Unraveling the Bidirectional Associations of Psychotic-Like Experiences With Depressive Symptoms and Suicidal Ideation Among Adolescents
Dongfang Wang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Conceptualization (equal), Data curation (equal), Writing - original draft (equal)
Search for more papers by this authorBrendan Ross
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Contribution: Conceptualization (equal), Writing - review & editing (equal)
Search for more papers by this authorMeng Sun
Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
Contribution: Conceptualization (equal), Writing - review & editing (equal)
Search for more papers by this authorHuolian Li
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorXiangting Zhang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorXuan Wang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorYang Qiu
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Zijuan Ma
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Correspondence:
Zijuan Ma ([email protected])
Fang Fan ([email protected])
Contribution: Conceptualization (equal), Data curation (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Fang Fan
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Correspondence:
Zijuan Ma ([email protected])
Fang Fan ([email protected])
Contribution: Conceptualization (equal), Data curation (equal), Funding acquisition (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorDongfang Wang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Conceptualization (equal), Data curation (equal), Writing - original draft (equal)
Search for more papers by this authorBrendan Ross
Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Contribution: Conceptualization (equal), Writing - review & editing (equal)
Search for more papers by this authorMeng Sun
Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
Contribution: Conceptualization (equal), Writing - review & editing (equal)
Search for more papers by this authorHuolian Li
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorXiangting Zhang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorXuan Wang
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorYang Qiu
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Contribution: Investigation (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Zijuan Ma
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Correspondence:
Zijuan Ma ([email protected])
Fang Fan ([email protected])
Contribution: Conceptualization (equal), Data curation (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorCorresponding Author
Fang Fan
School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
Correspondence:
Zijuan Ma ([email protected])
Fang Fan ([email protected])
Contribution: Conceptualization (equal), Data curation (equal), Funding acquisition (equal), Supervision (equal), Writing - review & editing (equal)
Search for more papers by this authorFunding: This study was funded by the Philosophy and Social Science Planning Project of Guangdong Province (GD25YXL16), Fundamental and Applied Basic Research Program in Guangzhou (2025A04J3416; 2024A1515220104), Science and Technology Program of Guangzhou (2024A04J10000, 2024A03J0223), Psychological services and counseling bases for the Happy Guangzhou project, which received funding from the Guangzhou Government, and Striving for the First-Class, Improving Weak Links and Highlighting Features (SIH) Key Discipline for Psychology in South China Normal University.
ABSTRACT
Background
Previous literature suggests that adolescent psychotic-like experiences (PLEs) are associated with depressive symptoms and suicidal ideation. This study aimed to explore these prospective relationships between PLEs, depressive symptoms, and suicidal ideation among adolescents.
Methods
A large-scale web-based survey was conducted using repeated measures at three time points: from 21 April to 12 May 2021 (T1), from 17 to 26 December 2021 (T2), and from 17 May to 6 June 2022 (T3). A total of 17,722 adolescents were assessed at both T1 and T2, and 15,694 adolescents also provided complete responses at both T1 and T3. Self-reported scales were used to assess PLEs and depressive symptoms, and suicidal ideation was assessed.
Results
PLEs at baseline were significantly associated with increased odds of depressive symptoms and suicidal ideation at both follow-up intervals after adjusting for covariates (all p < 0.001). Moreover, baseline depressive symptoms and suicidal ideation were significantly associated with increased likelihoods of subsequent PLEs (all p < 0.001).
Conclusions
This study underscores bidirectional prospective associations between PLEs, depressive symptoms, and suicidal ideation among adolescents, and its findings underscore the critical educational and clinical importance of screening for PLEs while treating depressive symptoms and suicidal ideation.
Conflicts of Interest
The authors declare no conflicts of interest.
References
- Altura, K. C., S. B. Patten, K. M. Fiest, C. Atta, A. G. Bulloch, and N. Jette. 2016. “Suicidal Ideation in Persons With Neurological Conditions: Prevalence, Associations and Validation of the PHQ-9 for Suicidal Ideation.” General Hospital Psychiatry 42: 22–26. https://doi.org/10.1016/j.genhosppsych.2016.06.006.
- Arrieta, J., M. Aguerrebere, G. Raviola, et al. 2017. “Validity and Utility of the Patient Health Questionnaire (PHQ)-2 and PHQ-9 for Screening and Diagnosis of Depression in Rural Chiapas, Mexico: A Cross-Sectional Study.” Journal of Clinical Psychology 73, no. 9: 1076–1090. https://doi.org/10.1002/jclp.22390.
- Asher, L., S. Zammit, S. Sullivan, S. Dorrington, J. Heron, and G. Lewis. 2013. “The Relationship Between Psychotic Symptoms and Social Functioning in a Non-Clinical Population of 12year Olds.” Schizophrenia Research 150, no. 2–3: 404–409. https://doi.org/10.1016/j.schres.2013.08.031.
- Barragan, M., K. R. Laurens, J. B. Navarro, and J. E. Obiols. 2011. “Psychotic-Like Experiences and Depressive Symptoms in a Community Sample of Adolescents.” European Psychiatry 26, no. 6: 396–401. https://doi.org/10.1016/j.eurpsy.2010.12.007.
- Bauer, A. M., Y. F. Chan, H. Huang, S. Vannoy, and J. Unutzer. 2013. “Characteristics, Management, and Depression Outcomes of Primary Care Patients Who Endorse Thoughts of Death or Suicide on the PHQ-9.” Journal of General Internal Medicine 28, no. 3: 363–369. https://doi.org/10.1007/s11606-012-2194-2.
- Chang, Q., Y. Shi, S. Yao, X. Ban, and Z. Cai. 2024. “Prevalence of Suicidal Ideation, Suicide Plans, and Suicide Attempts Among Children and Adolescents Under 18 Years of Age in Mainland China: A Systematic Review and Meta-Analysis.” Trauma, Violence & Abuse 25, no. 3: 2090–2102. https://doi.org/10.1177/15248380231205828.
- Freeman, D., and P. A. Garety. 2003. “Connecting Neurosis and Psychosis: The Direct Influence of Emotion on Delusions and Hallucinations.” Behaviour Research and Therapy 41, no. 8: 923–947. https://doi.org/10.1016/s0005-7967(02)00104-3.
- Freeman, D., B. Sheaves, G. M. Goodwin, et al. 2017. “The Effects of Improving Sleep on Mental Health (OASIS): A Randomised Controlled Trial With Mediation Analysis.” Lancet Psychiatry 4, no. 10: 749–758. https://doi.org/10.1016/S2215-0366(17)30328-0.
- Grattan, R. E., N. R. Karcher, A. M. Maguire, B. Hatch, D. M. Barch, and T. A. Niendam. 2021. “Psychotic Like Experiences Are Associated With Suicide Ideation and Behavior in 9 to 10 Year Old Children in the United States.” Research on Child and Adolescent Psychopathology 49, no. 2: 255–265. https://doi.org/10.1007/s10802-020-00721-9.
- Grossberg, A., and T. Rice. 2023. “Depression and Suicidal Behavior in Adolescents.” Medical Clinics of North America 107, no. 1: 169–182. https://doi.org/10.1016/j.mcna.2022.04.005.
- Hafeez, D., and A. R. Yung. 2021. “Early Persistence of Psychotic-Like Experiences in a Community Sample of Adolescents.” Early Intervention in Psychiatry 15, no. 6: 1575–1583. https://doi.org/10.1111/eip.13096.
- He, X., P. Yang, Q. Yu, and B. Yang. 2023. “Correlations Between Negative Life Events and Suicidal Ideation Among Chinese Adolescents: A Meta-Analysis.” Frontiers in Psychiatry 14: 1201786. https://doi.org/10.3389/fpsyt.2023.1201786.
- Healy, C., R. Brannigan, N. Dooley, et al. 2019. “Childhood and Adolescent Psychotic Experiences and Risk of Mental Disorder: A Systematic Review and Meta-Analysis.” Psychological Medicine 49, no. 10: 1589–1599. https://doi.org/10.1017/S0033291719000485.
- Hedegaard, H., S. C. Curtin, and M. Warner. 2021. “Suicide Mortality in the United States, 1999-2019.” NCHS Data Brief 398: 1–8.
- Hielscher, E., J. Devylder, P. Hasking, M. Connell, G. Martin, and J. G. Scott. 2021. “Can't Get You out of My Head: Persistence and Remission of Psychotic Experiences in Adolescents and Its Association With Self-Injury and Suicide Attempts.” Schizophrenia Research 229: 63–72. https://doi.org/10.1016/j.schres.2020.11.019.
- Hielscher, E., J. E. Devylder, S. Saha, M. Connell, and J. G. Scott. 2018. “Why Are Psychotic Experiences Associated With Self-Injurious Thoughts and Behaviours? A Systematic Review and Critical Appraisal of Potential Confounding and Mediating Factors.” Psychological Medicine 48, no. 9: 1410–1426. https://doi.org/10.1017/S0033291717002677.
- Honings, S., M. Drukker, R. Groen, and J. van Os. 2016. “Psychotic Experiences and Risk of Self-Injurious Behaviour in the General Population: A Systematic Review and Meta-Analysis.” Psychological Medicine 46, no. 2: 237–251. https://doi.org/10.1017/S0033291715001841.
- Isaksson, J., S. Vadlin, S. Olofsdotter, C. Aslund, and K. W. Nilsson. 2020. “Psychotic-Like Experiences During Early Adolescence Predict Symptoms of Depression, Anxiety, and Conduct Problems Three Years Later: A Community-Based Study.” Schizophrenia Research 215: 190–196. https://doi.org/10.1016/j.schres.2019.10.033.
- Jang, J. H., Y. J. Lee, S. J. Cho, I. H. Cho, N. Y. Shin, and S. J. Kim. 2014. “Psychotic-Like Experiences and Their Relationship to Suicidal Ideation in Adolescents.” Psychiatry Research 215, no. 3: 641–645. https://doi.org/10.1016/j.psychres.2013.12.046.
- Karcher, N. R., K. O'Hare, S. Y. Jay, and R. Grattan. 2023. “Strengthening Associations Between Psychotic Like Experiences and Suicidal Ideation and Behavior Across Middle Childhood and Early Adolescence.” Psychological Medicine 53, no. 13: 6002–6010. https://doi.org/10.1017/S0033291722003166.
- Kelleher, I., and M. Cannon. 2011. “Psychotic-Like Experiences in the General Population: Characterizing a High-Risk Group for Psychosis.” Psychological Medicine 41, no. 1: 1–6. https://doi.org/10.1017/S0033291710001005.
- Kelleher, I., D. Connor, M. C. Clarke, N. Devlin, M. Harley, and M. Cannon. 2012. “Prevalence of Psychotic Symptoms in Childhood and Adolescence: A Systematic Review and Meta-Analysis of Population-Based Studies.” Psychological Medicine 42, no. 9: 1857–1863. https://doi.org/10.1017/S0033291711002960.
- Kelleher, I., J. T. Wigman, M. Harley, et al. 2015. “Psychotic Experiences in the Population: Association With Functioning and Mental Distress.” Schizophrenia Research 165, no. 1: 9–14. https://doi.org/10.1016/j.schres.2015.03.020.
- Kindt, K. C., M. Kleinjan, J. M. Janssens, and R. H. Scholte. 2015. “Cross-Lagged Associations Between Adolescents' Depressive Symptoms and Negative Cognitive Style: The Role of Negative Life Events.” Journal of Youth and Adolescence 44, no. 11: 2141–2153. https://doi.org/10.1007/s10964-015-0308-y.
- Klonsky, E. D., B. Y. Saffer, and C. J. Bryan. 2018. “Ideation-To-Action Theories of Suicide: A Conceptual and Empirical Update.” Current Opinion in Psychology 22: 38–43. https://doi.org/10.1016/j.copsyc.2017.07.020.
- Koyanagi, A., B. Stubbs, E. Lara, et al. 2018. “Psychotic Experiences and Subjective Cognitive Complaints Among 224 842 People in 48 Low- and Middle-Income Countries.” Epidemiology and Psychiatric Sciences 29: e11. https://doi.org/10.1017/S2045796018000744.
- Kroenke, K., R. L. Spitzer, and J. B. Williams. 2003. “The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener.” Medical Care 41, no. 11: 1284–1292. https://doi.org/10.1097/01.MLR.0000093487.78664.3C.
- Lataster, T., M. Wichers, N. Jacobs, et al. 2009. “Does Reactivity to Stress Cosegregate With Subclinical Psychosis? A General Population Twin Study.” Acta Psychiatrica Scandinavica 119, no. 1: 45–53. https://doi.org/10.1111/j.1600-0447.2008.01263.x.
- Lau, J., D. L. Walden, A. Wu, K. M. Cheng, M. Lau, and P. Mo. 2018. “Bidirectional Predictions Between Internet Addiction and Probable Depression Among Chinese Adolescents.” Journal of Behavioral Addictions 7, no. 3: 633–643. https://doi.org/10.1556/2006.7.2018.87.
- Lee, J., Y. H. Ko, S. Chi, M. S. Lee, and H. K. Yoon. 2022. “Impact of the COVID-19 Pandemic on Korean Adolescents' Mental Health and Lifestyle Factors.” Journal of Adolescent Health 71, no. 3: 270–276. https://doi.org/10.1016/j.jadohealth.2022.05.020.
- Li, Y., Y. Li, and J. Cao. 2012. “Factors Associated With Suicidal Behaviors in Mainland China: A Meta-Analysis.” BMC Public Health 12: 524. https://doi.org/10.1186/1471-2458-12-524.
- Li, Y., L. Zhou, D. Wang, L. Jing, and M. Sun. 2023. “Potential Mechanisms Between Psychotic-Like Experiences and Suicidal Ideation in the Context of COVID-19: A Longitudinal Study.” Schizophrenia Research 255: 182–188. https://doi.org/10.1016/j.schres.2023.03.036.
- Lin, A., J. T. Wigman, B. Nelson, et al. 2011. “The Relationship Between Coping and Subclinical Psychotic Experiences in Adolescents From the General Population–A Longitudinal Study.” Psychological Medicine 41, no. 12: 2535–2546. https://doi.org/10.1017/S0033291711000560.
- Liu, X., L. Liu, J. Yang, et al. 1997. “Reliability and Validity of the Adolescents Self-Rating Life Events Checklist.” Chinese Journal of Clinical Psychology 1: 39–41.
- Luo, X., T. Yu, Z. Yang, and D. Wang. 2023. “Psychotic-Like Experiences and Suicidal Ideation Among Adolescents: The Chain Mediating Role of Insomnia Symptoms and Resilience.” Psychology Research and Behavior Management 16: 3519–3530. https://doi.org/10.2147/PRBM.S426363.
- Maijer, K., T. Staring, A. A. Bartels-Velthuis, S. J. Palmen, and I. E. Sommer. 2020. “Stronger Than Your Voices: A Cognitive Behavioral Therapy for Youth Suffering From Auditory Verbal Hallucinations.” Clinical Child Psychology and Psychiatry 25, no. 2: 386–400. https://doi.org/10.1177/1359104519888011.
- Monson, R. R. 1990. Occupational Epidemiology. 2nd ed. CRC Press.
- Murphy, J., M. Shevlin, L. Arseneault, et al. 2022. “Externalizing the Threat From Within: A New Direction for Researching Associations Between Suicide and Psychotic Experiences.” Development and Psychopathology 34, no. 3: 1034–1044. https://doi.org/10.1017/S0954579420001728.
- Murphy, J., M. Shevlin, P. Hyland, M. N. Christoffersen, A. Elklit, and R. Bentall. 2018. “Reconsidering the Association Between Psychosis and Suicide: A Suicidal Drive Hypothesis.” Psychosis 10: 286–297. https://doi.org/10.1080/17522.
- Myin-Germeys, I., and J. van Os. 2007. “Stress-Reactivity in Psychosis: Evidence for an Affective Pathway to Psychosis.” Clinical Psychology Review 27, no. 4: 409–424. https://doi.org/10.1016/j.cpr.2006.09.005.
- Rao, W. W., D. D. Xu, X. L. Cao, et al. 2019. “Prevalence of Depressive Symptoms in Children and Adolescents in China: A Meta-Analysis of Observational Studies.” Psychiatry Research 272: 790–796. https://doi.org/10.1016/j.psychres.2018.12.133.
- Ribeiro, J. D., X. Huang, K. R. Fox, and J. C. Franklin. 2018. “Depression and Hopelessness as Risk Factors for Suicide Ideation, Attempts and Death: Meta-Analysis of Longitudinal Studies.” British Journal of Psychiatry 212, no. 5: 279–286. https://doi.org/10.1192/bjp.2018.27.
- Shorey, S., E. D. Ng, and C. Wong. 2022. “Global Prevalence of Depression and Elevated Depressive Symptoms Among Adolescents: A Systematic Review and Meta-Analysis.” British Journal of Clinical Psychology 61, no. 2: 287–305. https://doi.org/10.1111/bjc.12333.
- Smith, B., D. G. Fowler, D. Freeman, et al. 2006. “Emotion and Psychosis: Links Between Depression, Self-Esteem, Negative Schematic Beliefs and Delusions and Hallucinations.” Schizophrenia Research 86, no. 1–3: 181–188. https://doi.org/10.1016/j.schres.2006.06.018.
- Stanyon, D., J. Devylder, S. Yamasaki, et al. 2023. “Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort.” Schizophrenia Bulletin 49, no. 2: 329–338. https://doi.org/10.1093/schbul/sbac155.
- Steare, T., M. C. Gutierrez, A. Sullivan, and G. Lewis. 2023. “The Association Between Academic Pressure and Adolescent Mental Health Problems: A Systematic Review.” Journal of Affective Disorders 339: 302–317. https://doi.org/10.1016/j.jad.2023.07.028.
- Tang, W., D. Xu, Y. Yang, and J. Xu. 2021. “Psychotic-Like Experiences in Chinese Children and Adolescents: The Effect of Earthquake Exposure, Maltreatment and Negative Life Events.” Early Intervention in Psychiatry 15, no. 3: 536–546. https://doi.org/10.1111/eip.12976.
- Tsai, F. J., Y. H. Huang, H. C. Liu, K. Y. Huang, Y. H. Huang, and S. I. Liu. 2014. “Patient Health Questionnaire for School-Based Depression Screening Among Chinese Adolescents.” Pediatrics 133, no. 2: e402–e409. https://doi.org/10.1542/peds.2013-0204.
- Uddin, R., N. W. Burton, M. Maple, S. R. Khan, and A. Khan. 2019. “Suicidal Ideation, Suicide Planning, and Suicide Attempts Among Adolescents in 59 Low-Income and Middle-Income Countries: A Population-Based Study.” Lancet Child & Adolescent Health 3, no. 4: 223–233. https://doi.org/10.1016/S2352-4642(18)30403-6.
- van Os, J., R. J. Linscott, I. Myin-Germeys, P. Delespaul, and L. Krabbendam. 2009. “A Systematic Review and Meta-Analysis of the Psychosis Continuum: Evidence for a Psychosis Proneness-Persistence-Impairment Model of Psychotic Disorder.” Psychological Medicine 39, no. 2: 179–195. https://doi.org/10.1017/S0033291708003814.
- Varghese, D., J. Scott, J. Welham, et al. 2011. “Psychotic-Like Experiences in Major Depression and Anxiety Disorders: A Population-Based Survey in Young Adults.” Schizophrenia Bulletin 37, no. 2: 389–393. https://doi.org/10.1093/schbul/sbp083.
- Wang, D., H. Chen, Z. Chen, et al. 2022. “Current Psychotic-Like Experiences Among Adolescents in China: Identifying Risk and Protective Factors.” Schizophrenia Research 244: 111–117. https://doi.org/10.1016/j.schres.2022.05.024.
- Wang, D., Y. Li, Y. Fan, et al. 2025. “Bidirectional Associations Between Short Sleep Duration, Insomnia Symptoms, and Psychotic-Like Experiences in Adolescents.” European Child & Adolescent Psychiatry 34, no. 1: 275–285. https://doi.org/10.1007/s00787-024-02490-y.
- Wang, D., Z. Ma, Y. Fan, H. Chen, M. Sun, and F. Fan. 2024. “Tobacco Smoking, Second-Hand Smoking Exposure in Relation to Psychotic-Like Experiences in Adolescents.” Early Intervention in Psychiatry 18, no. 2: 102–112. https://doi.org/10.1111/eip.13439.
- Wang, D., Z. Ma, A. Scherffius, et al. 2023. “Sleep Disturbance Is Predictive of Psychotic-Like Experiences Among Adolescents: A Two-Wave Longitudinal Survey.” Sleep Medicine 101: 296–304. https://doi.org/10.1016/j.sleep.2022.11.011.
- Wang, D., B. Ross, X. Zhou, et al. 2021. “Sleep Disturbance Predicts Suicidal Ideation During COVID-19 Pandemic: A Two-Wave Longitudinal Survey.” Journal of Psychiatric Research 143: 350–356. https://doi.org/10.1016/j.jpsychires.2021.09.038.
- Wang, D., M. Sun, X. Ouyang, and F. Fan. 2022. “Validity and Reliability of the Simplfied Version of Community Assessment of Psychic Experiences in College Students.” Chinese Mental Health Journal 36, no. 2: 172–178. https://doi.org/10.3969/j.issn.1000-6729.2002.02.014.
10.3969/j.issn.1000?6729.2002.02.014 Google Scholar
- Wang, D., M. Sun, C. Xi, et al. 2020. “Gender and Longitudinal Measurement Invariance of the Community Assessment of Psychic Experiences-Positive Subscale.” Chinese Journal of Clinical Psychology 28, no. 1: 41–45. https://doi.org/10.16128/j.cnki.1005-3611.2020.01.010.
10.16128/j.cnki.1005?3611.2020.01.010 Google Scholar
- World Health Organization. 2021. “Suicide Worldwide in 2019: Global Health Estimates.” https://iris.who.int/bitstream/handle/10665/326948/WHO-MSD-MER-19.3-eng.pdf.
- Wu, Z., Z. Liu, Z. Zou, et al. 2021. “Changes of Psychotic-Like Experiences and Their Association With Anxiety/Depression Among Young Adolescents Before COVID-19 and After the Lockdown in China.” Schizophrenia Research 237: 40–46. https://doi.org/10.1016/j.schres.2021.08.020.
- Xiao, M., B. Fu, S. Huang, Y. Hu, G. Tang, and J. Lei. 2023. “Trajectories of Perinatal Suicidal Ideation From Early Pregnancy to Six Weeks Postpartum and Their Influencing Factors: A Prospective Longitudinal Study.” Psychiatry Research 328: 115467. https://doi.org/10.1016/j.psychres.2023.115467.
- Yates, K., U. Lang, M. Cederlof, et al. 2019. “Association of Psychotic Experiences With Subsequent Risk of Suicidal Ideation, Suicide Attempts, and Suicide Deaths: A Systematic Review and Meta-Analysis of Longitudinal Population Studies.” JAMA Psychiatry 76, no. 2: 180–189. https://doi.org/10.1001/jamapsychiatry.2018.3514.
- Zhou, R., J. C. Foo, A. Nishida, S. Ogawa, F. Togo, and T. Sasaki. 2024. “Longitudinal Relationships of Psychotic-Like Experiences With Suicidal Ideation and Self-Harm in Adolescents.” European Child & Adolescent Psychiatry 33, no. 6: 1977–1985. https://doi.org/10.1007/s00787-023-02299-1.
