Longitudinal Association Between Psychotic-Like Experiences and New-Onset Mental Disorders in Late Adolescents

The study aimed to examine the temporal association between psychotic-like experiences (PLEs) and new-onset mental disorders in late adolescents.

This longitudinal study used data from the Guangzhou Early Mental Health Screening for University Students (GEMSS), conducted in China from 2020 to 2024. PLEs conditions were defined based on the participants' baseline assessment. Person-year incidence rates of any new-onset mental disorder (MD), psychotic disorder (PD), and non-psychotic disorder (non-PD) were calculated in different PLEs groups. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of different PLEs conditions, and their population attributable fractions (PAFs) for mental disorders were computed.

Of the 6,737 included participants (56.2% female; mean [SD] age, 18.84 [0.72] years), 876 (13.0%) were currently experiencing PLEs at baseline (cur-PLEs), 2,815 (41.8%) had previously experienced PLEs (pre-PLEs), and 3,046 (45.2%) had never experienced PLEs before (non-PLEs). Compared to the non-PLEs group, the cur-PLEs group exhibited a significantly higher risk for developing any new-onset MD (HR = 4.83, 95% CI = 3.22, 7.24), PD (HR = 10.59, 95% CI = 1.23, 91.0), and non-PD (HR = 6.22. 95% CI = 3.96, 9.80), whereas the pre-PLEs group exhibited a significantly higher risk for incident MD (HR = 2.11, 95% CI = 1.44, 3.07) and non-PD (HR = 2.25, 95% CI = 1.48, 3.40). The PLEs conditions accounted for 49.1% (95% CI = 0.483, 0.499), 74.4% (95% CI = 0.738, 0.749), and 52.4% (95% CI = 0.515, 0532) of new-onset MD, PD, and non-PD.

PLEs in late adolescence are closely associated with the onset of psychotic and non-psychotic disorders. These findings underscore the critical importance of PLEs in screening high-risk populations as a transdiagnostic predictor of mental disorders.

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. Diverse cell lines and/or genomic datasets were not available.ne or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.