Background

There has been a wealth of research on psychotic experiences (PEs) in children and adolescents, highlighting their prevalence and clinical characteristics. However, the prevalence of PEs has not been systematically evaluated in youth mental health services. We aimed to conduct a systematic review and meta-analysis of the prevalence of PEs in child and adolescent mental health services.

Study design

Five electronic databases were searched from inception to March 2024 for literature relevant to childhood or adolescent PEs and mental health service use. Data on the prevalence of PEs from all relevant papers was extracted. The literature search, data extraction, and quality review were conducted independently by two reviewers. A random effects model was used to calculate a meta-analytic estimate of PE prevalence across studies and results were stratified by associated distress and PE measurement. We produced a narrative summary of research on clinical outcomes associated with the presence of PEs.

Study results

Eighteen studies were identified, involving 6126 individuals in total. The pooled prevalence of PEs in mental health services was 54% (95% CI: 39%-68%). The prevalence of PEs with associated distress was 45% (95% CI: 30%-60%). The prevalence of PEs based on interview studies was 36% (95% CI: 26%-46%).

Conclusions

PEs are very common in children and adolescents presenting to mental health services. Future research should evaluate for specific PE features that predict clinical and functional outcomes, as well as research to investigate how PEs may act as a marker of response to treatment within clinical services.