John J McGrath1, Sukanta Saha, Ali O Al-Hamzawi2, Jordi Alonso3, Laura Andrade4, Guilherme Borges5, Evelyn J Bromet6, Mark Oakley Browne7, Ronny Bruffaerts8, Jose M Caldas de Almeida9, John Fayyad10, Silvia Florescu11, Giovanni de Girolamo12, Oye Gureje13, Chiyi Hu14, Peter de Jonge15, Viviane Kovess-Masfety16, Jean Pierre Lepine17, Carmen C W Lim18, Fernando Navarro-Mateu19, Maria Piazza20, Nancy Sampson21, José Posada-Villa22, Kenneth S Kendler23, Ronald C Kessler21. 1. j.mcgrath@uq.edu.au. 2. Department of Psychiatry, College of Medicine, Qadisia University, Diwania Province, Iraq; 3. IMIM-Hospital del Mar Medical Research Institute, Parc de Salut Mar, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; 4. Department/Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; 5. National Institute of Psychiatry, Mexico City, Mexico and Metropolitan Autonomous University, Mexico City, Mexico; 6. Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY; 7. Centre for Mental Health, University of Melbourne, Melbourne, Australia; 8. Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuvan, Belgium; 9. Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal; 10. Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; 11. National School of Public Health, Management and Professional Development, Bucharest, Romania; 12. IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; 13. Department of Psychiatry, University College Hospital, Ibadan, Nigeria; 14. Shenzhen Institute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China; 15. Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; 16. Ecole des Hautes Etudes en Santé Publique (EHESP), Paris Descartes University, Paris, France; 17. Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes Paris, Paris, France; 18. Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; 19. IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar (Murcia), Murcia, Spain; 20. National Institute of Health, Peru, Universidad Cayetano Hereidia, Lima, Peru; 21. Department of Health Care Policy, Harvard University, Boston, MA; 22. El Bosque University, Bogota, Colombia; 23. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
Abstract
BACKGROUND: Given the early age of onset (AOO) of psychotic disorders, it has been assumed that psychotic experiences (PEs) would have a similar early AOO. The aims of this study were to describe (a) the AOO distribution of PEs, (b) the projected lifetime risk of PEs, and (c) the associations of PE AOO with selected PE features. METHODS: Data came from the WHO World Mental Health (WMH) surveys. A total of 31 261 adult respondents across 18 countries were assessed for lifetime prevalence of PE. Projected lifetime risk (at age 75 years) was estimated using a 2-part actuarial method. AOO distributions were described for the observed and projected estimates. We examined associations of AOO with PE type metric and annualized PE frequency. RESULTS: Projected lifetime risk for PEs was 7.8% (SE = 0.3), slightly higher than lifetime prevalence (5.8%, SE = 0.2). The median (interquartile range; IQR) AOO based on projected lifetime estimates was 26 (17-41) years, indicating that PEs commence across a wide age range. The AOO distributions for PEs did not differ by sex. Early AOO was positively associated with number of PE types (F = 14.1, P < .001) but negatively associated with annualized PE frequency rates (F = 8.0, P < .001). DISCUSSION: While most people with lifetime PEs have first onsets in adolescence or young adulthood, projected estimates indicate that nearly a quarter of first onsets occur after age 40 years. The extent to which late onset PEs are associated with (a) late onset mental disorders or (b) declining cognitive and/or sensory function need further research.
BACKGROUND: Given the early age of onset (AOO) of psychotic disorders, it has been assumed that psychotic experiences (PEs) would have a similar early AOO. The aims of this study were to describe (a) the AOO distribution of PEs, (b) the projected lifetime risk of PEs, and (c) the associations of PE AOO with selected PE features. METHODS: Data came from the WHO World Mental Health (WMH) surveys. A total of 31 261 adult respondents across 18 countries were assessed for lifetime prevalence of PE. Projected lifetime risk (at age 75 years) was estimated using a 2-part actuarial method. AOO distributions were described for the observed and projected estimates. We examined associations of AOO with PE type metric and annualized PE frequency. RESULTS: Projected lifetime risk for PEs was 7.8% (SE = 0.3), slightly higher than lifetime prevalence (5.8%, SE = 0.2). The median (interquartile range; IQR) AOO based on projected lifetime estimates was 26 (17-41) years, indicating that PEs commence across a wide age range. The AOO distributions for PEs did not differ by sex. Early AOO was positively associated with number of PE types (F = 14.1, P < .001) but negatively associated with annualized PE frequency rates (F = 8.0, P < .001). DISCUSSION: While most people with lifetime PEs have first onsets in adolescence or young adulthood, projected estimates indicate that nearly a quarter of first onsets occur after age 40 years. The extent to which late onset PEs are associated with (a) late onset mental disorders or (b) declining cognitive and/or sensory function need further research.
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