In a baseline study among 7–8 year old children with auditory vocal hallucinations (AVH), only limited functional impact of AVH was observed.

To assess AVH 5-year course and its predictors, as well as AVH 5-year incidence and its risk factors.

A sample of 337 12- and 13-year-old children were reassessed on AVH after a mean follow-up period of 5.1 years. Parents completed the Child Behaviour Checklist (CBCL). School performance was assessed.

The AVH 5-year persistence and incidence rates were 24% and 9% respectively, more new cases arising in urban areas. Both persistent and incident AVH were associated with problem behaviour in the (CBCL) clinical range, particularly at follow-up, as well as with other psychosis-like symptoms, particularly at baseline. AVH persistence was predicted by baseline AVH severity, notably in terms of external attribution of voices and hearing multiple voices, and was associated with worse primary school test scores and lower level secondary school.

First-onset AVH in middle childhood is neither rare nor neutral in terms of psychopathological and behavioural comorbidity. Persistence of AVH in early childhood similarly is not rare and associated with psychopathological, behavioural and cognitive alterations.