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Psychol Med. 2018 Dec;48(16):2730-2739. doi: 10.1017/S0033291718000363. Epub 2018 Feb 26.

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.

Author information

1
Department of Psychological Medicine,University of Otago,Dunedin,New Zealand.
2
Queensland Centre for Mental Health Research and Queensland Brain Institute, The University of Queensland,St. Lucia, Queensland,Australia.
3
Center for Reducing Health Disparities,UC Davis Health System, Sacramento, California,USA.
4
College of Medicine, Al-Qadisiya University,Diwaniya Governorate,Iraq.
5
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain.
6
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
7
Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook, New York,USA.
8
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg, Leuven,Belgium.
9
Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School Faculdade de Ciências Médicas, Universidade Nova de Lisboa,Lisbon,Portugal.
10
Unit of Epidemiological and Evaluation Psychiatry,Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS)-St. John of God Clinical Research Centre,Via Pilastroni 4, Brescia,Italy.
11
Developmental Psychology, Department of Psychology,Rijksuniversiteit Groningen,Groningen,The Netherlands.
12
National Drug and Alcohol Research Centre, University of New South Wales,Sydney,Australia.
13
Management and Development,National School of Public Health,Bucharest,Romania.
14
Department of Psychiatry,University College Hospital,Ibadan,Nigeria.
15
Parc Sanitari Sant Joan de Déu,CIBERSAM, Universitat de Barcelona,Sant Boi de Llobregat, Barcelona,Spain.
16
Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China.
17
Department of Psychiatry and Clinical Psychology,Faculty of Medicine, Balamand University,Beirut,Lebanon.
18
Ecole des Hautes Etudes en Santé Publique (EHESP), Paris Descartes University,Paris, EA 4057,France.
19
Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
20
Hôpital Lariboisière- Fernand Widal, Assistance Publique Hôpitaux de Paris, Universités Paris Descartes-Paris Diderot, INSERM UMR-S 1144,Paris,France.
21
Survey Research Center, Institute for Social Research, University of Michigan,Ann Arbor, Michigan,USA.
22
UDIF-SM, Subdirección General de Planificación,Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia,Murcia,Spain.
23
Universidad Cayetano Heredia,Lima,Peru.
24
Colegio Mayor de Cundinamarca University,Faculty of Social Sciences,Bogota,Colombia.
25
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
26
Departamento de Psiquiatría y Salud Mental,Facultad de Medicina,Universidad de Buenos Aires,Argentina.

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.

KEYWORDS:

Arthritis; asthma; diabetes; general medical conditions; headache; heart disease; mental disorders; pain; physical disorders; psychotic experiences

PMID:
29478433
PMCID:
PMC6109618
[Available on 2019-06-01]
DOI:
10.1017/S0033291718000363

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