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

Kate M Scott, Sukanta Saha, Carmen C W Lim, Sergio Aguilar-Gaxiola, Ali Al-Hamzawi, Jordi Alonso, Corina Benjet, Evelyn J Bromet, Ronny Bruffaerts, José Miguel Caldas-de-Almeida, Giovanni de Girolamo, Peter de Jonge, Louisa Degenhardt, Silvia Florescu, Oye Gureje, Josep M Haro, Chiyi Hu, Elie G Karam, Viviane Kovess-Masfety, Sing LeeJean-Pierre Lepine, Zeina Mneimneh, Fernando Navarro-Mateu, Marina Piazza, José Posada-Villa, Nancy A Sampson, Juan Carlos Stagnaro, Ronald C Kessler, John J McGrath

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)2730-2739
Number of pages10
JournalPsychological Medicine
Volume48
Issue number16
DOIs
Publication statusPublished - Dec 2018

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Health Surveys
Mental Disorders
Mental Health
Chronic Pain
Confidence Intervals
Diagnostic and Statistical Manual of Mental Disorders
Headache
Odds Ratio
Social Adjustment
Neck Pain
Pressure Ulcer
Back Pain
Survival Analysis
Peptic Ulcer
Arthritis
Heart Diseases
Asthma
Surveys and Questionnaires
Global Health
Prospective Studies

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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; McGrath, John J.

In: Psychological Medicine, Vol. 48, No. 16, 12.2018, p. 2730-2739.

Research output: Contribution to journalArticle

Scott, KM, Saha, S, Lim, CCW, Aguilar-Gaxiola, S, Al-Hamzawi, A, Alonso, J, Benjet, C, Bromet, EJ, Bruffaerts, R, Caldas-de-Almeida, JM, de Girolamo, G, de Jonge, P, Degenhardt, L, Florescu, S, Gureje, O, Haro, JM, Hu, C, Karam, EG, Kovess-Masfety, V, Lee, S, Lepine, J-P, Mneimneh, Z, Navarro-Mateu, F, Piazza, M, Posada-Villa, J, Sampson, NA, Stagnaro, JC, Kessler, RC & McGrath, JJ 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, vol. 48, no. 16, pp. 2730-2739. https://doi.org/10.1017/S0033291718000363
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. / 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. In: Psychological Medicine. 2018 ; Vol. 48, No. 16. pp. 2730-2739.
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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.",
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T1 - Psychotic experiences and general medical conditions

T2 - a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys

AU - Scott, Kate M

AU - Saha, Sukanta

AU - Lim, Carmen C W

AU - Aguilar-Gaxiola, Sergio

AU - Al-Hamzawi, Ali

AU - Alonso, Jordi

AU - Benjet, Corina

AU - Bromet, Evelyn J

AU - Bruffaerts, Ronny

AU - Caldas-de-Almeida, José Miguel

AU - de Girolamo, Giovanni

AU - de Jonge, Peter

AU - Degenhardt, Louisa

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Haro, Josep M

AU - Hu, Chiyi

AU - Karam, Elie G

AU - Kovess-Masfety, Viviane

AU - Lee, Sing

AU - Lepine, Jean-Pierre

AU - Mneimneh, Zeina

AU - Navarro-Mateu, Fernando

AU - Piazza, Marina

AU - Posada-Villa, José

AU - Sampson, Nancy A

AU - Stagnaro, Juan Carlos

AU - Kessler, Ronald C

AU - McGrath, John J

PY - 2018/12

Y1 - 2018/12

N2 - 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.

AB - 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.

U2 - 10.1017/S0033291718000363

DO - 10.1017/S0033291718000363

M3 - Article

C2 - 29478433

VL - 48

SP - 2730

EP - 2739

JO - Psychological Medicine

JF - Psychological Medicine

SN - 0033-2917

IS - 16

ER -