Les hallucinations acoustico-verbales (HAV) représentent une prévalence de 12 % en population pédiatrique générale et sont considérées comme un phénomène développemental transitoire et bénin. La persistance des HAV représenterait un mauvais pronostic d’évolution vers un trouble psychotique. L’altération des marqueurs de cognition sociale et émotionnels sont décrits comme prodromiques de cette évolution. L’objectif de cette étude était d’évaluer ces marqueurs chez l’enfant et l’adolescent présentant des HAV.

Cette étude multicentrique prospective et longitudinale incluait des sujets de 8 à 16 ans issus d’une population pédiatrique clinique. Les patients étaient répartis en deux groupes avec et sans HAV et étaient appariés selon le sexe, l’âge et les diagnostics psychiatriques associés (MINI-Kid). Un diagnostic de trouble du spectre de la schizophrénie (K-SADS-PL) était un critère de non-inclusion. La NEPSY II évaluait la cognition sociale. Le marqueur émotionnel était évalué avec l’Échelle des Émotions Différentielles et BAVQ-R, catégorisant les émotions réactionnelles aux HAV.

Il n’a pas été retrouvé de lien significatif entre les marqueurs de cognition sociale et émotionnels et la présence des HAV à l’inclusion. À 6 mois, 50 % des sujets HAV+ présentaient des HAV persistantes et 18 % évoluaient vers un trouble du spectre de la schizophrénie. La persistance des HAV était significativement corrélée à la présence de tristesse, peur, d’hostilité envers soi et de colère et inversement corrélée à la joie.

Les HAV en population pédiatrique ne sont pas liées au marqueur de cognition sociale mais les émotions négatives apparaissent comme marqueur de persistance des HAV.

NCT02567500.

Auditory-verbal hallucinatory experiences (AVH) represent a prevalence of 12% in the general pediatric population. They are most often considered as a transient and benign developmental phenomenon, associated with mood and anxiety disorders. The persistence of AVHs for several years and into adolescence would represent a poor prognosis of progression into a psychiatric disorder, and more particularly psychotic disorder. The alteration of social and emotional cognitive markers are described as prodromal of this unfavorable progression which should be considered within the continuum between subclinical and clinical signs of the “psychosis phenotype”. The objective of this study was to assess these markers in children and adolescents with AVH and their correlation with the presence and persistence of hallucinations.

Multicenter prospective case-control study, longitudinal over 6months. Patients were included based on the presence of HAV on clinical examination. Forty subjects aged 8 to 16years from a clinical pediatric population were included. They were divided into two groups according to the Diagnostic Interview Schedule for Children-Child version (DISC-C): a group with AVH (“AVH+”), and a group without HAV (“AVH−”). A diagnosis of schizophrenia spectrum disorder was a non-inclusion criterion according to the criteria of DSM-5 (K-SADS-PL). This group was matched to the control group without AVH (AVH−) according to sex, age (±6months) and associated psychiatric diagnoses assessed by the MINI-Kid. The marker of social cognition was assessed with the NEPSY II test. The emotional marker was assessed with the self-questionnaires: EED IV, which highlights the emotions currently being felt by the subject, and the BAVQ-R, which categorizes the child's emotions in reaction to AVH.

No significant link was found between the social and emotional cognition markers and the presence of AVH at T0. At 6months, 50% of subjects in the AVH+ group suffered from persistent AVH and 18% progressed to a diagnosis of schizophrenia spectrum disorder. The persistence of AVH was not significantly correlated with the marker of social cognition, but it was significantly correlated with the presence of negative emotions (sadness, fear, hostility and anger) and inversely correlated with emotions of joy.

In this study, AVH experiences in the pediatric population are not linked to markers of social cognition, but negative emotions appear as early markers of AVH persistence.

NCT02567500.