The continuum of psychotic symptoms in the general population: a cross-national study.
OBJECTIVE
To identify the cross-national prevalence of psychotic symptoms in the general population and to analyze their impact on health status.


METHODS
The sample was composed of 256,445 subjects (55.9% women), from nationally representative samples of 52 countries worldwide participating in the World Health Organization's World Health Survey. Standardized and weighted prevalence of psychotic symptoms were calculated in addition to the impact on health status as assessed by functioning in multiple domains.


RESULTS
Overall prevalences for specific symptoms ranged from 4.80% (SE = 0.14) for delusions of control to 8.37% (SE = 0.20) for delusions of reference and persecution. Prevalence figures varied greatly across countries. All symptoms of psychosis produced a significant decline in health status after controlling for potential confounders. There was a clear change in health impact between subjects not reporting any symptom and those reporting at least one symptom (effect size of 0.55).


CONCLUSIONS
The prevalence of the presence of at least one psychotic symptom has a wide range worldwide varying as much as from 0.8% to 31.4%. Psychotic symptoms signal a problem of potential public health concern, independent of the presence of a full diagnosis of psychosis, as they are common and are related to a significant decrement in health status. The presence of at least one psychotic symptom is related to a significant poorer health status, with a regular linear decrement in health depending on the number of symptoms.
Nuevo
Roberto
R
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
Chatterji
Somnath
S
Verdes
Emese
E
Naidoo
Nirmala
N
Arango
Celso
C
Ayuso-Mateos
José Luis
JL
D000328:Adult; D000349:Africa / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D003702:Delusions / Q000145:classification / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006212:Hallucinations / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D013020:South America / Q000453:epidemiology; D014944:World Health Organization