Psychotic experiences in the general population: a cross-national analysis based on 31 261 respondents from 18 countries.

Author: McGrath, J.J., Saha, S., Al Hamzawi, A., Alonso, J., Bromet, E.J., Bruffaerts, R., Caldas de Almeida, J.M., Chiu, W.T., deJonge, P., Fayyad, J., Florescu, S., Gureje, O., Haro, J.M., Hu, C., Kovess Masfety, V., Lepine, J.P., Lim, C.C.W., Medina Mora, M.E.

Source:
JAMA psychiatry, 72(7), 697-705.
IMPORTANCE Community-based surveys find that many otherwise healthy individuals report histories of hallucinations and delusions. To date, most studies have focused on the overall lifetime prevalence of ever having any of these psychotic experiences (PEs), possibly masking important features related to types and frequencies of PEs. OBJECTIVE To explore detailed epidemiological information of PEs in a large cross-national sample. DESIGN, SETTING, AND PARTICIPANTS Data came from the WHO World Mental Health (WMH) Surveys, a coordinated set of community epidemiological surveys of the prevalence and correlates of mental disorders in representative household samples in countries throughout the world. 31 261 adult (aged 18 and older) WMH respondents across 18 countries were asked about lifetime and 12-month prevalence and frequency of six types of PEs (two hallucinatory experiences [HEs] and four delusional experiences [DEs]). MAIN OUTCOMES Prevalence, frequency, and correlates of PEs. RESULTS Mean lifetime prevalence (standard error) of ever having a lifetime PE was 5.8% (0.2), with hallucinatory experiences (5.2% [0.2]) much more common than delusional experiences (1.3% [0.1]), More than two-thirds (72.0%) of respondents with lifetime PEs reported experiencing only one type. PEs were typically infrequent, with 32.2% of respondents with lifetime PEs reporting only one occurrence and an additional 31.8% only 2–5 occurrences. There was a significant relationship between having more than one type of PE and having more frequent PE episodes. Lifetime prevalence estimates were significantly higher among respondents in middle and high income countries than low income countries, women than men, the non-married than the married, not employed and those with low family income. CONCLUSIONS AND RELEVANCE The epidemiology of PEs is more nuanced than previously thought. Research is needed that focuses on similarities and differences in predictors of the onset, course, and consequences of distinct PEs.