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

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  • Kate M. Scott, University of Otago
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  • Sukanta Saha, The University of Queensland
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  • Carmen C.W. Lim, The University of Queensland
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  • Sergio Aguilar-Gaxiola, UC Davis Health System
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  • Ali Al-Hamzawi, Al-Qadisiya University
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  • Jordi Alonso, Hospital del Mar, Universitat Pompeu Fabra, Barcelona, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)
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  • Corina Benjet, National Institute of Psychiatry Ramón de la Fuente
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  • Evelyn J. Bromet, Stony Brook University School of Medicine
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  • Ronny Bruffærts, Dentistry, University Hospitals, KU Leuven
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  • José Miguel Caldas-De-Almeida, Universidade Nova de Lisboa
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  • Giovanni De Girolamo, IRCCS Istituto Centro San Giovanni di Dio-Fatebenefratelli
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  • Peter De Jonge, Rijksuniversiteit Groningen, Universitair Medisch Centrum Groningen
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  • Louisa Degenhardt, UNSW, National Drug & Alcohol Research Centre
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  • Silvia Florescu, National School of Public Health
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  • Oye Gureje, University College Hospital, Ibadan
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  • Josep M. Haro, Universitat Pompeu Fabra, Barcelona
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  • Chiyi Hu, Shenzhen Kangning Hospital
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  • Elie G. Karam, Balamand University, St George Hospital University Medical Center, Institute for Development Research Advocacy and Applied Care (IDRAAC)
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  • Viviane Kovess-Masfety, Université Descartes, Sorbonne Paris Cité
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  • Sing Lee, Chinese University Hong Kong
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  • Jean Pierre Lepine, Université Descartes, Sorbonne Paris Cité
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  • Zeina Mneimneh, University of Michigan, Ann Arbor, Michigan.
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  • Fernando Navarro-Mateu, Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP)
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  • Marina Piazza, Universidad Cayetano Heredia, University of Rochester
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  • José Posada-Villa, Colegio Mayor de Cundinamarca University
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  • Nancy A. Sampson, Harvard Medical School
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  • Juan Carlos Stagnaro, Universidad de Buenos Aires, Buenos Aires, Argentina.
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  • Ronald C. Kessler, Harvard Medical School
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  • John J. McGrath

Background Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders.Methods In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments.Results After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1-1.5] to 1.9 (95% CI 1.4-2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2-1.9) to 1.7 (95% CI 1.2-2.4).Conclusions PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.

Original languageEnglish
JournalPsychological Medicine
Volume48
Issue16
Pages (from-to)2730-2739
Number of pages10
ISSN0033-2917
DOIs
Publication statusPublished - 1 Dec 2018

    Research areas

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

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