The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries.
Journal: Psychological medicine
Volume: 47
Issue: 7
Year of Publication: 2017
Affiliated Institutions:
Queensland Centre for Mental Health Research, andQueensland Brain Institute,University of Queensland,Australia.
Department of Psychology,University of Washington,Seattle,Washington,USA.
Center for Reducing Health Disparities,UC Davis Health System,Sacramento,California,USA.
College of Medicine, Al-Qadisiya University,Diwaniya governorate,Iraq.
Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain.
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg,Leuven,Belgium.
IRCCS St John of God Clinical Research Centre,IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy.
Department of Developmental Psychology,Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen,Groningen,The Netherlands.
Department of Psychiatry,University of Ibadan,Nigeria.
National School of Public Health, Management and Professional Development,Bucharest,Romania.
Department of Psychiatry,University College Hospital,Ibadan,Nigeria.
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain.
Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China.
Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon.
Ecole des Hautes Etudes en Santé Publique (EHESP), EA Paris Descartes University,Paris,France.
Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
Hôpital Lariboisière Fernand Widal,Assistance Publique Hôpitaux de Paris INSERM UMR-S ,University Paris Diderot and Paris Descartes,Paris,France.
Queensland Brain Institute, The University of Queensland,St. Lucia, Queensland,Australia.
National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor,Michigan,USA.
Universidad Cayetano Heredia,Lima,Peru.
Colegio Mayor de Cundinamarca University,Bogota,Colombia.
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
Department of Social Medicine,Federal University of Espírito Santo,Vitoria,Brazil.
Department of Mental Health,Faculdade de Ciências Médicas,Chronic Diseases Research Center (CEDOC) and Universidade Nova de Lisboa,Campo dos Mártires da Pátria,Lisbon,Portugal.
Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook,New York,USA.
Department of Psychiatry,Virginia Commonwealth University,USA.
Abstract summary
Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9-2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6-20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.
Authors & Co-authors:
McGrath J J JJ
McLaughlin K A KA
Saha S S
Aguilar-Gaxiola S S
Al-Hamzawi A A
Alonso J J
Bruffaerts R R
de Girolamo G G
de Jonge P P
Esan O O
Florescu S S
Gureje O O
Haro J M JM
Hu C C
Karam E G EG
Kovess-Masfety V V
Lee S S
Lepine J P JP
Lim C C W CC
Medina-Mora M E ME
Mneimneh Z Z
Pennell B E BE
Piazza M M
Posada-Villa J J
Sampson N N
Viana M C MC
Xavier M M
Bromet E J EJ
Kendler K S KS
Kessler R C RC
Study Outcome
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