Persistence and outcome of auditory hallucinations in adolescence: A longitudinal general population study of 1800 individuals

BACKGROUND Auditory hallucinations are common in adolescents. However, it has been suggested that not the presence of low-grade psychotic experiences per se, but rather the level of persistence and associated clinical complications over time may lead to psychotic illness. The current paper investigated, in a large representative sample of adolescents, to what degree hallucinations persist, and whether persistence of hallucinations increases the risk of developing secondary delusional ideation and affective dysregulation. METHODS Data were derived from a general health screening of all 1912 adolescents living in the Maastricht area. Baseline assessment was in the second grade of secondary school (T0) and follow-up occurred 2 years later (T1). Questions included the psychosis screening questions (Poulton et al., 2000), the SDQ assessing general psychopathology and a question assessing depression. RESULTS Five percent of adolescents reported hallucinations at T0 and 27% of these hallucinations were still present 2 years later. Hallucinations at T0 were associated with increased levels of depressed mood and general psychopathology at T1, and the degree of persistence of hallucinations was associated with a progressively greater risk for T1 delusional ideation as well as increased levels of follow-up depressed mood and general psychopathology. CONCLUSION Although hallucinations in adolescents are a common and mainly transitory phenomenon, the persistence rate over time is far from negligible, and associated with clinical deterioration.