Comportement des enfants et des adolescents

Abstrait

The Occurrence of Positive Psychotic Experiences in an Outpatient Clinic in Flanders

Krystle Gaul, E De Loore and D van West

Objective: Psychotic like experiences (PLEs) resemble psychotic symptoms but are more benign and transient. They occur numerously in clinical and non-clinical samples and have a peak incidence in adolescence. PLEs can be linked to psychopathology and, in the presence of risk factors, PLEs can make a transition to psychotic symptoms and psychosis. The aim of this study was to measure the occurrence of PLEs in a Flemish clinical sample of adolescents using the CAPE (Community Assessment of Psychic Experiences). Gender, age, IQ differences and possible links with psychopathology, distress and impairment have been investigated. Method: 1176 adolescents between 12 and 17 years old were referred to a child and adolescent psychiatric outpatient clinic for psychiatric assessment. PLEs were measured using the CAPE, more precisely the CAPE positive experiences scale (CAPE-P, 20 questions). PLEs were divided into 5 subdimensions: Hallucination, Paranoia, Delusion, Grandiosity and Paranormal Belief. Results: 734 CAPEs were valid for research. 94.2% of adolescents in the clinical sample reported at least one PLE at least ‘sometimes’. 62.3% of our population reported at least one PLE at least ‘often’, which was a higher rate than found in the general population. 83.2% of the population reported at least ‘a bit distress’ for at least one PLE, whereas 51% reported to be ‘quite or very distressed’ about at least one PLE. Girls reported more PLEs than boys and reported higher levels of distress. There was no significant general trend in PLEs found when looked at age or IQ distribution. PLEs with distress could be linked to psychopathology in general, but not to specific diagnoses. Conclusion: In comparison to the general population, adolescents in a clinical population experience PLEs more often and with a higher degree of distress. The CAPE can be used in a clinical population for follow up and identification in the risk of transition. Higher risk can be defined by a higher score of frequency and distress on the CAPE and the persistence of this score over time. Risk of transition increases with a certain degree of impairment (that might be caused by comorbid psychopathology) and the combination with specific risk factors for psychosis.