Journal
PSYCHOLOGICAL MEDICINE
Volume 48, Issue 16, Pages 2730-2739Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291718000363
Keywords
Arthritis; asthma; diabetes; general medical conditions; headache; heart disease; mental disorders; pain; physical disorders; psychotic experiences
Categories
Funding
- United States National Institute of Mental Health (NIMH) [R01 MH070884]
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- United States Public Health Service [R13-MH066849, R01-MH069864, R01 DA016558]
- Fogarty International Center (FIRCA) [R03-TW006481]
- Pan American Health Organization
- Eli Lilly and Company
- Ortho-McNeil Pharmaceutical Inc.
- Bristol-Myers Squibb
- Argentinian Ministry of Health (Ministerio de Salud de la Nacion)
- Ministry of Social Protection
- Fondo de Investigacion Sanitaria, Instituto de Salud Carlos III, Spain [FIS 00/0028]
- Ministerio de Ciencia y Tecnologia, Spain [SAF 2000-158-CE]
- Departament de Salut, Generalitat de Catalunya, Spain
- GlaxoSmithKline
- Iraqi IMHS team
- European Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF)
- National Council on Science and Technology [CONACyT-G30544]
- PanAmerican Health Organization (PAHO)
- New Zealand Ministry of Health, Alcohol Advisory Council
- Health Research Council
- Champalimaud Foundation
- Foundation for Science and Technology (FCT)
- Ministry of Health
- Shenzhen Bureau of Health
- Shenzhen Bureau of Science, Technology, and Information
- National Institute of Psychiatry Ramon de la Fuente [INPRFMDIES 4280]
- Japanese Funds through United Nations Development Group Iraq Trust Fund (UNDG ITF)
- National Institute of Health of the Ministry of Health of Peru
- Gulbenkian Foundation
- Ministry of Public Health
- Eli Lilly Romania SRL
- National Institute of Mental Health (NIMH) [U01-MH60220]
- National Institute of Drug Abuse (NIDA)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- Robert Wood Johnson Foundation (RWJF) [044708]
- Australian National Health and Medical Research Council [APP1056929]
- FOGARTY INTERNATIONAL CENTER [R03TW006481] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [R01MH069864, R01MH070884, R13MH066849, U01MH060220] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [R01DA016558] Funding Source: NIH RePORTER
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Background. Previous work has identified associations between psychotic experiences (PEs) and general medical conditions (GMCs), but their temporal direction remains unclear as does the extent to which they are independent of comorbid mental disorders. Methods. In total, 28 002 adults in 16 countries from the WHO World Mental Health (WMH) Surveys were assessed for PEs, GMCs and 21 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) mental disorders. Discrete-time survival analyses were used to estimate the associations between PEs and GMCs with various adjustments. Results. After adjustment for comorbid mental disorders, temporally prior PEs were significantly associated with subsequent onset of 8/12 GMCs (arthritis, back or neck pain, frequent or severe headache, other chronic pain, heart disease, high blood pressure, diabetes and peptic ulcer) with odds ratios (ORs) ranging from 1.3 [95% confidence interval (CI) 1.1-1.5] to 1.9 (95% CI 1.4-2.4). In contrast, only three GMCs (frequent or severe headache, other chronic pain and asthma) were significantly associated with subsequent onset of PEs after adjustment for comorbid GMCs and mental disorders, with ORs ranging from 1.5 (95% CI 1.2-1.9) to 1.7 (95% CI 1.2-2.4). Conclusions. PEs were associated with the subsequent onset of a wide range of GMCs, independent of comorbid mental disorders. There were also associations between some medical conditions (particularly those involving chronic pain) and subsequent PEs. Although these findings will need to be confirmed in prospective studies, clinicians should be aware that psychotic symptoms may be risk markers for a wide range of adverse health outcomes. Whether PEs are causal risk factors will require further research.
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