Abstract
Background
Evidence suggests that individuals with intellectual disabilities (ID) may be at increased risk of affective and non-affective psychotic disorders. However, studies so far have been limited by small and selected samples, while little is known on the factors influencing risk in this population. Using data from Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, we investigated the associations between ID, psychotic disorders, and psychotic experiences in adulthood, and assessed the potential mediating role of trauma in childhood.
Methods
ID cases were identified using a multisource measure utilising cognitive, functional, and diagnostic indicators from ALSPAC as well as health and administrative records. Psychotic disorder diagnoses were extracted through linkage to primary care records using relevant Read codes. Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. Multiple imputation was performed across all analyses to mitigate potential bias due to missing data.
Findings
The maximum sample after multiple imputation was 9,407. We found evidence of associations between ID and psychotic disorders (OR= 4.57; 95%CIs: 1.56-13.39). Evidence was weaker in the case of psychotic experiences (OR=1.63; 95%CIs: 0.93-2.84). There was some evidence to suggest a potential mediating role of traumatic experiences in the associations between ID and psychotic experiences (OR= 1.09; 95%CIs: 1.03-1.15). Complete case analyses yielded comparable estimates.
Interpretation
ID seems to be associated with psychotic disorders and experiences in young adulthood. Further research into the contribution of trauma is expected to shape current intervention strategies for psychotic disorders in this population.
Evidence suggests that individuals with intellectual disabilities (ID) may be at increased risk of affective and non-affective psychotic disorders. However, studies so far have been limited by small and selected samples, while little is known on the factors influencing risk in this population. Using data from Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort, we investigated the associations between ID, psychotic disorders, and psychotic experiences in adulthood, and assessed the potential mediating role of trauma in childhood.
Methods
ID cases were identified using a multisource measure utilising cognitive, functional, and diagnostic indicators from ALSPAC as well as health and administrative records. Psychotic disorder diagnoses were extracted through linkage to primary care records using relevant Read codes. Psychotic experiences were assessed at ages 18 and 24 using the semi-structured Psychosis-Like Symptoms interview (PLIKSi). Traumatic experiences between ages 5 and 11 were assessed with questionnaires and interviews administered to children and parents at multiple ages. Multiple imputation was performed across all analyses to mitigate potential bias due to missing data.
Findings
The maximum sample after multiple imputation was 9,407. We found evidence of associations between ID and psychotic disorders (OR= 4.57; 95%CIs: 1.56-13.39). Evidence was weaker in the case of psychotic experiences (OR=1.63; 95%CIs: 0.93-2.84). There was some evidence to suggest a potential mediating role of traumatic experiences in the associations between ID and psychotic experiences (OR= 1.09; 95%CIs: 1.03-1.15). Complete case analyses yielded comparable estimates.
Interpretation
ID seems to be associated with psychotic disorders and experiences in young adulthood. Further research into the contribution of trauma is expected to shape current intervention strategies for psychotic disorders in this population.
| Original language | English |
|---|---|
| Journal | Psychological Medicine |
| DOIs | |
| Publication status | Submitted - 2024 |
Research Groups and Themes
- ALSPAC