Psychosis and Hearing Impairment: a Link in Adolescence

Much of modern medical, psychiatric literature is in agreement that highest rates of psychotic behavior occur in adolescents and young adults. Yet, a particular subset of this literature provides evidence for a link between adolescent hearing impairment and increased risk for psychosis. A recent study published in Psychological Medicine explored the possibility of adolescent development of psychosis as an outcome of hearing impairment. The van der Werf et al. research team documented a ten-year long longitudinal study of 3,021 adolescents aged 14-24 years old. The group hypothesized that individuals exposed to hearing impairment in adolescence would be at highest risk of developing psychotic symptoms during their progression into adulthood. They launched the cohort study outlined above and assessed psychosis expression at multiple time points over the duration of 10 years, using a diagnostic interview administered by a team of professional clinical psychologists. These interviews provide a means of measuring psychosis expression by assessing symptoms, syndromes, and diagnoses of various mental disorders; furthermore, the interviews allow for self-reported symptoms throughout the 10 years of the study.

This study yielded the finding that hearing impairment was in fact associated with psychotic symptoms, with an odds ratio of 2.04 (a 2:1 chance of expressing psychotic symptoms as an adolescent with hearing impairment). Furthermore, subjects between ages 14 and 17 exhibited even higher levels of psychosis expression, with self-reported experiences like delusional thinking and hallucinations. This finding suggests that perhaps the social and personal vulnerabilities that accompany adolescent hearing loss disrupt a critical phase in development, causing the observed increased in psychotic symptoms throughout adulthood development.
Although I find the implications of this article fascinating, I do wish that van der Werf et al. had further delved into which specific social interactions and events throughout these individuals adolescence had made those patients with adolescent hearing loss more prone to psychosis. After having read the previous article I posted in my blog, it is clear to me that that is an undeniable connection with behavioral/neural plasticity in response to social events, and I believe that much of this is in play when considering individuals whose adolescent developments have been so altered by hearing impairment at such a young age.