Psychotic experiences in the population: Association with functioning and mental distress

Kelleher, Ian; Wigman, Johanna T. W.; Harley, Michelle; O’Hanlon, Erik; Coughlan, Helen; Rawdon, Caroline; Murphy, Jamie; Power, Emmet; Higgins, Noelle; Cannon, Mary

doi:10.1016/j.schres.2015.03.020

Cited by 122 publications

(109 citation statements)

References 49 publications

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“…The findings contribute to a growing body of literature suggesting that PEs, regardless of the presence or absence of mental disorders, are linked to functional impairment (15). However, alternative hypotheses cannot be excluded.…”

Section: Discussionsupporting

confidence: 60%

The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

Navarro‐Mateu

Alonso

Lim

et al. 2017

Acta Psychiatr Scand

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Objective While psychotic experiences (PEs) are known to be associated with a range of mental and general medical disorders, little is known about the association between PEs and measures of disability. We aimed to investigate this question using the World Mental Health surveys. Method Lifetime occurrences of 6 types of PEs were assessed along with 21 mental disorders and 14 general medical conditions. Disability was assessed with a modified version of the WHO Disability Assessment Schedule. Descriptive statistics and logistic regression models were used to investigate the association between PEs and high disability scores (top quartile) with various adjustments. Results Respondents with PEs were more likely to have top quartile scores on global disability than respondents without PEs (19.1% vs. 7.5%; χ2 = 190.1, p<.001) as well as greater likelihood of cognitive, social, and role impairment. Relationships persisted in each adjusted model. A significant dose-response relationship was also found for the PE type measures with most of these outcomes. Conclusions Psychotic experiences are associated with disability measures with a dose response relationship. These results are consistent with the view that PEs are associated with disability regardless of the presence of comorbid mental or general medical disorders.

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Section: Discussionsupporting

confidence: 60%

The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

Navarro‐Mateu

Alonso

Lim

et al. 2017

Acta Psychiatr Scand

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“…In keeping with a recent commentary, 28 we do not propose that the presence of isolated PEs is sufficient to identified individuals with an ultra-high risk of later transition to psychotic disorder; however these individuals do have an increased risk of a range of other adverse outcomes, including STBs. We hypothesize that as PEs are associated with both psychological distress 29 and disability, 30,31 these factors may be sufficient to contribute to the emergence of subsequent STBs. We note, however, that it is conceivable that PEs and STBs may both emerge during a prodromal phase of a later mental disorder (i.e., a disorder with an age of onset after prior STBs).…”

Section: Discussionmentioning

confidence: 99%

Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors

et al. 2017

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IMPORTANCE Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life-course or if mental disorders (antecedent to the STBs) contribute to these associations. OBJECTIVE To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations. DESIGN, SETTING, AND PARTICIPANTS A total of 33,370 adult respondents across 19 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, STBs (ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onsets of STBs. MAIN OUTCOMES AND MEASURES Prevalence and frequency of STBs with PEs, and odds ratios and 95%CIs. Results Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5%(1.3), 10.8%(0.7), and 10.2%(0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95%CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95%CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95%CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively. Conclusions PEs are associated with elevated odds of subsequent STBs across the life-course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs.

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“…These traits are commonly observed in trauma survivors, in fact a dissociative subtype of PTSD has been included in the DSM-5 [94,95,117] and a dissociation trait predicts future PTSD [58]. Psychoticism (and closely-related schizotypal personality disorder) has been associated with numerous general risk factors for psychopathology that can also impinge on physical health and functioning [118][119][120][121][122], which might explain its associations with all signature WTC disorders. Another explanation for the broad associations between perceptual dysregulation and initial levels of health and functioning problems could be common genetic vulnerability, as genetic overlap had previously been found for perceptual dysregulation, and insomnia and depression symptoms [123,124].…”

Section: Personality Facets and Initial Health Consequences Of Traumamentioning

confidence: 99%

Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

Waszczuk

Ruggero

et al. 2018

Annals of Behavioral Medicine

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Background Personality is a major predictor of many mental and physical disorders, but its contributions to illness course are understudied. Purpose The current study aimed to explore whether personality is associated with a course of psychiatric and medical illness over 10 years following trauma. Methods World Trade Center (WTC) responders (N = 532) completed the personality inventory for DSM-5, which measures both broad domains and narrow facets. Responders' mental and physical health was assessed in the decade following the WTC disaster during annual monitoring visits at a WTC Health Program clinic. Multilevel modeling was used in an exploratory manner to chart the course of health and functioning, and examine associations of maladaptive personality domains and facets with intercepts (initial illness) and slopes (course) of illness trajectories.Results Three maladaptive personality domains-negative affectivity, detachment and psychoticism-were uniquely associated with initial posttraumatic stress disorder (PTSD); detachment and psychoticism were also associated with initial functional impairment. Five facets-emotional lability, anhedonia, callousness, distractibility and perceptual dysregulation-were uniquely associated with initial mental and physical health and functional impairment. Anxiousness and depressivity facets were associated with worse initial levels of psychiatric outcomes only. With regard to illness trajectory, callousness and perceptual dysregulation were associated with the increase in PTSD symptoms. Anxiousness was associated with greater persistence of respiratory symptoms. Conclusions Several personality domains and facets were associated with initial levels and long-term course of illness and functional impairment in a traumatized population. Results inform the role of maladaptive personality in the development and maintenance of chronic mental-physical comorbidity. Personality might constitute a transdiagnostic prognostic and treatment target.

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Psychotic experiences in the population: Association with functioning and mental distress

Cited by 122 publications

References 49 publications

The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys

Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors

Maladaptive Personality Traits and 10-Year Course of Psychiatric and Medical Symptoms and Functional Impairment Following Trauma

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