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Posttraumatic stress disorder (PTSD) is a chronic, under-detected and under-treated psychiatric consequence of trauma that is often linked to new-onset medical and psychological conditions, impaired quality of life and long-term disability across the globe. This book is the first systematic analysis of the rates, risk factors, consequences and global burden of trauma and PTSD across a variety of wealthy and underdeveloped settings. An analysis of a global survey conducted by the World Health Organization and featuring findings from over 70,000 participants around the world, this text demonstrates a unique perspective on the prevalence of exposure to trauma and PTSD and the impact it has on population health. The findings inside this text underscore the urgent need for policymakers and healthcare providers to prioritize interventions aimed at reducing the burden of trauma, PTSD and its consequences.
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.
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.
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).
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.