Mary Cannon is a Professor at the Royal College of Surgeons in Ireland. Her work focuses on youth mental health, with a particular focus on early risk factors for conditions like schizophrenia. We talk to her about how common it is for children to experience psychotic experiences – and what it means when they do.
Psychotic experiences in young people like hearing voices has been discussed in the mental health press for a few years. How common are they?
They’re actually surprisingly common. We have found in Ireland, in our study, that up to 1 in 5 young people have actually reported something like hearing voices, or feeling people are following them or having people interfering in their thoughts.
What we’ve found is that early and late childhood time appears to be the peak for these kinds of experiences. When you go on further in adolescence the number of young people reporting these symptoms drops to about 7/8% and then in adulthood, about 4/5% will experience these kinds of symptoms, which aren’t necessarily interfering with their lives.
So these symptoms are much more common than we realise, up to 1 in 20 people have them – and they appear to be more associated with specific age groups.
So the fact that young people are hearing voices or seeing visual hallucinations doesn’t necessarily mean they’re going to go on to develop schizophrenia or other mental health conditions?
No. I came from a background in schizophrenia research and initially everyone had viewed these symptoms as a risk marker for later schizophrenia – but it’s not at all like that. What we need to find out is – what do they mean? It seems to be that young people who hear these voices or report seeing things are more at risk for a range of mental disorders in childhood, like depression and anxiety, which we need to think more about.
We can’t ignore these symptoms and we need to find out more. In about 70% of people these symptoms will just resolve.
I’m fascinated by the link between stresses and traumas earlier in life, which seem to increase the risk of these symptoms - we need to find out more about that link.
Presumably, there’s a lot of young people who see things and hear things that aren’t there, who don’t talk to anyone about it. So surely the first thing is to try and reduce the stigma surrounding these experiences?
That’s exactly right. That’s what we’ve been trying to do with our work, when our first study came out in Ireland – the one in five young people – the media, teachers and parents were all very interested.
We weren’t expecting this reaction to a scientific paper, but we got into the news. We need to not only inform the public, but we also need to tell children and adolescent psychologists about this – we need to ask young people about these symptoms because they won’t necessarily tell you because there’s a stigma. Then we can figure out, why are you experiencing this? Is this something we need to worry about or not? Or we can just reassure – sometimes just telling someone is such a relief for young people.
How are young people that do talk about these experiences responded to by healthcare professionals?
What’s interesting is that we’re finding in a lot of cases these young people will be experiencing depression or anxiety, or having some sort of ongoing trauma such as bullying. That’s what gets treated in the first instance, we don’t have a treatment for voice-hearing in childhood – maybe we don’t need one, maybe we deal with these other things and it’ll go away, or maybe it’ll continue throughout life.
My feeling is that in a lot of cases, these symptoms are an indication of some sort of stresses or trauma where the child is not able to verbalise, so it is coming through in these experiences. We discovered a very powerful finding which was published in 2013 (American Journal, Psychiatry 2013), showing that these symptoms are associated with bullying. Over the course of the year, we found that if the bullying stopped, the voice-hearing stopped, even over the course of a few months.
We're funding research to gain a better understanding about childhood psychosis, looking at how trauma can lead to experience symptoms like hearing voices and seeing things which others don't. Read more about Dr Helen Fisher's work here.
Listen to Mary Cannon talking to Andre Tomlin from Mental Elf at our Mental Health Science Meeting.
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Last updated: 15 March 2017