The bi-directional associations between psychotic experiences and DSM-IV mental disorders
Published Date:Mar 17 2016
Source:Am J Psychiatry. 173(10):997-1006.
Pubmed Central ID:PMC5175400
Funding:R01 DA016558/DA/NIDA NIH HHS/United States
U01 OH010718/OH/NIOSH CDC HHS/United States
U01 OH010712/OH/NIOSH CDC HHS/United States
R03 TW006481/TW/FIC NIH HHS/United States
R01 MH069864/MH/NIMH NIH HHS/United States
U01 MH060220/MH/NIMH NIH HHS/United States
R01 AG049953/AG/NIA NIH HHS/United States
R01 MH070884/MH/NIMH NIH HHS/United States
R13 MH066849/MH/NIMH NIH HHS/United States
While it is now recognized that psychotic experiences (PEs) 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 PEs and mental disorders.
The WHO World Mental Health (WMH) surveys assessed lifetime prevalence and age-of-onset of PEs and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries.
Temporally primary PEs were significantly associated with subsequent first onset of 8 of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, alcohol abuse), with ORs (95%CI) ranging from 1.3 (1.2–1.5; major depressive disorder) to 2.0 (1.5–2.6; bipolar disorder). In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of PEs, with ORs (95% CI) ranging from 1.5 (1.0–2.1; childhood separation anxiety disorder) to 2.8 (1.0–7.8; anorexia nervosa).
While temporally primary PEs are associated with an elevated risk of several subsequent mental disorders, we found that most mental disorder are associated with an elevated risk of subsequent PEs. Further investigation of the underlying factors accounting for these time-order relationships might shed light on the etiology of PEs.
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