TY - JOUR
T1 - Psychotic Experiences and Related Distress
T2 - A Cross-national Comparison and Network Analysis Based on 7141 Participants From 13 Countries
AU - Genetic Risk and OUtcome of Psychosis (GROUP) Investigators
AU - Wüsten, Caroline
AU - Schlier, Björn
AU - Jaya, Edo S
AU - Fonseca-Pedrero, Eduardo
AU - Peters, Emmanuelle
AU - Verdoux, Hélène
AU - Woodward, Todd S
AU - Ziermans, Tim B
AU - Lincoln, Tania M
AU - Study group members AMC, null
AU - de Haan, Lieuwe
N1 - With supplementary materials
PY - 2018/10/17
Y1 - 2018/10/17
N2 - Psychotic experiences (PEs) are common in the general population but do not necessarily reflect a risk status if they occur in relative isolation or are not distressing. Emerging evidence suggests that PEs might be experienced as more benign for individuals from collectivistic low- and middle-income countries (LAMIC) compared with individualistic high-income countries (HIC). The aim of this study was to determine whether: (1) self-reported PEs are less distressing in community samples from LAMIC than from HIC; (2) the network of PEs is significantly less connected in a sample from LAMIC than from HIC. Adults from 8 HIC (n = 4669) and 5 LAMIC (n = 2472) were compared. The lifetime frequency of PEs and related distress were assessed with the Community Assessment of Psychic Experiences. We analyzed the associations of PEs with distress and country type. The interconnection of PEs was visualized by a network analysis and tested for differences in global connection strengths. The average endorsement rates of PEs were significantly higher in LAMIC than in HIC (χ2 = 1772.87, P < .01, Φcramer = 0.50). There was a universal positive correlation between higher frequency of PEs and more distress, but the distress levels controlled for frequency were significantly higher in HIC (R2 = 0.11; b = 0.26; SE = 0.01; T = 17.68; P < .001). Moreover, the network of PEs was significantly less connected in LAMIC (S = 0.40, P < .05). The findings indicate that PEs are of less clinical relevance in LAMIC compared with HIC. The universal use of current high-risk criteria might thus not be adequate without consideration of associated distress and cultural values.
AB - Psychotic experiences (PEs) are common in the general population but do not necessarily reflect a risk status if they occur in relative isolation or are not distressing. Emerging evidence suggests that PEs might be experienced as more benign for individuals from collectivistic low- and middle-income countries (LAMIC) compared with individualistic high-income countries (HIC). The aim of this study was to determine whether: (1) self-reported PEs are less distressing in community samples from LAMIC than from HIC; (2) the network of PEs is significantly less connected in a sample from LAMIC than from HIC. Adults from 8 HIC (n = 4669) and 5 LAMIC (n = 2472) were compared. The lifetime frequency of PEs and related distress were assessed with the Community Assessment of Psychic Experiences. We analyzed the associations of PEs with distress and country type. The interconnection of PEs was visualized by a network analysis and tested for differences in global connection strengths. The average endorsement rates of PEs were significantly higher in LAMIC than in HIC (χ2 = 1772.87, P < .01, Φcramer = 0.50). There was a universal positive correlation between higher frequency of PEs and more distress, but the distress levels controlled for frequency were significantly higher in HIC (R2 = 0.11; b = 0.26; SE = 0.01; T = 17.68; P < .001). Moreover, the network of PEs was significantly less connected in LAMIC (S = 0.40, P < .05). The findings indicate that PEs are of less clinical relevance in LAMIC compared with HIC. The universal use of current high-risk criteria might thus not be adequate without consideration of associated distress and cultural values.
UR - https://pure.uva.nl/ws/files/30032484/sby087_suppl_supplementary_materials.doc
UR - https://pure.uva.nl/ws/files/30032486/sby087_suppl_cape_country.xls
UR - https://pure.uva.nl/ws/files/30032488/sby087_suppl_subgroup_hic.xls
UR - https://pure.uva.nl/ws/files/30032490/sby087_suppl_subgroup_lmic.xls
U2 - https://doi.org/10.1093/schbul/sby087
DO - https://doi.org/10.1093/schbul/sby087
M3 - Article
C2 - 29982814
SN - 0586-7614
VL - 44
SP - 1185
EP - 1194
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 6
ER -