title: Correlates of hallucinations in schizophrenia: A cross-cultural evaluation.
abstract: BACKGROUND
  Demographic, clinical and familial factors may plausibly influence the manifestation of hallucinations. It is unclear if the pattern of the effects is similar in different environmental/cultural settings.
  
  
  OBJECTIVE
  To evaluate factors associated with hallucination from a demographic, clinical and familial perspective in two distinct cultural settings.
  
  
  METHODS
  Patients with a clinical diagnosis of schizophrenia (SZ) or schizoaffective disorder (SZA) were diagnosed systematically using DSM IV criteria. Two independent samples were recruited in India and USA using identical inclusion/exclusion criteria and assessment procedures (n=1287 patients total; 807 Indian and 480 US participants). The association of key demographic and clinical factors with hallucinations of different modalities was examined. To evaluate the impact of familial factors, we separately analyzed correlations among affected sibling pairs (ASPs, n=136, Indian; n=77, US).
  
  
  RESULTS
  The prevalence of different modalities of hallucinations differed in the Indian and US samples, though the rank order of frequency was similar. The pattern of associations between selected variables and the risk of hallucinations was different across cultures, except for some correlations with indices of severity. No significant concordance was observed among the ASPs after correcting for multiple comparisons.
  
  
  CONCLUSIONS
  The factors associated with hallucinations vary across environments. Our results are consistent with a multi-factorial etiology of psychopathology, but re-direct attention to endophenotypic features in the causal chain that precede the symptoms themselves.
authors.affiliation: Indo-US project "Genetic Susceptibility in Schizophrenia", Department of Psychiatry, Dr. RML Hospital, Delhi, India.
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Mathur
authors.forename: I I
authors.initials: II
authors.lastname: Gottesman
authors.forename: R
authors.initials: R
authors.lastname: Nagpal
authors.forename: V L
authors.initials: VL
authors.lastname: Nimgaonkar
authors.forename: S N
authors.initials: SN
authors.lastname: Deshpande
mesh_terms: D000328:Adult; D003431:Cross-Cultural Comparison; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004777:Environment; D005163:Factor Analysis, Statistical; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000208:ethnology* / Q000235:genetics; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D010641:Phenotype; D015995:Prevalence; D011618:Psychotic Disorders / Q000175:diagnosis / Q000208:ethnology / Q000235:genetics; D012559:Schizophrenia / Q000175:diagnosis / Q000208:ethnology* / Q000235:genetics; D014481:United States / Q000453:epidemiology