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The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders
Open accessAbstract
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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“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
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Metadata
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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