TY - JOUR
T1 - Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries
AU - Koyanagi, A.
AU - Stubbs, B.
AU - Lara, E.
AU - Veronese, N.
AU - Vancampfort, D.
AU - Smith, L.
AU - Haro, J. M.
AU - Oh, H.
AU - DeVylder, J. E.
PY - 2018/12/26
Y1 - 2018/12/26
N2 - AIMS: Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. METHODS: Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. RESULTS: The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16-1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18-44 years OR = 1.19 (95% CI 1.17-1.20); 45-64 years OR = 1.15 (95% CI 1.12-1.17); ⩾65 years OR = 1.14 (95% CI 1.09-1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). CONCLUSIONS: SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.
AB - AIMS: Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. METHODS: Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. RESULTS: The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16-1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18-44 years OR = 1.19 (95% CI 1.17-1.20); 45-64 years OR = 1.15 (95% CI 1.12-1.17); ⩾65 years OR = 1.14 (95% CI 1.09-1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). CONCLUSIONS: SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.
KW - Cognition
KW - epidemiology
KW - low- and middle-income countries
KW - psychotic experiences
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U2 - 10.1017/S2045796018000744
DO - 10.1017/S2045796018000744
M3 - Article
C2 - 30585571
AN - SCOPUS:85076376819
SN - 2045-7960
VL - 29
SP - e11
JO - Epidemiology and Psychiatric Sciences
JF - Epidemiology and Psychiatric Sciences
ER -