The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

J J McGrath¹, K A McLaughlin², S Saha¹, S Aguilar-Gaxiola³, A Al-Hamzawi⁴, J Alonso⁵, R Bruffaerts⁶, G de Girolamo⁷, P de Jonge⁸, O Esan⁹, S Florescu¹⁰, O Gureje¹¹, J M Haro¹², C Hu¹³, E G Karam¹⁴, V Kovess-Masfety¹⁵, S Lee¹⁶, J P Lepine¹⁷, C C W Lim¹⁸, M E Medina-Mora¹⁹, Z Mneimneh²⁰, B E Pennell²⁰, M Piazza²¹, J Posada-Villa²², N Sampson²³, M C Viana²⁴, M Xavier²⁵, E J Bromet²⁶, K S Kendler²⁷, R C Kessler²³

Affiliations

¹ Queensland Centre for Mental Health Research, andQueensland Brain Institute,University of Queensland,Australia.
² Department of Psychology,University of Washington,Seattle,Washington,USA.
³ Center for Reducing Health Disparities,UC Davis Health System,Sacramento,California,USA.
⁴ College of Medicine, Al-Qadisiya University,Diwaniya governorate,Iraq.
⁵ Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain.
⁶ Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg,Leuven,Belgium.
⁷ IRCCS St John of God Clinical Research Centre,IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy.
⁸ Department of Developmental Psychology,Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen,Groningen,The Netherlands.
⁹ Department of Psychiatry,University of Ibadan,Nigeria.
¹⁰ National School of Public Health, Management and Professional Development,Bucharest,Romania.
¹¹ Department of Psychiatry,University College Hospital,Ibadan,Nigeria.
¹² Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain.
¹³ Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China.
¹⁴ Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon.
¹⁵ Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris,France.
¹⁶ Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
¹⁷ Hôpital Lariboisière Fernand Widal,Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144,University Paris Diderot and Paris Descartes,Paris,France.
¹⁸ Queensland Brain Institute, The University of Queensland,St. Lucia, Queensland,Australia.
¹⁹ National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
²⁰ Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor,Michigan,USA.
²¹ Universidad Cayetano Heredia,Lima,Peru.
²² Colegio Mayor de Cundinamarca University,Bogota,Colombia.
²³ Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
²⁴ Department of Social Medicine,Federal University of Espírito Santo,Vitoria,Brazil.
²⁵ Department of Mental Health,Faculdade de Ciências Médicas,Chronic Diseases Research Center (CEDOC) and Universidade Nova de Lisboa,Campo dos Mártires da Pátria,Lisbon,Portugal.
²⁶ Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook,New York,USA.
²⁷ Department of Psychiatry,Virginia Commonwealth University,USA.

PMID: 28065209
PMCID: PMC5590103
DOI: 10.1017/S0033291716003263

The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

J J McGrath et al. Psychol Med. 2017 May.

. 2017 May;47(7):1230-1245.

doi: 10.1017/S0033291716003263. Epub 2017 Jan 9.

Authors

Affiliations

¹ Queensland Centre for Mental Health Research, andQueensland Brain Institute,University of Queensland,Australia.
² Department of Psychology,University of Washington,Seattle,Washington,USA.
³ Center for Reducing Health Disparities,UC Davis Health System,Sacramento,California,USA.
⁴ College of Medicine, Al-Qadisiya University,Diwaniya governorate,Iraq.
⁵ Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain.
⁶ Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL),Campus Gasthuisberg,Leuven,Belgium.
⁷ IRCCS St John of God Clinical Research Centre,IRCCS Centro S. Giovanni di Dio Fatebenefratelli,Brescia,Italy.
⁸ Department of Developmental Psychology,Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen,Groningen,The Netherlands.
⁹ Department of Psychiatry,University of Ibadan,Nigeria.
¹⁰ National School of Public Health, Management and Professional Development,Bucharest,Romania.
¹¹ Department of Psychiatry,University College Hospital,Ibadan,Nigeria.
¹² Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona,Barcelona,Spain.
¹³ Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital,Shenzhen,China.
¹⁴ Department of Psychiatry and Clinical Psychology, Faculty of Medicine,Balamand University,Beirut,Lebanon.
¹⁵ Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University,Paris,France.
¹⁶ Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
¹⁷ Hôpital Lariboisière Fernand Widal,Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144,University Paris Diderot and Paris Descartes,Paris,France.
¹⁸ Queensland Brain Institute, The University of Queensland,St. Lucia, Queensland,Australia.
¹⁹ National Institute of Psychiatry Ramón de la Fuente,Mexico City,Mexico.
²⁰ Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor,Michigan,USA.
²¹ Universidad Cayetano Heredia,Lima,Peru.
²² Colegio Mayor de Cundinamarca University,Bogota,Colombia.
²³ Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
²⁴ Department of Social Medicine,Federal University of Espírito Santo,Vitoria,Brazil.
²⁵ Department of Mental Health,Faculdade de Ciências Médicas,Chronic Diseases Research Center (CEDOC) and Universidade Nova de Lisboa,Campo dos Mártires da Pátria,Lisbon,Portugal.
²⁶ Department of Psychiatry,Stony Brook University School of Medicine,Stony Brook,New York,USA.
²⁷ Department of Psychiatry,Virginia Commonwealth University,USA.

PMID: 28065209
PMCID: PMC5590103
DOI: 10.1017/S0033291716003263

Abstract

Background: Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.

Method: We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.

Results: Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9-2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6-20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).

Conclusions: Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.

Keywords: Childhood adversity; World Mental Health survey; discrete-time survival analysis; maladaptive family functioning; population attributable risk proportion; psychotic experiences.

PubMed Disclaimer

Conflict of interest statement

Competing interests: In the past 3 years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis, was a consultant for Johnson & Johnson Wellness and Prevention, and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. Kessler is a co-owner of DataStat, Inc., a market research firm that carries out healthcare research.

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The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

Affiliations

The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23 998 respondents from 17 countries

Authors

Affiliations

Abstract

Conflict of interest statement

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References

MeSH terms

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Medical