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A Dimensional Approach to Assessing Psychiatric Risk in Adults Born Very Preterm

Background Individuals who were born very preterm have higher rates of psychiatric diagnoses compared to term-born controls; however, it remains unclear whether they also display increased sub-clinical psychiatric symptomatology. Hence our objective is to utilise a dimensional approach to assess psychiatric symptomatology in adults who were born very preterm. Methods 152 adults who were born very preterm (before 33 weeks’ gestation; gestational range 24–32 weeks) and 96 term-born controls. We examined participants’ clinical profile using the Comprehensive Assessment of At-Risk Mental States (CAARMS), a measure of sub-clinical symptomatology that yields seven subscales including general psychopathology, positive, negative, cognitive, behavioural, motor and emotional symptoms, in addition to a total psychopathology score. Intellectual abilities were examined using the Wechsler Abbreviated Scale of Intelligence. Results Between-group differences on the CAARMS showed elevated symptomatology in very preterm participants compared to controls in positive, negative, cognitive and behavioural symptoms. Total psychopathology scores were significantly correlated with IQ in the very preterm group only. In order to examine the characteristics of participants’ clinical profile a principal component analysis was conducted. This revealed two components, one reflecting a non-specific psychopathology dimension, and the other indicating a variance in symptomatology along a positive-to-negative symptom axis. K-means (k=4) were used to further separate the study sample into clusters. Very preterm adults were more likely to belong to the high non-specific psychopathology cluster compared to controls. Conclusion and Relevance Very preterm individuals demonstrated elevated psychopathology compared to full-term controls. Psychiatric risk was characterised by a non-specific clinical profile and was associated with lower IQ.