Physical injury and psychotic experiences in 48 low- A nd middle-income countries

A. Stickley, T. Sumiyoshi, Z. Narita, H. Oh, J. E. Devylder, L. Jacob, A. Koyanagi

Research output: Contribution to journalArticlepeer-review


BackgroundPsychotic experiences (PEs) may be associated with injuries, but studies focusing specifically on low- A nd middle-income countries (LAMICs) are scarce. Thus, the current study examined the link between injuries and PEs in a large number of LAMICs.MethodCross-sectional data were used from 242 952 individuals in 48 LAMICs that were collected during the World Health Survey in 2002-2004 to examine the association between traffic-related and other (non-traffic-related) forms of injury and PEs. Multivariable logistic regression analysis and meta-analysis were used to examine associations while controlling for a variety of covariates including depression.ResultsIn fully adjusted analyses, any injury [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.85-2.31], traffic injury (OR 1.84, 95% CI 1.53-2.21) and other injury (OR 2.09, 95% CI 1.84-2.37) were associated with higher odds for PEs. Results from a country-wise analysis showed that any injury was associated with significantly increased odds for PEs in 39 countries with the overall pooled OR estimated by meta-analysis being 2.46 (95% CI 2.22-2.74) with a moderate level of between-country heterogeneity (I2 = 56.3%). Similar results were observed across all country income levels (low, lower-middle and upper-middle).ConclusionsDifferent types of injury are associated with PEs in LAMICs. Improving mental health systems and trauma capacity in LAMICs may be important for preventing injury-related negative mental health outcomes.

Original languageEnglish (US)
Pages (from-to)2751-2758
JournalPsychological Medicine
Issue number16
StatePublished - Dec 2020


  • Delusion
  • epidemiology
  • hallucination
  • injuries
  • World Health Survey

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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