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Title: 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
Authors: Scott, Kate M
Saha, Sukanta
Lim, Carmen C W
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Benjet, Corina
Bromet, Evelyn J
Bruffaerts, Ronny
Caldas-de-Almeida, José Miguel
de Girolamo, Giovanni
de Jonge, Peter
Degenhardt, Louisa
Florescu, Silvia
Gureje, Oye
Haro, Josep M
Karam, Elie G.
Hu, Chiyi
Kovess-Masfety, Viviane
Lee, Sing
Lepine, Jean-Pierre
Mneimneh, Zeina
Navarro-Mateu, Fernando
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A
Stagnaro, Juan Carlos
Kessler, Ronald C
McGrath, John J
Affiliations: Faculty of Medicine 
Keywords: Arthritis
General medical conditions
Heart disease
Mental disorders
Physical disorders
Psychotic experiences
Issue Date: 2018
Publisher: National Library of Medicine
Part of: Psychological Medicine
Volume: 48
Issue: 16
Start page: 2730
End page: 2739
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.
ISSN: 00332917
DOI: 10.1017/S0033291718000363
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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