Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys

Scott, Kate M., Saha, Sukanta, Lim, Carmen C. W., Aguilar-Gaxiola, Sergio, Al-Hamzawi, Ali, Alonso, Jordi, Benjet, Corina, Bromet, Evelyn J., Bruffaerts, Ronny, Caldas-de-Almeida, José Miguel, de Girolamo, Giovanni, de Jonge, Peter, Degenhardt, Louisa, Florescu, Silvia, Gureje, Oye, Haro, Josep M., Hu, Chiyi, Karam, Elie G., Kovess-Masfety, Viviane, Lee, Sing, Lepine, Jean-Pierre, Mneimneh, Zeina, Navarro-Mateu, Fernando, Piazza, Marina, Posada-Villa, José, Sampson, Nancy A., Stagnaro, Juan Carlos, Kessler, Ronald C. and McGrath, John J. (2018) Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys. Psychological Medicine, 1-10. doi:10.1017/S0033291718000363


Author Scott, Kate M.
Saha, Sukanta
Lim, Carmen C. W.
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Benjet, Corina
Bromet, Evelyn J.
Bruffaerts, Ronny
Caldas-de-Almeida, José Miguel
de Girolamo, Giovanni
de Jonge, Peter
Degenhardt, Louisa
Florescu, Silvia
Gureje, Oye
Haro, Josep M.
Hu, Chiyi
Karam, Elie G.
Kovess-Masfety, Viviane
Lee, Sing
Lepine, Jean-Pierre
Mneimneh, Zeina
Navarro-Mateu, Fernando
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A.
Stagnaro, Juan Carlos
Kessler, Ronald C.
McGrath, John J.
Title Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys
Journal name Psychological Medicine   Check publisher's open access policy
ISSN 1469-8978
0033-2917
Publication date 2018-02-26
Sub-type Article (original research)
DOI 10.1017/S0033291718000363
Open Access Status Not yet assessed
Start page 1
End page 10
Total pages 10
Place of publication Cambridge, United Kingdom
Publisher Cambridge University Press
Language eng
Subject 3202 Applied Psychology
2738 Psychiatry and Mental health
Abstract Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders.

In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments.

After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1-1.5] to 1.9 (95% CI 1.4-2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2-1.9) to 1.7 (95% CI 1.2-2.4).

PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.
Formatted abstract
Background: Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders.

Methods: In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments.

Results: After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1–1.5] to 1.9 (95% CI 1.4–2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2–1.9) to 1.7 (95% CI 1.2–2.4).

Conclusions: PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.
Keyword Arthritis
Asthma
Diabetes
General medical conditions
Headache
Heart disease
Mental disorders
Pain
Physical disorders
Psychotic experiences
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID R01 DA016558
R03 TW006481
R01 MH069864
U01 MH060220
R01 MH070884
R13 MH066849
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
Queensland Brain Institute Publications
 
Versions
Version Filter Type
Citation counts: Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Wed, 28 Feb 2018, 11:02:00 EST