Unraveling the Bidirectional Associations of Psychotic‐Like Experiences With Depressive Symptoms and Suicidal Ideation Among Adolescents

Jun 26, 2025Suicide & life-threatening behavior

Two-Way Links Between Psychotic-Like Experiences, Depression, and Suicidal Thoughts in Adolescents

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

In a survey of 17,722 adolescents, psychotic-like experiences (PLEs) at baseline were significantly associated with increased odds of depressive symptoms and suicidal ideation at follow-ups.

Adolescents reporting PLEs showed higher chances of experiencing depressive symptoms and suicidal thoughts later.
Baseline depressive symptoms and suicidal ideation were linked to a greater likelihood of subsequent PLEs.
All associations were statistically significant with p-values less than 0.001.
The findings suggest a bidirectional relationship between PLEs, depressive symptoms, and suicidal ideation.

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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.

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Unraveling the Bidirectional Associations of Psychotic‐Like Experiences With Depressive Symptoms and Suicidal Ideation Among Adolescents

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