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Title: The associations between psychotic experiences and substance use and substance use disorders: findings from the World Health Organization World Mental Health surveys
Authors: Degenhardt, Louisa
Saha, Sukanta
Lim, Carmen C W
Aguilar-Gaxiola, Sergio
Al-Hamzawi, Ali
Alonso, Jordi
Andrade, Laura H
Bromet, Evelyn J
Bruffaerts, Ronny
Caldas-de-Almeida, José Miguel
de Girolamo, Giovanni
Florescu, Silvia
Gureje, Oye
Haro, Josep M
Karam, Elie G.
Karam, Georges
Kovess-Masfety, Viviane
Lee, Sing
Lepine, Jean-Pierre
Makanjuola, Victor
Medina-Mora, Maria E
Mneimneh, Zeina
Navarro-Mateu, Fernando
Piazza, Marina
Posada-Villa, José
Sampson, Nancy A
Scott, Kate M
Stagnaro, Juan Carlos
Ten Have, Margreet
Kendler, Kenneth S
Kessler, Ronald C
McGrath, John J
Affiliations: Faculty of Medicine 
Keywords: Alcohol
Mental disorder
Prescription drug
Psychotic experiences
Substance abuse disorder
Substance dependence disorder
Substance use
Issue Date: 2018
Publisher: National Library of Medicine
Part of: Addiction
Volume: 113
Issue: 5
Start page: 924
End page: 934
Background and aims
Prior research has found bidirectional associations between psychotic experiences (PEs), and selected substance use disorders. We aimed to extend this research by examining the bidirectional association between PEs, and various types of substance use (SU), and substance use disorders (SUDs), and the influence of antecedent mental disorders on these associations.

Design, setting, participants and measurements
We used data from the World Health Organisation World Mental Health surveys. A total of 30,902 adult respondents across 18 countries were assessed for (a) six types of lifetime PEs, (b) a range of types of SU and DSM-IV SUDs, and (c) mental disorders using the Composite International Diagnostic Interview. Discrete-time survival analyses based on retrospective age-at-onset reports examined the bidirectional associations between PEs and SU/SUDs controlling for antecedent mental disorders.

After adjusting for demographics, comorbid SU/SUDs and antecedent mental disorders, those with prior alcohol use disorders (OR=1.6, 95% CI=1.2–2.0), extra-medical prescription drug use (OR=1.5, 95% CI=1.1–1.9), alcohol use (OR=1.4, 95% CI=1.1–1.7), and tobacco use (OR=1.3, 95% CI=1.0–1.8) had increased odds of subsequent first onset of PEs. In contrast, those with temporally prior PEs had increased odds of subsequent onset of tobacco use (OR=1.5, 95% CI=1.2–1.9), alcohol use (OR=1.3, 95% CI=1.1–1.6) or cannabis use (OR=1.3, 95% CI=1.0–1.5) as well as of all substance use disorders (ORs ranged between 1.4 and 1.5). There was a dose response relationship between both count and frequency of PEs and increased subsequent odds of selected SU/SUDs.

Associations between psychotic experiences (PEs) and substance use/substance use disorders (SU/SUDs) are often bidirectional, but not all types of SU/SUDs are associated with PEs. These findings suggest that it is important to be aware of the presence of PEs within those with SUDs or at risk of SUDs, given the plausibility that they may each impact upon the other.
ISSN: 09652140
DOI: 10.1111/add.14145
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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