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Hall LM, Moussa-Tooks AB, Sheffield JM. Associations between social engagement, internalizing symptoms, and delusional ideation in the general population. Soc Psychiatry Psychiatr Epidemiol 2024; 59:989-1002. [PMID: 37624462 DOI: 10.1007/s00127-023-02540-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically. METHODS Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate. RESULTS Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = - 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = - 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = - 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement. CONCLUSIONS These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.
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Affiliation(s)
- Lauren M Hall
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA.
| | - Alexandra B Moussa-Tooks
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
| | - Julia M Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA
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Herms EN, Bolbecker AR, Wisner KM. Impaired Sleep Mediates the Relationship Between Interpersonal Trauma and Subtypes of Delusional Ideation. Schizophr Bull 2024; 50:642-652. [PMID: 37315337 PMCID: PMC11059790 DOI: 10.1093/schbul/sbad081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND HYPOTHESIS Trauma is a robust risk factor for delusional ideation. However, the specificity and processes underlying this relationship are unclear. Qualitatively, interpersonal traumas (i.e., trauma caused by another person) appear to have a specific relationship with delusional ideation, particularly paranoia, given the commonality of social threat. However, this has not been empirically tested and the processes by which interpersonal trauma contributes to delusional ideation remain poorly understood. Given the role of impaired sleep in both trauma and delusional ideation, it may be a critical mediator between these variables. We hypothesized that interpersonal trauma, but not non-interpersonal trauma, would be positively related to subtypes of delusional ideation, especially paranoia, and that impaired sleep would mediate these relationships. STUDY DESIGN In a large, transdiagnostic community sample (N = 478), an exploratory factor analysis of the Peter's Delusion Inventory identified three subtypes of delusional ideation, namely magical thinking, grandiosity, and paranoia. Three path models, one for each subtype of delusional ideation, tested whether interpersonal trauma and non-interpersonal trauma were related to subtypes of delusional ideation, and impaired sleep as a mediating variable of interpersonal trauma. STUDY RESULTS Paranoia and grandiosity were positively related to interpersonal trauma and unrelated to non-interpersonal trauma. Furthermore, these relationships were significantly mediated by impaired sleep, which appeared strongest for paranoia. In contrast, magical thinking was unrelated to traumatic experiences. CONCLUSIONS These findings support a specific relationship between interpersonal trauma and paranoia as well as grandiosity, with impaired sleep appearing as an important process by which interpersonal trauma contributes to both.
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Affiliation(s)
- Emma N Herms
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Amanda R Bolbecker
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Krista M Wisner
- Department of Psychological & Brain Sciences, Indiana University, Bloomington, IN, USA
- Program of Neuroscience, Indiana University, Bloomington, IN, USA
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Bartoli F, Bachi B, Callovini T, Palpella D, Piacenti S, Morreale M, Di Lella ME, Crocamo C, Carrà G. Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates. CNS Spectr 2024; 29:49-53. [PMID: 37489522 DOI: 10.1017/s1092852923002377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE Most people with major depressive episodes meet the criteria for the anxious distress (AD) specifier defined by DSM-5 as the presence of symptoms such as feelings of tension, restlessness, difficulty concentrating, and fear that something awful may happen. This cross-sectional study was aimed at identifying clinical correlates of AD in people with unipolar or bipolar depression. METHODS Inpatients with a current major depressive episode were included. Data on socio-demographic and clinical variables were collected. The SCID-5 was used to diagnose depressive episodes and relevant specifiers. The Montgomery-Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to assess the severity of depressive and manic (mixed) symptoms, respectively. Multiple logistic regression analyses were carried out to identify clinical correlates of AD. RESULTS We included 206 people (mean age: 48.4 ± 18.6 yrs.; males: 38.8%) admitted for a major depressive episode (155 with major depressive disorder and 51 with bipolar disorder). Around two-thirds of the sample (N = 137; 66.5%) had AD. Multiple logistic regression models showed that AD was associated with mixed features, higher YMRS scores, psychotic features, and a diagnosis of major depressive disorder (p < 0.05). CONCLUSION Despite some limitations, including the cross-sectional design and the inpatient setting, our study shows that AD is likely to be associated with mixed and psychotic features, as well as with unipolar depression. The identification of these clinical domains may help clinicians to better contextualize AD in the context of major depressive episodes.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Bianca Bachi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Tommaso Callovini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Dario Palpella
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Susanna Piacenti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Morreale
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Division of Psychiatry, University College London, London, UK
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Antosz-Rekucka R, Prochwicz K. Depression and anxiety mediate the relationship between the retrospectively measured symptoms of premenstrual disorders and negative but not positive psychotic-like experiences. Sci Rep 2023; 13:17711. [PMID: 37853110 PMCID: PMC10584974 DOI: 10.1038/s41598-023-44573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023] Open
Abstract
The aim of this study was to examine the relationship between retrospectively measured premenstrual symptoms and subclinical forms of positive and negative psychotic symptoms (psychotic-like experiences; PLEs). It was hypothesised that subjective intensity of the symptoms of premenstrual disorders predicts PLEs frequency and that this relationship is mediated by anxiety and depression. The study sample comprised 108 non-clinical subjects. Study variables were assessed with self-report questionnaires: the Premenstrual Symptoms Screening Tool (PSST); the Beck Depression Inventory Second Edition (BDI-II); the State-Trait Anxiety Inventory (STAI; trait sub-scale); the Community Assessment of Psychic Experiences (CAPE). Regression and mediation analyses were performed. The PSST scores were significantly and positively associated with psychotic-like experiences frequency. The relation was stronger for positive PLEs. Anxiety and depression partially mediated the relationship between premenstrual symptoms and negative PLEs, but not between premenstrual symptoms and positive PLEs. Although the design of the study does not allow to infer causality, it demonstrates strong, positive relationship between the symptoms of premenstrual disorders and psychotic-like experiences. The relationship between premenstrual disorders and negative PLEs seems to be partially based on a general psychopathological factor. Further longitudinal studies are needed to test whether premenstrual disturbances increase risk of psychotic symptoms.
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Affiliation(s)
- Rachela Antosz-Rekucka
- Doctoral School in the Social Sciences, Jagiellonian University, Kraków, Poland.
- Institute of Psychology, Jagiellonian University, Kraków, Poland.
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Monshouwer K, Ten Have M, Tuithof M, van Dorsselaer S, Bak M, Gunter N, Delespaul P, van Os J, de Graaf R. Prevalence, incidence, and persistence of psychotic experiences in the general population: results of a 9-year follow-up study. Psychol Med 2023; 53:3750-3761. [PMID: 36117284 DOI: 10.1017/s0033291722002690] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) frequently occur and are associated with a range of negative health outcomes. Prospective studies on PEs are scarce, and to date no study investigated PE prevalence, incidence, persistence, their risk indicators, and psychiatric comorbidity, in one dataset. Furthermore, most studies are based on self-report, and it is unclear how this compares to clinical interviews. METHODS Data are used from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a psychiatric cohort study among a representative sample of adults (baseline characteristics: N = 6646; 49.6% female; 18-64 years). Results are presented for self-reported and clinically validated PEs. Associations are assessed for mental disorders, socio-demographic, vulnerability, physical health, and substance use factors. RESULTS Based on self-report, at baseline 16.5% of respondents had at least one PE in their lifetime, of those, 30.1% also reported a PE at 3-year follow-up. 4.8% had a first PE at 3-year follow up. The 3-year prevalence of PE was associated with almost all studied risk indicators. Generally, the strongest associations were found for mental health disorders. Prevalence and incidence rates were two to three times higher in self-report than in clinical interview but results on associated factors were similar. CONCLUSIONS Validated prevalence and incidence estimates of PE are substantially lower than self-reported figures but results on associated factors were similar. Therefore, future studies on associations of PEs can rely on relatively inexpensive self-reports of PEs. The associations between PE and mental disorders underline the importance of assessment of PE in general practice.
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Affiliation(s)
- Karin Monshouwer
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Margreet Ten Have
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- FACT, Mondriaan, Heerlen/Maastricht, The Netherlands
| | - Nicole Gunter
- School of Psychology, Open University, Heerlen, The Netherlands
| | - Philippe Delespaul
- School for Mental Health & Neurosciences, Maastricht University, Maastricht, The Netherlands
- Mondriaan, Heerlen, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Department Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
- King's Health Partners Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Ron de Graaf
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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Psychotic-like experiences as a co-occurring psychopathological indicator of multi-dimensional affective symptoms: Findings from a cross-sectional survey among college students. J Affect Disord 2023; 323:33-39. [PMID: 36435396 DOI: 10.1016/j.jad.2022.11.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/05/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although connections between psychotic-like experiences (PLEs) and a series of non-psychotic disorders have been widely explored in previous research, it is unclear whether PLEs could act as a co-occurring psychopathological indicator of multi-dimensional affective symptoms. METHODS A total of 4761 students took part in an online survey which assessed the frequency of PLEs and three types of affective symptoms over lifetime. Binary logistic regression models were used to examine associations between PLEs and each type of affective symptom. Network analysis was conducted to explore the relationship among three subtypes of PLEs - persecutory ideation (PI), bizarre experiences (BEs) and perceptual abnormalities (PAs), and different types of affective symptoms. RESULTS The results showed that compared with the non-PLEs group, the PLEs group suffered significantly higher risk of experiencing three types of affective symptoms, including manic symptoms [adjusted odds ratio (aOR) 11.50, 95 % confidence interval (CI) (4.59-28.81)], depressive symptoms [aOR 7.28, 95 % CI (4.98-10.66)] and anxiety symptoms [aOR 4.47, 95 % CI (3.10-6.43)]. In the network model, bizarre experiences were the most critical central symptom. Both depressive and anxiety symptoms were most strongly associated with persecutory ideation while manic symptoms were most closely related to bizarre experiences. LIMITATIONS Cross-sectional data and self-reported symptoms. CONCLUSIONS These findings suggest that PLEs are a vital co-occurring indicator of multi-dimensional affective symptoms and show its enormous potential as a target for a host of mental health problems. Further investigation may shed light on the aetiology of the relationship between different subtypes of PLEs and affective symptoms.
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Sex difference in the prevalence of psychotic-like experiences in adolescents: results from a pooled study of 21,248 Chinese participants. Psychiatry Res 2022; 317:114894. [PMID: 36252420 DOI: 10.1016/j.psychres.2022.114894] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
Psychotic-like experiences (PLEs) are subclinical psychotic symptoms in the general population which are linked to increased risks for later psychiatric disorders. Male and female adolescents were reported to experience PLEs differently, but the results were mixed in previous studies. This study aimed to investigate possible sex differences in the prevalence of adolescent PLEs using a large pooled sample. A total of 21,248 Chinese adolescents aged 11 to 19 years were included, which were drawn from five separate cross-sectional surveys undertaken between 2015 to 2021 in China. PLEs were measured by the 8-item Community Assessment of Psychic Experiences. Using binary logistic regression analyses, no significant sex differences were found in the overall prevalence of PLEs after controlling for age and dataset effects. As for specific PLE subtypes, however, being female was associated with a higher prevalence of delusion of reference and a lower prevalence of visual hallucinations. Furthermore, post-hoc subgroup analyses showed that the sex differences in visual hallucinations persist across both early (<= 14 years old) and late (> 14 years old) adolescence, while differences in the delusion of reference were significant in only early adolescence. These findings may help us to further understand the biological basis of PLEs.
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Herms EN, Bolbecker AR, Wisner KM. Emotion regulation and delusion-proneness relate to empathetic tendencies in a transdiagnostic sample. Front Psychiatry 2022; 13:992757. [PMID: 36226099 PMCID: PMC9548608 DOI: 10.3389/fpsyt.2022.992757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022] Open
Abstract
Empathetic tendencies (i.e., perspective taking and empathic concern) are a key factor in interpersonal relationships, which may be impacted by emotion regulation (i.e., reappraisal and suppression) and mental health symptoms, such as psychotic-like experiences. However, it is unclear if certain psychotic-like experiences, such as delusion-proneness, are still associated with reduced empathetic tendencies after accounting for emotion regulation style and dimensions of psychopathology that are often comorbid. In the current study, linear models tested these associations in a transdiagnostic community sample (N = 128), using the Interpersonal Reactivity Index (IRI), Emotion Regulation Questionnaire, and the Peter's Delusion Inventory. Results indicated that perspective taking was positively associated with reappraisal and negatively associated with delusion-proneness, after controlling for age, sex, race, intelligence, and symptoms of anxiety and depression. A significant change in R 2 supported the addition of delusion-proneness in this model. Specificity analyses demonstrated perspective taking was also negatively associated with suppression, but this relationship did not remain after accounting for the effects of reappraisal and delusion-proneness. Additional specificity analyses found no association between empathic concern and reappraisal or delusion-proneness but replicated previous findings that empathic concern was negatively associated with suppression. Taken together, delusion-proneness accounts for unique variance in perspective taking, which can inform future experimental research and may have important implications for psychosocial interventions.
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Affiliation(s)
- Emma N. Herms
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Amanda R. Bolbecker
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Krista M. Wisner
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
- Program of Neuroscience, Indiana University, Bloomington, IN, United States
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Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D, Cannon M. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med 2022; 52:1-12. [PMID: 36004805 PMCID: PMC9772919 DOI: 10.1017/s0033291722002550] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/31/2022]
Abstract
Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College, Dublin 4, Ireland
- Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin 6, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
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Social media use and mental health during the COVID-19 pandemic in young adults: a meta-analysis of 14 cross-sectional studies. BMC Public Health 2022; 22:995. [PMID: 35581597 PMCID: PMC9112239 DOI: 10.1186/s12889-022-13409-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Public isolated due to the early quarantine regarding coronavirus disease 2019 (COVID-19) increasingly used more social media platforms. Contradictory claims regarding the effect of social media use on mental health needs to be resolved. The purpose of the study was to summarise the association between the time spent on social media platform during the COVID-19 quarantine and mental health outcomes (i.e., anxiety and depression). Methods Studies were screened from the PubMed, Embase, and Cochrane Library databases. Regarding eligibility criteria, studies conducted after the declaration of the pandemic, studies that measured mental health symptoms with validated tools, and studies that presented quantitative results were eligible. The studies after retrieval evaluated the association between time spent on social media platform and mental health outcomes (i.e. anxiety and depression). The pooled estimates of retrieved studies were summarised in odds ratios (ORs). Data analyses included a random-effect model and an assessment of inter-study heterogeneity. Quality assessment was conducted by two independent researchers using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This meta-analysis review was registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO/, registration No CRD42021260223, 15 June 2021). Results Fourteen studies were included. The increase in the time spent using social media platforms were associated with anxiety symptoms in overall studies (pooled OR = 1.55, 95% CI: 1.30–1.85), and the heterogeneity between studies was mild (I2 = 26.77%). Similarly, the increase in social media use time was also associated with depressive symptoms (pooled OR = 1.43, 95% CI: 1.30–1.85), and the heterogeneity between studies was moderate (I2 = 67.16%). For sensitivity analysis, the results of analysis including only the “High quality” studies after quality assessment were similar to those of the overall study with low heterogeneity (anxiety: pooled OR = 1.45, 95% CI: 1.21–1.96, I2 = 0.00%; depression: pooled OR = 1.42, 95% CI: 0.69–2.90, I2 = 0.00%). Conclusions The analysis demonstrated that the excessive time spent on social media platform was associated with a greater likelihood of having symptoms of anxiety and depression. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13409-0.
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Chan SKW, Lee KKW, Chan VHY, Pang HH, Wong CSM, Hui CLM, Chang WC, Lee EHM, Chan WC, Cheung EFC, Chiu HFK, Chiang TP, Lam M, Lau JTF, Ng RMK, Hung SF, Lam LCW, Chen EYH. The 12-month prevalence of psychotic experiences and their association with clinical outcomes in Hong Kong: an epidemiological and a 2-year follow up studies. Psychol Med 2021; 51:2501-2508. [PMID: 32466813 DOI: 10.1017/s0033291720001452] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms. METHOD This is a population-based two-phase household survey of Chinese population in Hong Kong aged 16-75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up. RESULTS The 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up. CONCLUSIONS Results highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.
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Affiliation(s)
- Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
| | | | - Veronica Hei Yan Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Herbert H Pang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Corine Sau Man Wong
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | | | | | | | | | - Joseph Tak Fai Lau
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong
| | | | - Se Fong Hung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
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Shoham N, Cooper C, Lewis G, Bebbington P, McManus S. Temporal trends in psychotic symptoms: Repeated cross-sectional surveys of the population in England 2000-14. Schizophr Res 2021; 228:97-102. [PMID: 33434740 DOI: 10.1016/j.schres.2020.11.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 08/13/2020] [Accepted: 11/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The number of antipsychotic prescriptions dispensed annually in England has increased substantially over the past decade. It is not known whether this is due to changes in prescribing practices, or an increase in the prevalence of psychosis. To our knowledge, no previous studies have investigated temporal trends in prevalence of psychotic symptoms in non-clinical populations. METHODS We used data from the nationally representative Adult Psychiatric Morbidity Surveys 2000, 2007 and 2014 to (1) test whether the prevalence of psychotic symptoms increased between 2000 and 2014; (2) compare prevalence of psychotic symptoms to the prevalence of being prescribed antipsychotic medication; and (3) identify correlates of experiencing psychotic symptoms. RESULTS There was a small increase in the prevalence of psychotic symptoms in 2014 compared to 2000 (prevalence in 2000 5.6%, 95% confidence intervals (CI) 5.1% to 6.2%; prevalence in 2014 6.8%, 95% CI 6.1% - 7.6%). This corresponded to an adjusted odds ratio of 1.2 (95% CI 1.02-1.40, p=0.026) for experiencing psychotic symptoms in 2014 compared to 2007. By comparison, antipsychotic medication use doubled over this period (prevalence in 2000 0.6%, 95% CI 0.4%-0.7%; prevalence in 2014 1.2% 95% CI 0.9%-1.5%; aOR 2.22 (1.52-3.25) p<0.001). Correlates of reporting psychotic symptoms included ethnic minority identity, younger age, lower social class, alcohol and cannabis use, and any psychiatric diagnosis. CONCLUSIONS While the rates of antipsychotic prescription doubled between 2000 and 2014, the odds of having psychotic symptoms rose only slightly. The reasons for this warrant further investigation.
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Affiliation(s)
- Natalie Shoham
- University College London, Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland; Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, United Kingdom of Great Britain and Northern Ireland.
| | - Claudia Cooper
- University College London, Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland; Camden and Islington NHS Foundation Trust, St Pancras Hospital, London NW1 0PE, United Kingdom of Great Britain and Northern Ireland
| | - Gemma Lewis
- University College London, Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Paul Bebbington
- University College London, Division of Psychiatry, 6th Floor, Maple House, 149 Tottenham Court Road, London W1T 7BN, United Kingdom of Great Britain and Northern Ireland
| | - Sally McManus
- City University, Northampton Square, London, United Kingdom of Great Britain and Northern Ireland; NatCen Social Research, 35 Northampton Square, London EC1V 0AX, United Kingdom of Great Britain and Northern Ireland
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Masdrakis VG, Baldwin DS. Anticonvulsant and antipsychotic medications in the pharmacotherapy of panic disorder: a structured review. Ther Adv Psychopharmacol 2021; 11:20451253211002320. [PMID: 33815761 PMCID: PMC7989133 DOI: 10.1177/20451253211002320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND As the remission rate of panic disorder (PD) achieved with conventional pharmacotherapy ranges between 20% and 50%, alternative psychopharmacological strategies are needed. We aimed to firstly review data regarding use of antipsychotic and non-benzodiazepine anticonvulsant medication in PD patients with or without comorbidities; secondly, to review data concerning reduction of panic symptoms during treatment of another psychiatric disorder with the same medications; and thirdly, to examine reports of anticonvulsant- or antipsychotic-induced new-onset panic symptomatology. METHODS We performed a PubMed search (last day: 28 April 2020) of English-language studies only, combining psychopathological terms (e.g. 'panic disorder') and terms referring either to categories of psychotropic medications (e.g. 'anticonvulsants') or to specific drugs (e.g. 'carbamazepine'). All duplications were eliminated. All studies included in the review met certain inclusion/exclusion criteria. The level of evidence for the efficacy of each drug was defined according to widely accepted criteria. RESULTS In treatment-resistant PD, beneficial effects have been reported after treatment (mostly augmentation therapy) with a range of anticonvulsant (carbamazepine, gabapentin, lamotrigine, levetiracetam, oxcarbamazepine, valproate, vigabatrin, tiagabine) and antipsychotic (aripiprazole, olanzapine, risperidone, sulpiride) medications: overall, most medications appear generally well tolerated. Additionally, bipolar patients receiving valproate or quetiapine-XR (but not risperidone or ziprasidone) demonstrated reductions of comorbid panic-related symptoms. There are case reports of new-onset panic symptoms associated with clozapine, haloperidol, olanzapine and topiramate, in patients with conditions other than PD. The small-to-modest sample size, the lack of control groups and the open-label and short-term nature of most of the reviewed studies hinder definitive conclusions regarding either the short-term and long-term efficacy of antipsychotic and anticonvulsant medications or their potential long-term side effects. CONCLUSION Some atypical antipsychotic and anticonvulsant medications may have a role in the treatment of some PD patients, mostly when more conventional approaches have not been successful, but the quality of supporting evidence is limited.
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Affiliation(s)
- Vasilios G Masdrakis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - David S Baldwin
- Clinical and Experimental Sciences, University of Southampton Faculty of Medicine; University Department of Psychiatry, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton, Hampshire, SO14 3DT, UK
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14
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Ahmed Siddiqui MY, Mushtaq K, Mohamed MFH, Al Soub H, Hussein Mohamedali MG, Yousaf Z. "Social Media Misinformation"-An Epidemic within the COVID-19 Pandemic. Am J Trop Med Hyg 2020; 103:920-921. [PMID: 32534600 PMCID: PMC7410422 DOI: 10.4269/ajtmh.20-0592] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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15
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Comorbidity rates of depression and anxiety in first episode psychosis: A systematic review and meta-analysis. Schizophr Res 2020; 216:322-329. [PMID: 31791816 DOI: 10.1016/j.schres.2019.11.035] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/09/2019] [Accepted: 11/22/2019] [Indexed: 01/09/2023]
Abstract
Anxiety and depression symptoms are frequently experienced by individuals with psychosis, although prevalence rates have not been reviewed in first-episode psychosis (FEP). The aim of this systematic review was to focus on the prevalence rates for both anxiety and depression, comparing the rates within the same study population. A systematic review and meta-analysis was completed for all studies measuring both anxiety and depression in FEP at baseline. The search identified 6040 citations, of which n = 10 met inclusion criteria. These reported 1265 patients (age 28.3 ± 9.1, females: 39.9%) with diagnosed FEP. Studies which used diagnosis to define comorbidity count were included in separate meta-analyses for anxiety and depression, although the heterogeneity was high limiting interpretation of separate prevalence rates. A random-effects meta-analysis also compared the mean difference between anxiety and depression within the same studies. We show that anxiety and depression co-occur at a similar rate within FEP, although the exact rates are not reliable due to the heterogeneity between the small number of studies. Future research in FEP should consider routinely measuring anxiety and depression using continuous self-report measures of symptoms. Clinically we recommend that both anxiety and depression are equally targeted during psychological intervention in FEP, together with the psychotic symptoms.
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Baryshnikov I, Aaltonen K, Suvisaari J, Koivisto M, Heikkinen M, Joffe G, Isometsä E. Features of borderline personality disorder as a mediator of the relation between childhood traumatic experiences and psychosis-like experiences in patients with mood disorder. Eur Psychiatry 2020; 49:9-15. [PMID: 29353179 DOI: 10.1016/j.eurpsy.2017.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022] Open
Abstract
AbstractBackgroundPsychosis-like experiences (PEs) are common in patients with non-psychotic disorders. Several factors predict reporting of PEs in mood disorders, including mood-associated cognitive biases, anxiety and features of borderline personality disorder (BPD). Childhood traumatic experiences (CEs), often reported by patients with BPD, are an important risk factor for mental disorders. We hypothesized that features of BPD may mediate the relationship between CEs and PEs. In this study, we investigated the relationships between self-reported PEs, CEs and features of BPD in patients with mood disorders.MethodsAs part of the Helsinki University Psychiatric Consortium study, McLean Screening Instrument (MSI), Community Assessment of Psychic Experiences (CAPE-42) and Trauma and Distress Scale (TADS) were filled in by patients with mood disorders (n = 282) in psychiatric care. Correlation coefficients between total scores of scales and their dimensions were estimated, multiple regression and mediation analyses were conducted.ResultsTotal scores of MSI correlated strongly with scores of the CAPE-42 dimension “frequency of positive symptoms” (rho = 0.56; p ≤ 0.001) and moderately with scores of TADS (rho = 0.4; p ≤ 0.001). Total score of MSI and its dimension “cognitive symptoms”, including identity disturbance, distrustfulness and dissociative symptoms, fully mediated the relation between TADS and CAPE-42. Each cognitive symptom showed a partial mediating role (dissociative symptoms 43% (CI = 25–74%); identity disturbance 40% (CI = 30-73%); distrustfulness 18% (CI = 12-50%)).ConclusionsSelf-reported cognitive-perceptual symptoms of BPD fully mediate, while affective, behavioural and interpersonal symptoms only partially mediate the relationships between CEs and PEs. Recognition of co-morbid features of BPD in patients with mood disorders reporting PEs is essential.
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Kırlı U, Binbay T, Drukker M, van Os J, Alptekin K, Kayahan B, Elbi H. Psychotic experiences and mood episodes predict each other bidirectionally: a 6-year follow-up study in a community-based population. Soc Psychiatry Psychiatr Epidemiol 2019; 54:331-341. [PMID: 30671600 DOI: 10.1007/s00127-018-1641-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 12/03/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) are not exclusive to psychotic disorders and highly correlated with mood episodes. In this representative general population-based study, longitudinal bidirectional associations between the extended psychosis phenotype and mood episodes were investigated, accounting for other possible causes. METHODS Households were contacted in a multistage clustered probability sampling frame covering 11 districts and 302 neighbourhoods at baseline (n = 4011) and at 6-year follow-up (n = 2185). Participants were interviewed with the relevant sections of the composite international diagnostic interview both at baseline and at follow-up. Sociodemographic, familial and environmental risk factors associated with the extended psychosis phenotype and mood episodes were assessed. Logistic regression and cross-lagged panel correlation models were used for the associations between the extended psychosis phenotype and mood episodes. RESULTS PEs were associated with subsequent depressive and manic episodes. There was bidirectionality in that mood episodes were associated with subsequent PEs, and PEs were associated with subsequent mood episodes. The associations occurred in a sub-additive pattern. There were substantial synchronous and cross-lagged correlations between these psychopathology domains, with reciprocally similar cross-lagged correlations. Familial risk and adverse life events were associated with both psychopathology domains, whereas some sociodemographic risk factors and alcohol/cannabis use were associated with only one domain. CONCLUSION The sub-additive bidirectional associations between PEs and mood episodes over time and the similarity of cross-lagged correlations are suggestive of mutually causal connections between affective and psychotic domains of psychopathology.
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Affiliation(s)
- Umut Kırlı
- Psychiatry Unit, Van Education and Research Hospital, Van, Turkey.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Tolga Binbay
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, 35340, Izmir, Turkey.
| | - Marjan Drukker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, King's Health Partners, King's College London, London, UK.,Department of Psychiatry, Brain Center Rudolf Magnus Institute, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Köksal Alptekin
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, 35340, Izmir, Turkey
| | - Bülent Kayahan
- Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Hayriye Elbi
- Department of Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
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18
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Oh H, Waldman K, Stubbs B, Koyanagi A. Psychotic experiences in the context of mood and anxiety disorders and their associations with health outcomes among people of color in the United States. J Psychosom Res 2019; 118:27-33. [PMID: 30782351 DOI: 10.1016/j.jpsychores.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Psychotic experiences appear to increase risk for health outcomes above and beyond mood/anxiety disorders. However, existing studies that have found this association were conducted mostly in low- and middle-income countries, calling for more studies to explore the association in other contexts, such as the U.S., where people of color face considerable health disparities. MATERIALS/METHODS Data from the National Latino and Asian American Survey, and the National Survey of American Life were analyzed. After restricting the analytic sample to individuals with at least one mood or anxiety disorder (N = 2929), multivariable logistic regression was used to examine the associations between psychotic experiences and health outcomes, disabilities, and help-seeking behaviors, adjusting for socio-demographic characteristics and psychiatric disorders. RESULTS Among people of color with mood/anxiety disorders, 16.58% (n = 519) of the weighted analytic sample reported psychotic experiences. Psychotic experiences were associated with 1.75 times greater odds (95% CI: 1.24-2.47) for reporting a lifetime health condition, with varying odds depending on the specific conditions (e.g. arthritis, heart disease, ulcers, and asthma), and specific disabilities (e.g. cognition, mobility, social interaction, and time out of role). Psychotic experiences were associated with 1.66 times the odds of seeking any treatment (95% CI: 1.20-2.29), and the perceived need for help among people who did not seek treatment (e.g. feeling the need for treatment, being encouraged to seek treatment by others). CONCLUSIONS Mental health practitioners serving people of color who have mood/anxiety disorders should routinely screen for psychotic experiences, which may suggest health problems and disabilities that warrant integrated healthcare.
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Affiliation(s)
- Hans Oh
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Kyle Waldman
- University of Southern California, Suzanne Dworak-Peck School of Social Work, CA, USA.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom.
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
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19
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Lee JY, Ban D, Kim SY, Kim JM, Shin IS, Yoon JS, Kim SW. Negative Life Events and Problematic Internet Use as Factors Associated With Psychotic-Like Experiences in Adolescents. Front Psychiatry 2019; 10:369. [PMID: 31191372 PMCID: PMC6549193 DOI: 10.3389/fpsyt.2019.00369] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/13/2019] [Indexed: 11/13/2022] Open
Abstract
Objectives: Psychotic-like experiences (PLEs) and problematic internet use (PIU) are common in adolescents. However, little is known about the association between PLEs and PIU among adolescents. The present study examined the associations between PLEs and PIU and negative life events among adolescents. Methods: In total, 1,678 adolescents attending high school were recruited for a cross-sectional survey. They completed self-reported assessments of PLEs using the Prodromal Questionnaire-16 (PQ-16) and measures of depression, anxiety, self-esteem, internet use, and negative life events using the Center for Epidemiological Studies Depression Scale (CES-D), the State-Trait Anxiety Inventory (STAI), the Rosenberg Self-Esteem Scale (RSES), the Korean Scale for Internet Addiction (K-scale), and the Lifetime Incidence of Traumatic Events for Children (LITE-C), including cybersexual harassment and school violence. Results: A total of 1,239 subjects (73.8%) scored at least 1 on the PQ-16. The mean total and distress PQ-16 scores were significantly higher in students who used mental health services. The total and distress prodromal questionnaire-16 (PQ-16) scores were positively correlated with the CES-D, STAI-S, STAI-T, LITE-C, and K-scale scores but negatively correlated with the RSES score. Hierarchical linear regression analysis revealed that PLEs were significantly associated with a high K-scale score and the incidence of negative life events, such as LITE-C, cybersexual harassment, and bully-victims. Conclusion: Our results demonstrate that PIU and negative life experiences were significantly associated with PLEs in adolescents. Assessment and therapeutic intervention with regard to internet use as a coping strategy for stress are needed to prevent the development of clinical psychotic symptoms.
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Affiliation(s)
- Ju-Yeon Lee
- Chonnam National University Medical School, Gwangju, South Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
| | - Dahye Ban
- Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
| | - Seon-Young Kim
- Chonnam National University Medical School, Gwangju, South Korea
| | - Jae-Min Kim
- Chonnam National University Medical School, Gwangju, South Korea
| | - Il-Seon Shin
- Chonnam National University Medical School, Gwangju, South Korea
| | - Jin-Sang Yoon
- Chonnam National University Medical School, Gwangju, South Korea
| | - Sung-Wan Kim
- Chonnam National University Medical School, Gwangju, South Korea.,Gwangju Bukgu Community Mental Health Center, Gwangju, South Korea
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20
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Pignon B, Peyre H, Szöke A, Geoffroy PA, Rolland B, Jardri R, Thomas P, Vaiva G, Roelandt JL, Benradia I, Behal H, Schürhoff F, Amad A. A latent class analysis of psychotic symptoms in the general population. Aust N Z J Psychiatry 2018; 52:573-584. [PMID: 29232967 DOI: 10.1177/0004867417744255] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Individuals with psychotic symptoms may actually correspond to various subgroups, characterized by different patterns of psychotic symptoms as well as specific sociodemographic and clinical correlates. We aimed to identify groups of individuals from the general population with specific patterns of psychotic symptoms. METHODS In a 38,694-subject survey, a latent class analysis was performed to identify subgroups based on the distribution of seven psychotic symptoms taken from the Mini International Neuropsychiatric Interview. The different classes were subsequently compared according to sociodemographic and clinical correlates. RESULTS The best fit was obtained with a four-class solution, including the following: (1) a class with a low prevalence of all psychotic symptoms ('LOW', 85.9%); (2) a class with a high prevalence of all psychotic symptoms ('HAL + DEL', 1.7%); and classes with a high prevalence of (3) hallucinations ('HAL', 4.5%) or (4) delusions ('DEL', 7.9%). The HAL + DEL class displayed higher rates of history of trauma, social deprivation and migrant status, while the HAL and DEL classes displayed intermediate rates between HAL + DEL and LOW. HAL + DEL displayed the highest rates of psychotic and non-psychotic disorders and the use of mental health treatment, while HAL and DEL displayed intermediate rates of these disorders between HAL + DEL and LOW. In comparison to the HAL class, psychotic and substance use disorders were more frequent in the DEL class, while anxiety and mood disorders were less frequent. CONCLUSION These findings support the hypothesis of a continuum model relating the level of psychotic symptoms to the level of global psychopathology.
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Affiliation(s)
- Baptiste Pignon
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Hugo Peyre
- 2 Assistance Publique-Hôpitaux de Paris, Robert Debré Hospital, Child and Adolescent Psychiatry Department and Cognitive Sciences and Psycholinguistic Laboratory, Ecole Normale Supérieure, Paris, France
| | - Andrei Szöke
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Pierre A Geoffroy
- 3 Inserm, U1144 and Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, and AP-HP, GH Saint-Louis-Lariboisière-F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, Fondation FondaMental, Créteil, France
| | - Benjamin Rolland
- 4 Service Universitaire d'Addictologie, Pôle UP-MOPHA, CH Le Vinatier, Univ. Lyon and CRNL Inserm U1028/CNRS UMR5292-CH Le Vinatier, Bron, France
| | - Renaud Jardri
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France
| | - Pierre Thomas
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Guillaume Vaiva
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France
| | - Jean-Luc Roelandt
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Imane Benradia
- 7 EPSM Lille Métropole and Centre Collaborateur de l'Organisation Mondiale de la Santé pour la recherche et la formation en santé mentale and Equipe Eceve Inserm UMR 1123, Lille, France
| | - Hélène Behal
- 8 Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Department of biostatistics, Lille, France
| | - Franck Schürhoff
- 1 AP-HP, DHU PePSY, Hôpitaux universitaires Henri-Mondor, Pôle de Psychiatrie and Inserm, U955, team 15 and Fondation FondaMental and UPEC, Université Paris-Est, Faculté de médecine, Créteil, France
| | - Ali Amad
- 5 Univ. Lille, CNRS UMR 9193-PsyCHIC-SCALab, & CHU Lille, Pôle de Psychiatrie, Unité CURE, Lille, France.,6 Fédération régionale de recherche en santé mentale (F2RSM) Nord-Pas-de-Calais, Lille, France.,9 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Pignon B, Tezenas du Montcel C, Carton L, Pelissolo A. The Place of Antipsychotics in the Therapy of Anxiety Disorders and Obsessive-Compulsive Disorders. Curr Psychiatry Rep 2017; 19:103. [PMID: 29110139 DOI: 10.1007/s11920-017-0847-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review was to assess and present the findings up to this date on the efficacy of antipsychotics in the treatment of generalized anxiety disorders (GAD), social anxiety disorders (SAD), panic disorders (PD), and obsessive-compulsive disorders (OCD), mostly based on published randomized controlled trials (RCTs) or on open-label studies when RCT were lacking. RECENT FINDINGS Quetiapine could be recommended in patients with GAD. The efficacy of aripiprazole in two open-label studies on patients with antidepressant-refractory GAD should be assessed in RCTs. Despite preliminary positive results in open studies, there are currently no strong evidence for the effectiveness of antipsychotics in refractory SAD and in refractory PD. Conversely, risperidone and aripiprazole can be used for the treatment of refractory OCD as augmentation agents to antidepressants. Contrary to SAD and PD, this review found evidence for the use of second-generation antipsychotics in GAD and OCD. Otherwise, first-generation antipsychotics cannot be recommended in anxiety disorders and OCD.
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Affiliation(s)
- Baptiste Pignon
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, 94000, Créteil, France. .,INSERM, U955, team 15, 94000, Créteil, France. .,Fondation FondaMental, 94000, Créteil, France. .,Faculté de médecine, UPEC, Université Paris-Est, 94000, Créteil, France. .,Hôpital Albert Chenevier, Groupe Hospitalier Henri-Mondor, CHU de Créteil, Assistance Publique-Hôpitaux de Paris (AP-HP), 40 rue de Mesly, 94 000, Créteil, France.
| | - Chloé Tezenas du Montcel
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, 94000, Créteil, France
| | - Louise Carton
- Département de Pharmacologie Médicale, Univ.Lille, Inserm U1171, CHU Lille, 59000, Lille, France.,Service d'addictologie, CHU Lille, 59000, Lille, France
| | - Antoine Pelissolo
- AP-HP, DHU PePSY, Hôpitaux Universitaires Henri-Mondor, Pôle de Psychiatrie, 94000, Créteil, France.,INSERM, U955, team 15, 94000, Créteil, France.,Fondation FondaMental, 94000, Créteil, France.,Faculté de médecine, UPEC, Université Paris-Est, 94000, Créteil, France
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22
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Psychotic-like experiences and happiness in the English general population. J Affect Disord 2017; 222:211-217. [PMID: 28711798 DOI: 10.1016/j.jad.2017.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 06/29/2017] [Accepted: 07/06/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) have been associated with a variety of adverse outcomes but how they affect happiness in individuals with PLE is unknown. Thus, the aim of the study was to assess the association between PLEs and happiness, and the factors that may influence this association. METHODS Nationally representative data from the 2007 Adult Psychiatric Morbidity Survey including adults aged ≥ 16 years was analyzed. The Psychosis Screening Questionnaire was used to assess past 12-month PLE. Individuals who endorsed at least one of the following were considered to have any PLE: thought control, paranoia, strange experiences, auditory hallucinations. Happiness (3-point scale) was assessed with a validated question with higher scores indicating lower levels of happiness. The association between PLE and happiness was assessed by multivariable ordinal logistic regression. Mediation analysis was also performed. RESULTS Among the 7363 individuals included in the analysis, the prevalence of any PLE increased with decreasing levels of happiness [very happy (2.3%), fairly happy (5.4%), not too happy (14.9%)]. This was also shown in the multivariable analysis adjusted for sociodemographic factors and stressful life events (from very happy to not too happy: OR = 2.41; 95%CI = 1.86-3.12). Mediation analysis showed that anxiety disorders explained the largest proportion of the association (38.8%) followed by depressive episode (28.5%), insomnia (21.9%), disability (16.5%), pain (12.5%), social support (10.0%), and physical health conditions (6.0%). LIMITATIONS The cross-sectional design limits causal inference. CONCLUSION Interventions to identify and address conditions that may have a negative impact on happiness in individuals with PLE may be important to improve their well-being.
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Bhavsar V, Maccabe JH, Hatch SL, Hotopf M, Boydell J, McGuire P. Subclinical psychotic experiences and subsequent contact with mental health services. BJPsych Open 2017; 3:64-70. [PMID: 28357132 PMCID: PMC5339598 DOI: 10.1192/bjpo.bp.117.004689] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 02/08/2017] [Accepted: 02/08/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Although psychotic experiences in people without diagnosed mental health problems are associated with mental health service use, few studies have assessed this prospectively or measured service use by real-world clinical data. AIMS To describe and investigate the association between psychotic experiences and later mental health service use, and to assess the role of symptoms of common mental health disorders in this association. METHOD We linked a representative survey of south-east London (SELCoH-1, n=1698) with health records from the local mental healthcare provider. Cox regression estimated the association of PEs with rate of mental health service use. RESULTS After adjustments, psychotic experiences were associated with a 1.75-fold increase in the rate of subsequent mental health service use (hazard ratio (HR) 1.75, 95% CI 1.03-2.97) compared with those without PEs. Participants with PEs experienced longer care episodes compared with those without. CONCLUSIONS Psychotic experiences in the general population are important predictors of public mental health need, aside from their relevance for psychoses. We found psychotic experiences to be associated with later mental health service use, after accounting for sociodemographic confounders and concurrent psychopathology. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.
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Affiliation(s)
- Vishal Bhavsar
- , MRCPsych, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - James H Maccabe
- , PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Stephani L Hatch
- , PhD, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Matthew Hotopf
- , PhD, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
| | - Jane Boydell
- , PhD, Cornwall Partnership NHS Foundation Trust, Bodmin, UK
| | - Philip McGuire
- , PhD, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Baryshnikov I, Suvisaari J, Aaltonen K, Koivisto M, Melartin T, Näätänen P, Suominen K, Karpov B, Heikkinen M, Oksanen J, Paunio T, Joffe G, Isometsä E. Self-reported psychosis-like experiences in patients with mood disorders. Eur Psychiatry 2017; 51:90-97. [PMID: 28797561 DOI: 10.1016/j.eurpsy.2016.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 07/12/2016] [Accepted: 07/12/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Self-reported psychosis-like experiences (PEs) may be common in patients with mood disorders, but their clinical correlates are not well known. We investigated their prevalence and relationships with self-reported symptoms of depression, mania, anxiety, borderline (BPD) and schizotypal (SPD) personality disorders among psychiatric patients with mood disorders. METHODS The Community Assessment of Psychic Experiences (CAPE-42), Mood Disorder Questionnaire (MDQ), McLean Screening Instrument (MSI), The Beck Depressive Inventory (BDI), Overall Anxiety Severity and Impairment Scale (OASIS) and Schizotypal Personality Questionnaire-Brief form (SPQ-B) were filled in by patients with mood disorders (n=282) from specialized care. Correlation coefficients between total scores and individual items of CAPE-42 and BDI, SPQ-B, MSI and MDQ were estimated. Hierarchical multivariate regression analysis was conducted to examine factors influencing the frequency of self-reported PE. RESULTS PEs are common in patients with mood disorders. The "frequency of positive symptoms" score of CAPE-42 correlated strongly with total score of SPQ-B (rho=0.63; P<0.001) and moderately with total scores of BDI, MDQ, OASIS and MSI (rho varied from 0.37 to 0.56; P<0.001). Individual items of CAPE-42 correlated moderately with specific items of BDI, MDQ, SPQ-B and MSI (rφ varied from 0.2 to 0.5; P<0.001). Symptoms of anxiety, mania or hypomania and BPD were significant predictors of the "frequency of positive symptoms" score of CAPE-42. CONCLUSIONS Several, state- and trait-related factors may underlie self-reported PEs among mood disorder patients. These include cognitive-perceptual distortions of SPD; distrustfulness, identity disturbance, dissociative and affective symptoms of BPD; and cognitive biases related to depressive or manic symptoms.
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Affiliation(s)
- I Baryshnikov
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - J Suvisaari
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland; National Institute for Health and Welfare, Mental Health Unit, 00271 Helsinki, Finland
| | - K Aaltonen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland; Department of Mental Health and Substance Abuse, Social Services and Health Care, Helsinki, Finland
| | - M Koivisto
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - T Melartin
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - P Näätänen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - K Suominen
- Department of Mental Health and Substance Abuse, Social Services and Health Care, Helsinki, Finland
| | - B Karpov
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - M Heikkinen
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - J Oksanen
- Department of Mental Health and Substance Abuse, Social Services and Health Care, Helsinki, Finland
| | - T Paunio
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - G Joffe
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland
| | - E Isometsä
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, P.O. Box 22 (Välskärinkatu 12 A), 00014 Helsinki, Finland; National Institute for Health and Welfare, Mental Health Unit, 00271 Helsinki, Finland.
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25
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Koyanagi A, Oh H, Stubbs B, Haro JM, DeVylder JE. Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries. Psychol Med 2017; 47:531-542. [PMID: 27786151 DOI: 10.1017/s0033291716002750] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions. METHOD Cross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed. RESULTS The crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3-2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07-1.59, p = 0.0086); angina 1.40 (95% CI 1.18-1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21-2.26, p = 0.0017). CONCLUSIONS The prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.
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Affiliation(s)
- A Koyanagi
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - H Oh
- University of California Berkeley School of Public Health,Berkeley,CA,USA
| | - B Stubbs
- Physiotherapy Department,South London and Maudsley NHS Foundation Trust,Denmark Hill,London,UK
| | - J M Haro
- Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Barcelona,Spain
| | - J E DeVylder
- School of Social Work,University of Maryland,Baltimore, MD,USA
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26
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McGrath JJ, Saha S, Al-Hamzawi A, Andrade L, Benjet C, Bromet EJ, Browne MO, Caldas de Almeida JM, Chiu WT, Demyttenaere K, Fayyad J, Florescu S, de Girolamo G, Gureje O, Haro JM, Have MT, Hu C, Kovess-Masfety V, Lim CCW, Navarro-Mateu F, Sampson N, Posada-Villa J, Kendler K, Kessler RC. The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders. Am J Psychiatry 2016; 173:997-1006. [PMID: 26988628 PMCID: PMC5175400 DOI: 10.1176/appi.ajp.2016.15101293] [Citation(s) in RCA: 165] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE While it is now recognized that psychotic experiences are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of psychotic experiences and mental disorders. Using data from World Health Organization World Mental Health (WMH) Surveys, the authors assessed the bidirectional temporal associations between psychotic experiences and mental disorders. METHOD The WMH Surveys assessed lifetime prevalence and age at onset of psychotic experiences and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries. Discrete-time survival models were used to examine bivariate and multivariate associations between psychotic experiences and mental disorders. RESULTS Temporally primary psychotic experiences were significantly associated with subsequent first onset of eight of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, posttraumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, and alcohol abuse), with odds ratios ranging from 1.3 (95% CI=1.2-1.5) for major depressive disorder to 2.0 (95% CI=1.5-2.6) for bipolar disorder. In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of psychotic experiences, with odds ratios ranging from 1.5 (95% CI=1.0-2.1) for childhood separation anxiety disorder to 2.8 (95% CI=1.0-7.8) for anorexia nervosa. CONCLUSIONS While temporally primary psychotic experiences are associated with an elevated risk of several subsequent mental disorders, these data show that most mental disorders are associated with an elevated risk of subsequent psychotic experiences. Further investigation of the underlying factors accounting for these time-order relationships may shed light on the etiology of psychotic experiences.
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Affiliation(s)
- John J. McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Discipline of Psychiatry, University of Queensland, St Lucia, QLD 4072, Australia,Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Discipline of Psychiatry, University of Queensland, St Lucia, QLD 4072, Australia,Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq
| | - Laura Andrade
- Department/Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente, Mexico City, Mexico
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, United States
| | | | - Jose M. Caldas de Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Wai Tat Chiu
- Department of Health Policy, Harvard University, Boston, MA, United States
| | - Koen Demyttenaere
- Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium
| | - John Fayyad
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Giovanni de Girolamo
- IRCCS St John of God Clinical Research Centre, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Deïu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - Margreet ten Have
- Trimbos-Instituut, Netherlands Institute of Mental Health and Addiction, Netherlands
| | - Chiyi Hu
- Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
| | - Carmen C. W. Lim
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | | | - Nancy Sampson
- Department of Health Policy, Harvard University, Boston, MA, United States
| | | | - Kenneth Kendler
- Department of Psychiatry, Virginia Commonwealth University, United States
| | - Ronald C. Kessler
- Department of Health Policy, Harvard University, Boston, MA, United States
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27
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Koyanagi A, Oh H, Stickley A, Haro JM, DeVylder J. Risk and functional significance of psychotic experiences among individuals with depression in 44 low- and middle-income countries. Psychol Med 2016; 46:2655-2665. [PMID: 27377628 DOI: 10.1017/s0033291716001422] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies on whether the co-occurrence of psychotic experiences (PEs) and depression confers a more pronounced decrement in health status and function compared with depression alone are scarce in the general adult population. METHOD Data on 195 479 adults aged ⩾18 years from the World Health Survey were analysed. Using the World Mental Health Survey version of the Composite International Diagnostic Interview (CIDI), depression in the past 12 months was categorized into four groups: depressive episode, brief depressive episode, subsyndromal depression, and no depression. Past 12-month psychotic symptoms were assessed using four questions on positive symptoms from the CIDI. Health status across seven domains (cognition, interpersonal activities, sleep/energy, self-care, mobility, pain/discomfort, vision) and interviewer-rated presence of a mental health problem were assessed. Multivariable logistic and linear regression analyses were performed to assess the associations. RESULTS When compared with those with no depression, individuals with depression had higher odds of reporting at least one PE, and this was seen across all levels of depression severity: subsyndromal depression [odds ratio (OR) 2.38, 95% confidence interval (CI) 2.02-2.81], brief depressive episode (OR 3.84, 95% CI 3.31-4.46) and depressive episode (OR 3.75, 95% CI 3.24-4.33). Having coexisting PEs and depression was associated with a higher risk for observable illness behavior and a significant decline in health status in the cognition, interpersonal activities and sleep/energy domains, compared with those with depression alone. CONCLUSIONS This coexistence of depression and PEs is associated with more severe social, cognitive and sleep disturbances, and more outwardly apparent illness behavior. Detecting this co-occurrence may be important for treatment planning.
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Affiliation(s)
- A Koyanagi
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr Antoni Pujadas,42,Sant Boi de Llobregat,Barcelona 08830,Spain
| | - H Oh
- University of California Berkeley School of Public Health,50 University Hall #7360,Berkeley,CA 94720-7360,USA
| | - A Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST),Södertörn University,Huddinge 141 89,Sweden
| | - J M Haro
- Research and Development Unit,Parc Sanitari Sant Joan de Déu,Universitat de Barcelona,Fundació Sant Joan de Déu,Dr Antoni Pujadas,42,Sant Boi de Llobregat,Barcelona 08830,Spain
| | - J DeVylder
- School of Social Work,University of Maryland,525 West Redwood Street,Baltimore,MD 21201,USA
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28
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Koyanagi A, Stickley A, Haro JM. Psychotic symptoms and smoking in 44 countries. Acta Psychiatr Scand 2016; 133:497-505. [PMID: 27028367 DOI: 10.1111/acps.12566] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess the association between psychotic symptoms and smoking among community-dwelling adults in 44 countries. METHOD Data from the World Health Survey (WHS) for 192 474 adults aged ≥18 years collected in 2002-2004 were analyzed. The Composite International Diagnostic Interview was used to identify four types of past 12-month psychotic symptoms. Smoking referred to current daily and non-daily smoking. Heavy smoking was defined as smoking ≥30 tobacco products/day. RESULTS The pooled age-sex-adjusted OR (95% CI) of psychotic symptoms (i.e., at least one psychotic symptom) for smoking was 1.35 (1.27-1.43). After adjustment for potential confounders, compared to those with no psychotic symptoms, the ORs (95% CIs) for smoking for 1, 2, and ≥3 psychotic symptoms were 1.20 (1.08-1.32), 1.25 (1.08-1.45), and 1.36 (1.13-1.64) respectively. Among daily smokers, psychotic symptoms were associated with heavy smoking (OR = 1.45, 95% CI = 1.10-1.92), and individuals who initiated daily smoking at ≤15 years of age were 1.22 (95% CI = 1.05-1.42) times more likely to have psychotic symptoms. CONCLUSIONS An increased awareness that psychotic symptoms are associated with smoking is important from a public health and clinical point of view. Future studies that investigate the underlying link between psychotic symptoms and smoking prospectively are warranted.
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Affiliation(s)
- A Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - A Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
| | - J M Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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29
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Koyanagi A, Stickley A, Haro JM. Psychotic-Like Experiences and Nonsuicidal Self-Injury in England: Results from a National Survey [corrected]. PLoS One 2015; 10:e0145533. [PMID: 26700475 PMCID: PMC4689421 DOI: 10.1371/journal.pone.0145533] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/04/2015] [Indexed: 01/08/2023] Open
Abstract
Background Little is known about the association between psychotic-like experiences (PLEs) and nonsuicidal self-injury (NSSI) in the general adult population. Thus, the aim of this study was to examine the association using nationally-representative data from England. Methods Data from the 2007 Adult Psychiatric Morbidity Survey was analyzed. The sample consisted of 7403 adults aged ≥16 years. Five forms of PLEs (mania/hypomania, thought control, paranoia, strange experience, auditory hallucination) were assessed with the Psychosis Screening Questionnaire. The association between PLEs and NSSI was assessed by multivariable logistic regression. Hierarchical models were constructed to evaluate the influence of alcohol and drug dependence, common mental disorders, and borderline personality disorder symptoms on this association. Results The prevalence of NSSI was 4.7% (female 5.2% and male 4.2%), while the figures among those with and without any PLEs were 19.2% and 3.9% respectively. In a regression model adjusted for sociodemographic factors and stressful life events, most types of PLE were significantly associated with NSSI: paranoia (OR 3.57; 95%CI 1.96–6.52), thought control (OR 2.45; 95%CI 1.05–5.74), strange experience (OR 3.13; 95%CI 1.99–4.93), auditory hallucination (OR 4.03; 95%CI 1.56–10.42), and any PLE (OR 2.78; 95%CI 1.88–4.11). The inclusion of borderline personality disorder symptoms in the models had a strong influence on the association between PLEs and NSSI as evidenced by a large attenuation in the ORs for PLEs, with only paranoia continuing to be significantly associated with NSSI. Substance dependence and common mental disorders had little influence on the association between PLEs and NSSI. Conclusions Borderline personality disorder symptoms may be an important factor in the link between PLEs and NSSI. Future studies on PLEs and NSSI should take these symptoms into account.
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Affiliation(s)
- Ai Koyanagi
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, (CIBERSAM), Madrid, Spain
- * E-mail:
| | - Andrew Stickley
- The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, (CIBERSAM), Madrid, Spain
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30
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DeVylder JE, Lehmann M, Chen FP. Social and clinical correlates of the persistence of psychotic experiences in the general population. Schizophr Res 2015; 169:286-291. [PMID: 26386897 DOI: 10.1016/j.schres.2015.08.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/24/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
Abstract
Recent epidemiological evidence suggests that sub-threshold psychotic experiences commonly occur in the general population. When these experiences persist over time, they may increase risk for psychotic disorder or lead to other clinical or functional impairments. The aims of this study were to distinguish the relative importance of sociodemographic factors and clinical factors, including characteristics of the psychotic experiences themselves, in determining the course of psychotic symptoms over time. Participants were drawn from the Collaborative Psychiatric Epidemiology Surveys. We tested for retrospectively-reported predictors of current psychotic experiences among individuals who reported lifetime psychotic experiences, with onset prior to the past year (n=921), using logistic regression. Persistence was primarily related to demographic variables, with lower odds associated with being married and having at least a college education. Individuals reporting prior to the past year auditory hallucinations were more likely to have persistent psychotic experiences than those reporting other types of psychotic experiences. Interventions aiming at strengthening family support and social skills may reduce the likelihood of persistence among individuals with psychotic experiences, thereby reducing risk for psychotic disorders and other related outcomes. Future studies should continue to identify predictors of persistence versus remission and further explore clinical services for those with persistent psychotic experiences.
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Affiliation(s)
- Jordan E DeVylder
- School of Social Work, University of Maryland, Baltimore, United States.
| | - Meshan Lehmann
- School of Social Work, University of Maryland, Baltimore, United States
| | - Fang-Pei Chen
- Department and Graduate Institute of Social Welfare, National Chung Cheng University, Taiwan
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Abstract
BACKGROUND Little is known about the occurrence of psychotic or quasi-psychotic experiences in older people with anxiety disorders. METHODS We used a cross-sectional national probability sample of community-residing individuals to investigate the prevalence and correlates of delusion-like experiences in older people with DSM-IV anxiety disorders. The 2007 Australian National Survey of Mental Health and Well-being (NSMHWB) included 1,905 persons between the ages of 65 and 85 years. Anxiety disorder diagnoses were established using the Composite International Diagnostic Interview (CIDI v3). Participants were asked about three types of delusion-like experiences: thought control or interference, special meaning, and special powers. We used multivariate logistic regression to examine the relationship between a 12-month history of any anxiety disorder and the presence of these delusion-like experiences, adjusting for several potential confounders. RESULTS Eighty-two of 1,905 (4.3%) older people met criteria for an anxiety disorder over the previous 12 months. Of these, six reported delusion-like experiences, whereas the prevalence of these experiences among older people without anxiety disorder was 26/1,822 (7.3% vs. 1.4%; χ(2) = 16.5; p = 0.000). In a logistic regression model, male gender (OR 0.38; p = 0.019), separated marital status (OR 4.86; p = 0.017), and the presence of anxiety disorder (OR 5.33; p = 0.001) were independently associated with delusion-like experiences, whereas MMSE (Mini-Mental State Examination) score, general medical conditions and affective disorder were not. CONCLUSIONS In this cross-sectional study, self-reported delusion-like experiences occurred at increased prevalence among community-residing older persons with anxiety disorder. More work is needed to clarify the nature and significance of these findings.
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McGrath JJ, Saha S, Al-Hamzawi A, Alonso J, Bromet EJ, Bruffaerts R, Caldas-de-Almeida JM, Chiu WT, de Jonge P, Fayyad J, Florescu S, Gureje O, Haro JM, Hu C, Kovess-Masfety V, Lepine JP, Lim CW, Mora MEM, Navarro-Mateu F, Ochoa S, Sampson N, Scott K, Viana MC, Kessler RC. Psychotic Experiences in the General Population: A Cross-National Analysis Based on 31,261 Respondents From 18 Countries. JAMA Psychiatry 2015; 72:697-705. [PMID: 26018466 PMCID: PMC5120396 DOI: 10.1001/jamapsychiatry.2015.0575] [Citation(s) in RCA: 339] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Community-based surveys find that many otherwise healthy individuals report histories of hallucinations and delusions. To date, most studies have focused on the overall lifetime prevalence of any of these psychotic experiences (PEs), which might mask important features related to the types and frequencies of PEs. OBJECTIVE To explore detailed epidemiologic information about PEs in a large multinational sample. DESIGN, SETTING, AND PARTICIPANTS We obtained data from the World Health Organization World Mental Health Surveys, a coordinated set of community epidemiologic surveys of the prevalence and correlates of mental disorders in representative household samples from 18 countries throughout the world, from 2001 through 2009. Respondents included 31,261 adults (18 years and older) who were asked about lifetime and 12-month prevalence and frequency of 6 types of PEs (2 hallucinatory experiences and 4 delusional experiences). We analyzed the data from March 2014 through January 2015. MAIN OUTCOMES AND MEASURES Prevalence, frequency, and correlates of PEs. RESULTS Mean lifetime prevalence (SE) of ever having a PE was 5.8% (0.2%), with hallucinatory experiences (5.2% [0.2%]) much more common than delusional experiences (1.3% [0.1%]). More than two-thirds (72.0%) of respondents with lifetime PEs reported experiencing only 1 type. Psychotic experiences were typically infrequent, with 32.2% of respondents with lifetime PEs reporting only 1 occurrence and 31.8% reporting only 2 to 5 occurrences. We found a significant relationship between having more than 1 type of PE and having more frequent PE episodes (Cochran-Armitage z = -10.0; P < .001). Lifetime prevalence estimates (SEs) were significantly higher among respondents in middle- and high-income countries than among those in low-income countries (7.2% [0.4%], 6.8% [0.3%], and 3.2% [0.3%], respectively; χ²₂ range, 7.1-58.2; P < .001 for each) and among women than among men (6.6% [0.2%] vs 5.0% [0.3%]; χ²₁ = 16.0; P < .001). We found significant associations with lifetime prevalence of PEs in the multivariate model among nonmarried compared with married respondents (χ²₂ = 23.2; P < .001) and among respondents who were not employed (χ²₄= 10.6; P < .001) and who had low family incomes (χ²₃ = 16.9; P < .001). CONCLUSIONS AND RELEVANCE The epidemiologic features of PEs are more nuanced than previously thought. Research is needed that focuses on similarities and differences in the predictors of the onset, course, and consequences of distinct PEs.
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Affiliation(s)
- John J. McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Discipline of Psychiatry, University of Queensland, St Lucia, QLD 4072, Australia,Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia,Corresponding author: Professor John McGrath, Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, 4076, Australia. , Phone: +61 7 3271 8694, Fax: +61 7 3271 8698
| | - Sukanta Saha
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia,Discipline of Psychiatry, University of Queensland, St Lucia, QLD 4072, Australia,Queensland Brain Institute, University of Queensland, St Lucia, QLD 4072, Australia
| | - Ali Al-Hamzawi
- College of Medicine, Al-Qadisiya University, Diwania governorate, Iraq
| | - Jordi Alonso
- Health Services Research Unit, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain,CIBER en EpidemiologÕïa y Salud Puïblica (CIBERESP), Barcelona, Spain
| | - Evelyn J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine
| | - Ronny Bruffaerts
- Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Belgium
| | - José Miguel Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Peter de Jonge
- University of Groningen, University Medical Center, Groningen Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - John Fayyad
- Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), Beirut, Lebanon
| | - Silvia Florescu
- National School of Public Health, Management and Professional Development, Bucharest, Romania
| | - Oye Gureje
- Department of Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Spain
| | - Chiyi Hu
- Shenzhen Insitute of Mental Health & Shenzhen Kanging Hospital, China
| | - Viviane Kovess-Masfety
- Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France
| | - Jean Pierre Lepine
- Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes Paris, France
| | - Carmen W. Lim
- Department of Psychological Medicine, Dunedin School of Medecine, University of Otago, New Zealand
| | | | - Fernando Navarro-Mateu
- Subdirección General de Salud Mental y Asistencia Psiquiátrica. Servicio Murciano de Salud, El Palmar (Murcia), Spain
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - Kate Scott
- Department of Psychological Medicine, Dunedin School of Medecine, University of Otago, New Zealand
| | - Maria Carmen Viana
- Department of Social Medicine, Federal University of Espírito Santo, Brazil
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Bortolon C, Raffard S. Self-reported psychotic-like experiences in individuals with obsessive-compulsive disorder versus schizophrenia patients: characteristics and moderation role of trait anxiety. Compr Psychiatry 2015; 57:97-105. [PMID: 25464835 DOI: 10.1016/j.comppsych.2014.10.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 10/15/2014] [Accepted: 10/20/2014] [Indexed: 01/22/2023] Open
Abstract
Psychotic-like experiences (PLEs) have been found to manifest themselves on a continuum spanning both the general and clinical populations. Despite robust evidence that anxiety disorders are associated with increased risk of PLEs, little is known about their characteristics in obsessive compulsive disorder (OCD). Therefore, this study aimed to explore the phenomenological similarities and differences of PLEs in OCD versus schizophrenia patients and healthy controls, and to test the impact of distress symptomatology on PLEs in OCD patients. The survey included the Peter et al. Delusion Inventory, the Launay-Slade Hallucinations Scale, the Beck Depression Inventory II, the Spielberger State-Trait Anxiety Inventory, and measures of severity of OCD and schizophrenia symptoms. Considering the clinical groups as a whole, few differences were found for both delusions and hallucination-like experiences. Nevertheless, after controlling for emotional distress differences between OCD and schizophrenia patients in some PLEs became significant. Moreover, obsessive symptoms moderated by anxiety trait predicted levels of delusion-like experiences in OCD patients. This study highlights PLEs are also present in OCD patients, in particularly in presence of higher emotional distress and that anxiety trait plays a relevant role in the development and maintenance of delusion-like experiences in OCD patients.
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Affiliation(s)
- Catherine Bortolon
- Epsylon Laboratory, EA 4556, Montpellier, France; University Department of Adult Psychiatry, CHRU Montpellier, Montpellier, France.
| | - Stéphane Raffard
- Epsylon Laboratory, EA 4556, Montpellier, France; University Department of Adult Psychiatry, CHRU Montpellier, Montpellier, France
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DeVylder JE, Burnette D, Yang LH. Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples. Psychol Med 2014; 44:3503-13. [PMID: 25065632 DOI: 10.1017/s0033291714000944] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Prior research with racially/ethnically homogeneous samples has demonstrated widespread co-occurrence of psychotic experiences (PEs) and common mental health conditions, particularly multi-morbidity, suggesting that psychosis may be related to the overall severity of psychiatric disorder rather than any specific subtype. In this study we aimed to examine whether PEs are associated with the presence of specific disorders or multi-morbidity of co-occurring disorders across four large racially/ethnically diverse samples of adults in the USA. METHOD Data were drawn from the National Comorbidity Survey Replication (NCS-R), the National Survey of American Life (NSAL) and separately from the Asian and Latino subsamples of the National Latino and Asian American Study (NLAAS). Logistic regression models were used to examine the relationship between PEs and individual subtypes of DSM-IV disorder, and to test for a linear dose-response relationship between the number of subtypes and PEs. RESULTS Prevalence of PEs was moderately greater among individuals with each subtype of disorder in each data set [odds ratios (ORs) 1.8-3.8], although associations were only variably significant when controlling for clinical and demographic variables. However, the sum of disorder subtypes was related to odds for PEs in a linear dose-response fashion across all four samples. CONCLUSIONS PEs are related primarily to the extent or severity of psychiatric illness, as indicated by the presence of multiple psychiatric disorders, rather than to any particular subtype of disorder in these data. This relationship applies to the general population and across diverse racial/ethnic groups.
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Affiliation(s)
- J E DeVylder
- Columbia University School of Social Work,New York, NY,USA
| | - D Burnette
- Columbia University School of Social Work,New York, NY,USA
| | - L H Yang
- Mailman School of Public Health,Columbia University,New York, NY,USA
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Asher L, Zammit S, Sullivan S, Dorrington S, Heron J, Lewis G. The relationship between psychotic symptoms and social functioning in a non-clinical population of 12year olds. Schizophr Res 2013; 150:404-9. [PMID: 24021878 DOI: 10.1016/j.schres.2013.08.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 08/21/2013] [Accepted: 08/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Psychotic symptoms are common in adolescents in the general population but it is unknown whether they are associated with poor social functioning. AIMS To investigate whether adolescent psychotic symptoms are associated with poor social functioning measured by peer relationships. METHOD Data from the Avon Longitudinal Study of Parents and Children cohort was used. Logistic regression was used to explore the relationship between psychotic symptoms at 12.9years detected using a semi-structured interview and poor social functioning at 13.2years using parent-reported peer problems from the Strengths and Difficulties Questionnaire. RESULTS There was strong evidence (p<0.001) of an unadjusted association between psychotic symptoms and poor social functioning (OR 1.41, 95% CI 1.24-1.61). The association was attenuated after adjusting for earlier social functioning, socio-demographic variables, bullying status and IQ (OR 1.28, 95% CI 1.09-1.50). The majority of the crude association was explained by additional adjustment for emotional problems including depression at age 12, emotional symptoms, hyperactivity and conduct problems at age 11 (OR 1.07, 95% CI 0.89-1.29). CONCLUSION Adolescents with psychotic symptoms may be no more likely to have poor social functioning than other adolescents, once other emotional problems have been taken into account. The discussion addressed two explanations. First, emotional problems may be on the causal pathway from psychotic symptoms to poor social functioning. Alternatively, emotional symptoms may act as a confounder, suggesting that medical intervention may be inappropriate. It is the impact of psychotic symptoms on the individual that should dictate whether any intervention is required.
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Affiliation(s)
- Laura Asher
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
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Service use for mental health problems in people with delusional-like experiences: a nationwide population based survey. PLoS One 2013; 8:e71951. [PMID: 23991012 PMCID: PMC3749219 DOI: 10.1371/journal.pone.0071951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/04/2013] [Indexed: 11/22/2022] Open
Abstract
Objective Previous population-based studies have found that delusional-like experiences (DLEs) are prevalent in the community, and are associated with a wide range of mental health disorders. The aim of the study was to investigate mental health service use by people with DLEs. Methods Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007 of 8 841community residents aged between 16 and 85 years. The Composite International Diagnostic Interview (CIDI) was used to identify DLEs. Service utilization was assessed using a module that elicited information about hospital admissions, consultations with various health professionals, and prescription medication use. This study focussed on service use for mental health problems. We used logistic regression to examine the association, adjusting for potential confounding factors. Results Of 8 773 included participants, 8.4% (n = 776) positively endorsed one or more DLEs. With respect to consultations for mental health needs, individuals who endorsed DLEs were more likely to consult health professionals compared with those who did not endorse DLEs. Individuals with DLEs were also more likely to use prescription medicine. When we repeated the main analysis in a subgroup excluding any CIDI diagnosis of mental health disorders the results remained largely unchanged. Conclusions DLEs are common in the general population, and individuals with DLEs have an increased rate of accessing services for their mental health needs. Individuals endorsing both DLEs and increased help-seeking may identify a group of vulnerable people who have increased risk of developing psychotic illnesses later in life. This needs closer scrutiny in longitudinal prospective studies.
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Saha S, Stedman TJ, Scott JG, McGrath JJ. The co-occurrence of common mental and physical disorders within Australian families: a national population-based study. Aust N Z J Psychiatry 2013; 47:754-61. [PMID: 23630393 DOI: 10.1177/0004867413486841] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Because comorbidity between mental and physical disorders is commonly found in patients, it would be expected that this pattern would also be reflected at the family level. During a recent population-based survey of common mental disorders, respondents were asked about the presence of selected mental and physical disorders in their relatives. The aim of this research was to describe the within-family co-occurrence of selected common physical and mental disorders in a population-based sample. METHODS Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. A modified version of the World Mental Health Survey Initiative of the Composite International Diagnostic Interview (WMH-CIDI 3.0, henceforth CIDI) was used to identify lifetime-ever common psychiatric disorders (anxiety disorders, depression, drug or alcohol disorders). The respondents were asked if any of their relatives had one of a list of psychiatric (anxiety, bipolar disorder, depression, drug or alcohol problem, schizophrenia) or general physical disorders (cancer, heart problems, intellectual disability, memory problems). We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. RESULTS Compared to otherwise-well respondents, those who had a CIDI diagnosis of major depressive disorders, anxiety disorders, or drug or alcohol abuse/dependence were significantly more likely to have first-degree relatives with (a) the same diagnosis as the respondent, (b) other mental disorders not identified in the respondent, and (c) a broad range of general physical conditions. CONCLUSIONS Individuals with common mental disorders report greater familial co-occurrence for a range of mental and physical disorders. When eliciting family histories, clinicians should remain mindful that both mental and physical disorders can co-occur within families.
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Affiliation(s)
- Sukanta Saha
- Queensland Centre for Mental Health Research, Brisbane, Australia.
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