Psychotic Experiences in Adolescents and Young Adults

Psychotic experiences encompass a range of subclinical phenomena such as unusual perceptual events, attenuated delusional beliefs and transient thought disorder. They occur along a continuum from benign, fleeting sensations to distressing symptoms that predict clinical need. In adolescence and early adulthood, a peak period for the first emergence of such experiences, they have been associated with elevated risk for later psychotic disorder, mood and anxiety disorders, functional impairment and increased healthcare utilisation. A convergence of genetic vulnerability, perinatal and prenatal adversities, neurodevelopmental alterations, adverse childhood experiences, substance use and cognitive factors appears to shape individual trajectories. While most adolescents with psychotic experiences do not transition to frank psychosis, persistence, frequency and associated distress heighten clinical significance. Early identification efforts have emphasised multidimensional assessment of symptom severity, distress and co-occurring internalising and externalising symptoms, along with measures of cognitive functioning and neurobiological markers. Intervention strategies range from universal school-based programmes to specialised cognitive-behavioural approaches targeted at individuals with persistent distressing experiences. A growing body of work highlights the importance of social support, family environment and community cohesion as protective factors. Globally, enhanced screening and prevention during the critical window of adolescence promise to reduce the burden of severe mental illness and optimise functional outcomes through timely, developmentally informed interventions.

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Psychotic Experiences in Adolescents and Young Adults publication trend

The graph below shows the total number of articles in psychotic experiences in adolescents and young adults across all publications each year (not limited to Nature Index journals).

Technical terms

Psychotic experiences (PEs): Subclinical hallucinations, delusions or thought-disorder phenomena occurring in non-clinical populations.

Psychotic-like experiences (PLEs): Transient or attenuated symptoms resembling psychosis that do not meet diagnostic threshold.

Persistent distressing PLEs: Psychotic-like experiences that are both ongoing over multiple time points and associated with significant subjective distress.

Internalising symptoms: Emotional difficulties such as anxiety and depression that occur within the individual and often co-occur with PEs.

Adverse childhood experiences: Potentially traumatic events in early life, including abuse, neglect and household dysfunction, linked to increased risk of PEs.

Cognitive-behavioural intervention: Psychotherapeutic approach targeting maladaptive thoughts and behaviours to reduce distress and improve coping with PEs.

References

1. Examining the association between prenatal and perinatal adversity and the psychotic experiences in childhood. Psychological Medicine (2024).
2. Psychotic experiences and psychological distress in adolescents: an examination of longitudinal bidirectional effects across sex. Child and Adolescent Psychiatry and Mental Health (2024).
3. Examining the Most Important Risk Factors for Predicting Youth Persistent and Distressing Psychotic-Like Experiences. Biological Psychiatry Cognitive Neuroscience and Neuroimaging (2024).
4. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychological Medicine (2022).