title: Psychotic Experiences in the General Population: A Cross-National Analysis Based on 31,261 Respondents From 18 Countries.
abstract: OBJECTIVE
  Community-based surveys find that many otherwise healthy individuals report histories of hallucinations and delusions. To date, most studies have focused on the overall lifetime prevalence of any of these psychotic experiences (PEs), which might mask important features related to the types and frequencies of PEs.
  
  
  OBJECTIVE
  To explore detailed epidemiologic information about PEs in a large multinational sample.
  
  
  METHODS
  We obtained data from the World Health Organization World Mental Health Surveys, a coordinated set of community epidemiologic surveys of the prevalence and correlates of mental disorders in representative household samples from 18 countries throughout the world, from 2001 through 2009. Respondents included 31,261 adults (18 years and older) who were asked about lifetime and 12-month prevalence and frequency of 6 types of PEs (2 hallucinatory experiences and 4 delusional experiences). We analyzed the data from March 2014 through January 2015.
  
  
  METHODS
  Prevalence, frequency, and correlates of PEs.
  
  
  RESULTS
  Mean lifetime prevalence (SE) of ever having a PE was 5.8% (0.2%), with hallucinatory experiences (5.2% [0.2%]) much more common than delusional experiences (1.3% [0.1%]). More than two-thirds (72.0%) of respondents with lifetime PEs reported experiencing only 1 type. Psychotic experiences were typically infrequent, with 32.2% of respondents with lifetime PEs reporting only 1 occurrence and 31.8% reporting only 2 to 5 occurrences. We found a significant relationship between having more than 1 type of PE and having more frequent PE episodes (Cochran-Armitage z = -10.0; P < .001). Lifetime prevalence estimates (SEs) were significantly higher among respondents in middle- and high-income countries than among those in low-income countries (7.2% [0.4%], 6.8% [0.3%], and 3.2% [0.3%], respectively; χ²₂ range, 7.1-58.2; P < .001 for each) and among women than among men (6.6% [0.2%] vs 5.0% [0.3%]; χ²₁ = 16.0; P < .001). We found significant associations with lifetime prevalence of PEs in the multivariate model among nonmarried compared with married respondents (χ²₂ = 23.2; P < .001) and among respondents who were not employed (χ²₄= 10.6; P < .001) and who had low family incomes (χ²₃ = 16.9; P < .001).
  
  
  CONCLUSIONS
  The epidemiologic features of PEs are more nuanced than previously thought. Research is needed that focuses on similarities and differences in the predictors of the onset, course, and consequences of distinct PEs.
authors.affiliation: Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia2Discipline of Psychiatry, University of Queensland, St Lucia, Australia3Queensland Brain Institute, University of Queensland, St Lucia, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: McGrath
authors.affiliation: Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Australia2Discipline of Psychiatry, University of Queensland, St Lucia, Australia3Queensland Brain Institute, University of Queensland, St Lucia, Australia.
authors.forename: Sukanta
authors.initials: S
authors.lastname: Saha
authors.affiliation: College of Medicine, Al-Qadisiya University, Al Diwaniya City, Iraq.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Hamzawi
authors.affiliation: Health Services Research Unit, Instituto Hospital del Mar de Investigaciones Médicas, Institut de Recerca Hospital del Mar, Barcelona, Spain6Centros de Investigación Biomédica en Red (CIBER) en Epidemiologõïa y Salud Puïblica, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York.
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.affiliation: Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven, Campus Gasthuisberg, Leuven, Belgium.
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.affiliation: Chronic Diseases Research Center and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Caldas-de-Almeida
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Wai Tat
authors.initials: WT
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation, University of Groningen, University Medical Center, Groningen, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.affiliation: Institute for Development, Research, Advocacy, and Applied Care, Beirut, Lebanon.
authors.forename: John
authors.initials: J
authors.lastname: Fayyad
authors.affiliation: National School of Public Health, Management and Professional Development, Bucharest, Romania.
authors.forename: Silvia
authors.initials: S
authors.lastname: Florescu
authors.affiliation: Department of Psychiatry, University College Hospital, Ibadan, Nigeria.
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.affiliation: Parc Sanitari Sant Joan de Déu, Centros de Investigación Biomédica en Red de Salud Mental, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Shenzhen Insitute of Mental Health and Shenzhen Kanging Hospital, Shenzhen, China.
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: Ecole des Hautes Etudes en Santé Publique, EA 4057 Paris Descartes University, Paris, France.
authors.forename: Viviane
authors.initials: V
authors.lastname: Kovess-Masfety
authors.affiliation: Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, Institut National de la Santé et de la Recherche Médicale, l'Unité Mixte de Recherche S 1144, University Paris Diderot and Paris Descartes, Paris, France.
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Lepine
authors.affiliation: Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Carmen C W
authors.initials: CC
authors.lastname: Lim
authors.affiliation: National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
authors.forename: Maria Elena Medina
authors.initials: ME
authors.lastname: Mora
authors.affiliation: Subdirección General de Salud Mental, Servicio Murciano de Salud, Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Murcia, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
authors.affiliation: Parc Sanitari Sant Joan de Déu, Centros de Investigación Biomédica en Red de Salud Mental, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Ochoa
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Kate
authors.initials: K
authors.lastname: Scott
authors.affiliation: Department of Social Medicine, Federal University of Espírito Santo, Vitória, Brazil.
authors.forename: Maria Carmen
authors.initials: MC
authors.lastname: Viana
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003702:Delusions / Q000453:epidemiology*; D005260:Female; D014943:Global Health; D006212:Hallucinations / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D055815:Young Adult