Psychotic features in adolescent mood disorders: clinical severity, neurodevelopmental vulnerabilities, and short-term naturalistic outcomes
9 affiliations
- 1Referent Center for Rare Diseases PSYRARE, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière University Hospital, Assistance Publique-Hôpitaux de Paris- Sorbonne University, Paris, France
- 2UMR-S1136 Sorbonne Public Health Institute, Social Epidemiology, Mental Health and Addictions (ESSMA) Team, INSERM/Sorbonne University, Paris, France
- 3CNRS UMR 7222, Institute for Intelligent Systems and Robotics, Sorbonne University, Paris, France
- 4Department of Child and Adolescent Psychopathology, Amiens University Hospital, Amiens, France
- 5INSERM Unit U1105 Research Group for Analysis of the Multimodal Cerebral Function, University of Picardy Jules Verne, Amiens, France
- 6Department of Psychology, Université du Québec à Montréal, Montréal, Québec Canada
- 7Centre for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, Québec Canada
- 8Laboratory of Childhood Genetic Diseases, INSERM/Sorbonne University UMR933, Trousseau Hospital, Paris, France
- 9Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, AP-HP.Sorbonne Université, 83 boulevard de l’Hôpital, Paris, 75013 France
Abstract
Background: In adolescents with mood disorders, psychotic features are linked to greater clinical severity, functional impairment, and a higher risk of misdiagnosis. This study aimed to better characterize factors associated with psychotic features in pediatric mood disorders based on a secondary analysis of data pooled from three cross-sectional studies.
Methods: Among 305 youths with mood disorders referred for specialized care (mean age 14.38 years; 57% female; 9% bipolar disorders, 91% depressive disorders), 41 presented psychotic features. A 72-item grid was used to collect main socio-demographic and clinical characteristics, in addition to the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children PL (KSADS-PL), the Clinical Global Impression Scale Severity and Improvement scales (CGI-S, CGI-I), and the Children’s Global Assessment Scale (CGAS).
Results: Patients with mood disorders and psychotic features had higher illness severity (+ 0.94 points on the CGI-S) and lower functioning (-11 points on the CGAS). Among psychosocial adversity factors, only parent-child conflicts were associated with psychotic features in the sample (Odds Ratio, OR = 2.36, 95% CI [1.21, 4.62]). Youths with mood disorders and psychotic features also had higher rates of communication disorders OR = 4.25, 95% CI [1.74, 10.42] and intellectual developmental disorder OR = 5.83, 95% CI [1.69, 20.10].
Conclusions: The findings should be interpreted with caution in light of several limitations of the study, in particular, heterogeneity in clinical practice across sites and time periods, underrepresentation of bipolar disorders, the small sample size, and the cross-sectional design. These findings suggest that among youths with mood disorders, a substantial burden of developmental difficulties is likely to be reported in those with psychotic features.
Clinical trial number: Not applicable.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12888-026-08496-x.
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BibTeX
@article{noschese2026psychotic,
title = {{Psychotic features in adolescent mood disorders: clinical severity, neurodevelopmental vulnerabilities, and short-term naturalistic outcomes}},
author = {Ilaria Noschese and Cyril Hanin and Angèle Consoli and Marie-Laure Paillere and David Cohen and Jean-Marc Guile and Réal Labelle and Claudine Laurent-Levinson and Xavier Benarous},
journal = {BMC Psychiatry},
year = {2026},
month = aug,
doi = {10.1186/s12888-026-08496-x},
url = {https://doi.org/10.1186/s12888-026-08496-x},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Psychotic features in adolescent mood disorders: clinical severity, neurodevelopmental vulnerabilities, and short-term naturalistic outcomes
AU - Ilaria Noschese
AU - Cyril Hanin
AU - Angèle Consoli
AU - Marie-Laure Paillere
AU - David Cohen
AU - Jean-Marc Guile
AU - Réal Labelle
AU - Claudine Laurent-Levinson
AU - Xavier Benarous
PY - 2026
DA - 2026/08/10
JO - BMC Psychiatry
DO - 10.1186/s12888-026-08496-x
UR - https://doi.org/10.1186/s12888-026-08496-x
AB - Background: In adolescents with mood disorders, psychotic features are linked to greater clinical severity, functional impairment, and a higher risk of misdiagnosis. This study aimed to better characterize factors associated with psychotic features in pediatric mood disorders based on a secondary analysis of data pooled from three cross-sectional studies. Methods: Among 305 youths with mood disorders referred for specialized care (mean age 14.38 years; 57% female; 9% bipolar disorders, 91% depressive disorders), 41 presented psychotic features. A 72-item grid was used to collect main socio-demographic and clinical characteristics, in addition to the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children PL (KSADS-PL), the Clinical Global Impression Scale Severity and Improvement scales (CGI-S, CGI-I), and the Children’s Global Assessment Scale (CGAS). Results: Patients with mood disorders and psychotic features had higher illness severity (+ 0.94 points on the CGI-S) and lower functioning (-11 points on the CGAS). Among psychosocial adversity factors, only parent-child conflicts were associated with psychotic features in the sample (Odds Ratio, OR = 2.36, 95% CI [1.21, 4.62]). Youths with mood disorders and psychotic features also had higher rates of communication disorders OR = 4.25, 95% CI [1.74, 10.42] and intellectual developmental disorder OR = 5.83, 95% CI [1.69, 20.10]. Conclusions: The findings should be interpreted with caution in light of several limitations of the study, in particular, heterogeneity in clinical practice across sites and time periods, underrepresentation of bipolar disorders, the small sample size, and the cross-sectional design. These findings suggest that among youths with mood disorders, a substantial burden of developmental difficulties is likely to be reported in those with psychotic features. Clinical trial number: Not applicable. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12888-026-08496-x.
SN - 1471-244X
ER -