1. Psychotic experiences, psychiatric comorbidity and mental health need in the general population: a cross-sectional and cohort study in Southeast London
- Author
-
Philip McGuire, Vishal Bhavsar, Paolo Fusar-Poli, James H. MacCabe, Sarah Dorrington, Matthew Hotopf, Craig Morgan, John G. Mills, and Stephani L. Hatch
- Subjects
Male ,Suicide, Attempted ,Comorbidity ,Anxiety ,Common mental disorders ,Suicide prevention ,Cohort Studies ,0302 clinical medicine ,London ,Applied Psychology ,education.field_of_study ,public mental health ,psychological treatment ,PTSD ,Middle Aged ,survey analysis ,Psychiatry and Mental health ,transdiagnostic ,Community health ,Female ,epidemiology ,medicine.symptom ,Needs Assessment ,Anxiety disorder ,Adult ,medicine.medical_specialty ,Adolescent ,Population ,Article ,Young Adult ,03 medical and health sciences ,medicine ,Humans ,psychotic experiences ,Psychiatry ,education ,Aged ,Suicide attempt ,business.industry ,longitudinal analysis ,medicine.disease ,Survival Analysis ,Mental health ,030227 psychiatry ,Cross-Sectional Studies ,Psychotic Disorders ,business ,030217 neurology & neurosurgery - Abstract
BackgroundCo-occurrence of common mental disorders (CMD) with psychotic experiences is well-known. There is little research on the public mental health relevance of concurrent psychotic experiences for service use, suicidality, and poor physical health. We aim to: (1) describe the distribution of psychotic experiences co-occurring with a range of non-psychotic psychiatric disorders [CMD, depressive episode, anxiety disorder, probable post-traumatic stress disorder (PTSD), and personality dysfunction], and (2) examine associations of concurrent psychotic experiences with secondary mental healthcare use, psychological treatment use for CMD, lifetime suicide attempts, and poor self-rated health.MethodsWe linked a prospective cross-sectional community health survey with a mental healthcare provider database. For each non-psychotic psychiatric disorder, patients with concurrent psychotic experiences were compared to those without psychotic experiences on use of secondary mental healthcare, psychological treatment for CMD, suicide attempt, physical functioning, and a composite multimorbidity score, using logistic regression and Cox regressions.ResultsIn all disorders except for anxiety disorder, concurrent psychotic experiences were accompanied by a greater odds of all outcomes (odds ratios) for a unit change in composite multimorbidity score ranged between 2.21 [95% confidence interval (CI) 1.49–3.27] and 3.46 (95% CI 1.52–7.85). Hazard ratios for secondary mental health service use for non-psychotic disorders with concurrent psychotic experiences, ranged from 0.53 (95% CI 0.15–1.86) for anxiety disorders with psychotic experiences to 4.99 (95% CI 1.22–20.44) among those with PTSD with psychotic experiences.ConclusionsCo-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.
- Published
- 2019