Abstract
Stress has a central role in most theories of psychosis etiology, but the relation between stress and psychosis has rarely been examined in large population-level data sets, particularly in low- and middle-income countries. We used data from 39 countries in the World Health Survey (n = 176 934) to test the hypothesis that stress sensitivity would be associated with psychotic experiences, using logistic regression analyses. Respondents in low-income countries reported higher stress sensitivity (P <. 001) and prevalence of psychotic experiences (P <. 001), compared to individuals in middle-income countries. Greater stress sensitivity was associated with increased odds for psychotic experiences, even when adjusted for co-occurring anxiety and depressive symptoms: adjusted odds ratio (95% CI) = 1.17 (1.15-1.19) per unit increase in stress sensitivity (range 2-10). This association was consistent and significant across nearly every country studied, and translated into a difference in psychotic experience prevalence ranging from 6.4% among those with the lowest levels of stress sensitivity up to 22.2% among those with the highest levels. These findings highlight the generalizability of the association between psychosis and stress sensitivity in the largest and most globally representative community-level sample to date, and support the targeting of stress sensitivity as a potential component of individual- and population-level interventions for psychosis.
Original language | English (US) |
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Pages (from-to) | 1353-1362 |
Number of pages | 10 |
Journal | Schizophrenia bulletin |
Volume | 42 |
Issue number | 6 |
DOIs | |
State | Published - Nov 1 2016 |
Keywords
- psychosis
- schizophrenia
- stress
- World Health Survey
ASJC Scopus subject areas
- Psychiatry and Mental health