The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders
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OBJECTIVE: While it is now recognized that psychotic experiences 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 psychotic experiences and mental disorders. Using data from World Health Organization World Mental Health (WMH) Surveys, the authors assessed the bidirectional temporal associations between psychotic experiences and mental disorders. METHOD: The WMH Surveys assessed lifetime prevalence and age at onset of psychotic experiences and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries. Discrete-time survival models were used to examine bivariate and multivariate associations between psychotic experiences and mental disorders. RESULTS: Temporally primary psychotic experiences were significantly associated with subsequent first onset of eight of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, posttraumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, and alcohol abuse), with odds ratios ranging from 1.3 (95% CI=1.2-1.5) for major depressive disorder to 2.0 (95% CI=1.5-2.6) for bipolar disorder. In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of psychotic experiences, with odds ratios ranging from 1.5 (95% CI=1.0-2.1) for childhood separation anxiety disorder to 2.8 (95% CI=1.0-7.8) for anorexia nervosa. CONCLUSIONS: While temporally primary psychotic experiences are associated with an elevated risk of several subsequent mental disorders, these data show that most mental disorders are associated with an elevated risk of subsequent psychotic experiences. Further investigation of the underlying factors accounting for these time-order relationships may shed light on the etiology of psychotic experiences.
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Prior WMH analyses have found models with dummy variables for three and four or more disorders and constant multiplier constraints to be useful.
“Models of this form have been shpwn to be useful in a number of prior WMH analyses (e.g., Stein et al. 2016; McGrath et al. 2016).”
From Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO World Mental Health (WMH) surveys (2018) · cites this paper as McGrath et al. 2016
The Method > Statistical Analysis section describes WMH models with dummy predictors for exactly three and more than three prior disorders, and says these predictors characterize non-additive associations. Our copy does not describe constant multiplier constraints, so it supports the cited example only in part. (LLM, conf=0.85)
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A latent class analysis of psychotic symptoms in the general population
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A neural efficiency-threshold model to understand psychotic experiences
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Steenkamp, L. R., de Neve-Enthoven, N. D., João, A., Bouter, D., Hillegers, M., Hoogendijk, W., Blanken, L., Kushner, S., Tiemeier, H., Mil, N. G. G.-V., et al. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.05.006 · Cited by 22 · see citing works
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Psychotic symptoms in adolescents with borderline personality disorder features
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Psychotic experiences and future school performance in childhood: a population‐based cohort study
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Ethnic disparities in psychotic experiences explained by area-level syndemic effects
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Very early hallucinatory experiences: a school‐based study
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Health Conditions and Psychotic Experiences: Cross-Sectional Findings From the American Life Panel
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During day and night: Childhood psychotic experiences and objective and subjective sleep problems
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Self-citationMoods in Clinical Depression Are More Unstable than Severe Normal Sadness
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What mediates the longitudinal relationship between psychotic experiences and psychopathology?
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- Authors
- McGrath, J. J., Saha, S., Al-Hamzawi, A., Andrade, L., Benjet, C., Bromet, E. J., Browne, M. O., Caldas de Almeida, J. M., Chiu, W. T., Demyttenaere, K., Fayyad, J., Florescu, S., de Girolamo, G., Gureje, O., Haro, J. M., ten Have, M., Hu, C., Kovess-Masfety, V., Lim, C. C. W., Navarro-Mateu, F., Sampson, N., Posada-Villa, J., Kendler, K. S., & Kessler, R. C.
- Affiliations
- The University of Queensland (AU)
- From the Queensland Centre for Mental Health Research, Park Centre for Mental Health, Wacol, Australia; the Discipline of Psychiatry and the Queensland Brain Institute, University of Queensland, St. Lucia, Australia; the College of Medicine, Al-Qadisiya University, Diwania Governorate, Iraq; the Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; the Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramon de la Fuente,...
- Universitat Autònoma de Barcelona (ES)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2016-10-01
- Volume
- 173
- Issue
- 10
- Pages
- 997-1006
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC5175400
- OpenAlex
- W2299849456
- Cited by
- 235
- References
- 35
- Citations by year
- 2026: 15 · 2025: 18 · 2024: 24 · 2023: 21 · 2022: 27 · 2021: 14 · 2020: 23 · 2019: 25 · 2018: 37 · 2017: 23 · 2016: 8
- FWCI
- 27.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (acceptedVersion)
- HAL (submittedVersion)
- RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, public-domain)
- Funders
- Robert Wood Johnson Foundation (044708)
- John D. and Catherine T. MacArthur Foundation (R01 DA016558, R13-MH066849)
- John W. Alden Trust (APP1056929)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- Sanofi
- World Health Organization
- F. Hoffmann-La Roche
- European Commission (1999-01042, QLG5–1999-01042, 2004123)
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- Generalitat de Catalunya (01042, CB06/02/0046)
- Bundesministerium für Gesundheit
- Universidade de Lisboa
- Regione Piemonte (00/0028)
- Fakultet Medicinskih Nauka, Univerziteta U Kragujevcu
- Servier
- H. Lundbeck A/S
- Fundação Champalimaud
- Ministerio de Salud
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Centers for Disease Control and Prevention
- Substance Abuse and Mental Health Services Administration
- U.S. Public Health Service (R13‐MH066849, R01‐MH069864 and R01 DA016558, R01-DA016558, R13‐MH066849, R01- MH069864)
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849)
- Pan American Health Organization
- Medical Research Council
- National Health and Medical Research Council (1056929)
- Fundação para a Ciência e a Tecnologia
- Instituto de Salud Carlos III (CB06/02/0046, RD06/0011, FIS 00/0028)
- Departament de Salut, Generalitat de Catalunya
- National Institute on Aging (R01AG049953)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, U01-MH-60220, MH60220, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558)
- Fogarty International Center (R01-TW006481, R03TW006481)
- National Institute for Occupational Safety and Health (U01 OH010718, U01 OH010712)
- Cilag
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- psychotic experiences, mental illness, bidirectional relationship, temporal order, major depressive disorder, bipolar disorder, generalized anxiety disorder, social anxiety disorder, post-traumatic stress disorder, separation anxiety disorder, bulimia nervosa, alcohol abuse, anorexia nervosa, etiology of psychosis, World Mental Health Surveys
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Health Surveys, Humans, Male, Psychotic Disorders, Time Factors, World Health Organization, Comorbidity, Prevalence, Age of Onset, Diagnostic and Statistical Manual of Mental Disorders, Young Adult
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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