the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol; G.L. acknowledges support from the NIHRBRC at University College London Hospital; P.B.J. acknowledges support from the NIHR Collaborations for Leadership in Applied Health Research and Care East of England (grant number NIHRPGfARRP-PG-0616-20003(TYPPEX)) and the Wellcome Trust Neuroscience in Psychiatry Network (grantnumber095844/Z/11/Z); M.C. acknowledges support from a European Research Council Consolidator Award(number iHEAR724809); and G.H. and L.A.H. from Wellcome Trust fellowships (numbers209138/Z/17/Zand209158/Z/17/Z). The views expressed in this article are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health and Social Care.

Data availability
Scripts used for the analyses conducted in this study are available on request from the corresponding author, A.R. The data that support the findings of this study are available from ALSPAC (see


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