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Co-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.
We 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.
In 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.
Co-occurring psychotic experiences indicate greater public mental health burden, suggesting psychotic experiences could be a marker for future preventive strategies improving public mental health.
Most studies of post-traumatic stress disorder (PTSD) in low- and
middle-income countries (LMICs) have focused on ‘high-risk’ populations
defined by exposure to trauma.
To estimate the prevalence of post-traumatic stress disorder (PTSD) in a
LMIC, the conditional probability of PTSD given a traumatic event and the
strength of associations between traumatic events and other psychiatric
Our sample contained a mix of 3995 twins and 2019 non-twins. We asked
participants about nine different traumatic exposures, including the
category ‘other’, but excluding sexual trauma.
Traumatic events were reported by 36.3% of participants and lifetime PTSD
was present in 2.0%. Prevalence of non-PTSD lifetime diagnosis was 19.1%.
Of people who had experienced three or more traumatic events, 13.3% had
lifetime PTSD and 40.4% had a non-PTSD psychiatric diagnosis.
Despite high rates of exposure to trauma, this population had lower rates
of PTSD than high-income populations, although the prevalence might have
been slightly affected by the exclusion of sexual trauma. There are high
rates of non-PTSD diagnoses associated with trauma exposure that could be
considered in interventions for trauma-exposed populations. Our findings
suggest that there is no unique relationship between traumatic
experiences and the specific symptomatology of PTSD.