The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders

Abstract

Objective 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. Methods 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. Results 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). Conclusions 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.

Psychotic experiences and disability: Findings from the Collaborative Psychiatric Epidemiology Surveys

“…Extant research suggests psychotic experiences are useful indicators of general health. In addition to being associated with an increased risk for psychotic disorder (Dominguez et al, 2011), psychotic experiences are associated with increased risk for a wide variety of adverse health outcomes such as (non-psychotic) mental disorders (DeVylder et al, 2014; Kelleher et al, 2012; McGrath et al, 2016; Wigman et al, 2012) and physical disorders (Moreno et al, 2013; Oh & DeVylder, 2015), as well as suicidal behavior (DeVylder et al, 2015; Kelleher et al, 2013), and perceived need for help and treatment-seeking behaviors (DeVylder et al, 2014; Murphy et al, 2010; Oh et al, 2015). …”

Commentary on Degenhardt et al. (2018): Cause or consequence? Disentangling the relationship between psychosis and substance use

“…While a wealth of research during the past 15 years has examined the co-occurrence of PE with common mental disorders [4][5][6][7][8], the relationship between PE and substance use disorders has been less well explored. In fact, many studies on PE have, as a matter of course, excluded PE that arise in the context of substance use because of an assumption that substance-related PE differ from other PE in their significance, although this assumption is questionable [9].…”

Breaking down the genetics of depression using brain endophenotypes

“…In our sample, comorbidities were widespread across the diagnoses (Table 5, Supplementary Document 3) consistent with previous epidemiological results [40,118,122,124,129,[138][139][140] and explained in part by genetic correlations between psychiatric diagnoses [10,11]. Thus, about 65.2% of our sample met the criteria for at least one DSM-5 diagnosis, with 29.3% of these reporting a second lifetime diagnoses, and 11.5% having 3 or more comorbid diagnoses.…”

“…In addition, MDD was also associated with presence of psychotic symptoms, previously reported in an Australian sample [139] and in a world-wide mega-analysis [140]. An association between Social Anxiety and psychotic symptoms had also been reported [139,140] but did not reach significance in our study. Furthermore, we replicated the known link between social anxiety and risk of CUD and AUD [141].…”

“…Furthermore, AUD and CUD were associated with higher rates of panic attacks [127] and manic episodes [142]. Finally, AUD was more likely to be reported by individuals with social anxiety [141], while CUD was more common in individuals reporting psychotic symptoms [140]. Age of onset was not collected for alcohol abuse, dependence and use disorder.…”