Surprisingly Many Teens Report Hallucinations and Delusions
Have you ever experienced hearing the voice of a grandmother or grandfather who has recently died, and perceived the voice as real?
Experiences like these are more common than you might think. As many as 10–17% report so-called psychosis-like experiences during their lifetime.
These experiences often occur during periods of high stress, strong emotions, substance use, or sleep deprivation. For most people the experiences resolve on their own. For others they can persist or grow in intensity and scope, eventually leading to mental illness..
In her doctoral thesis, Viktoria Birkenæs found that 30% of 22,000 Norwegian adolescents reported psychosis-like experiences. Although the vast majority did not develop a psychiatric disorder, those who reported these experiences had a higher risk of receiving a diagnosis of mental illness.
Findings from the project suggest that psychosis-like experiences can serve as early warnings of mental disorders, which may have important implications for early intervention and treatment.
Psychosis, which often appears as hallucinations and delusions, is a mental state that can progress from transient psychotic symptoms to serious disorders such as schizophrenia. Early detection of people at risk is crucial to prevent mild symptoms from developing into a chronic condition.
Project background
Psychotic disorders typically emerge during adolescence or early adulthood and can have serious consequences for the person affected as well as for family and friends. Early detection and treatment are essential for good quality of life and prognosis. Many people at risk of developing psychosis still do not receive the help they need. There is a great need for methods that can identify those at high risk of psychosis at an early stage.
How can we detect psychosis earlier?
For early detection of psychosis we need simple and effective strategies. Self-report questionnaires that measure psychosis-like experiences can serve as an easy and cost-effective psychosis screening tool. Before we implement such tools, however, we must ensure that the questionnaires are reliable. Various factors influence how people respond to such questionnaires. Major societal changes (for example the COVID-19 pandemic or increased mobile phone use) can change how people understand questions about unusual experiences. Thus, before we investigate whether questionnaires can be used for early detection of psychosis, we need to examine whether people’s responses are stable across different contexts.
Approach
The aim of the doctoral project was to investigate whether a self-report questionnaire on psychosis-like experiences was reliable and could be used to predict development of psychosis in over 20,000 adolescents from the Norwegian Mother, Father and Child Cohort Study (MoBa), led by the Norwegian Institute of Public Health. The MoBa study includes a large cross-section of Norway’s population and gives us the opportunity to study the development of psychosis in the population.
Results
A surprisingly large proportion of the teenagers reported psychosis-like symptoms (26.3%), particularly compared with men from the parental generation (2.3%). This may indicate generational differences in how young people and adults interpret the questions, or in how they report their own experiences. It is important to note that today’s adolescents may be more open about their mental health challenges than the parental generation.
The fact that Norwegian youth spend a large portion of their time on digital media may also affect how they experience and report mental health symptoms, without necessarily meaning that young people actually struggle more today than in the past.
In large surveys like this, one must therefore consider how adolescents understand the questions before drawing conclusions about what the reporting means.
Why is this important?
Psychotic disorders are highly stigmatized. Adolescents’ psychotic experiences can indicate a higher risk of developing a psychotic disorder later in life. Still, the vast majority of young people who report these experiences will not develop mental health problems. This suggests that psychotic experiences can occur on a spectrum: some will have distressing experiences that affect daily functioning, while others may have brief, transient experiences that do not trouble them.
This knowledge can contribute to efforts to reduce stigma around psychosis and also to identifying who is at risk of developing more serious problems.
Conclusion
The findings from this doctoral thesis indicate that psychosis-like experiences in youth may increase the risk for a range of psychiatric conditions, especially psychosis. This can help identify young people who need more extensive clinical assessment and follow-up at an earlier stage.The researchers also hope their research can help reduce the stigma surrounding psychosis.
Further research is needed to validate the findings, but this is an exciting opportunity to improve early detection of psychosis, says Victoria Birkenæs.
Links:
Read the research article:
Youth psychotic experiences: psychometric evaluation and diagnostic associations of the CAPE-16 in adolescents from the Norwegian Mother, Mather and Child Cohort.
Birkenæs V, Parekh P, Hegemann L, Bakken NR, Frei E, Jaholkowski P, Smeland OB, Susser E, Rodriguez KM, Tesfaye M, Andreassen OA, Havdahl A, Sønderby IE.
J Child Psychol Psychiatry. 2025 Aug 4. doi: 10.1111/jcpp.70007.
PMID: 40759589
News articles about the findings in Norwegian, from major news outlets:
forskning.no: Overraskende mange ungdommer har hallusinasjoner og vrangforestillinger
UiO: Overraskende mange ungdommer har hallusinasjoner og vrangforestillinger - Forskningsnytt
NRK P3: https://radio.nrk.no/serie/poensj/sesong/202511/MYNN16016825