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Epidemiol Psychiatr Sci. 2018 Dec 26:1-11. doi: 10.1017/S2045796018000744. [Epub ahead of print]

Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries.

Author information

Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain.
Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK.
Instituto de Salud Carlos III,Centro de Investigación Biomédica en Red de Salud Mental,CIBERSAM,Madrid,Spain.
National Research Council,Neuroscience Institute,Aging Branch,Padova,Italy.
Department of Rehabilitation Sciences,KU Leuven,Leuven,Belgium.
The Cambridge Centre for Sport and Exercise Sciences,Department of Life Sciences,Anglia Ruskin University,Cambridge,UK.
University of Southern California,Suzanne Dworak-Peck School of Social Work,Los Angeles, CA,USA.
Graduate School of Social Service,Fordham University,New York, NY,USA.


AimsCognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries.


Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed.


The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16-1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18-44 years OR = 1.19 (95% CI 1.17-1.20); 45-64 years OR = 1.15 (95% CI 1.12-1.17); ⩾65 years OR = 1.14 (95% CI 1.09-1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%).


SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.


Cognition; epidemiology; low- and middle-income countries; psychotic experiences


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