title: Age of Onset and Lifetime Projected Risk of Psychotic Experiences: Cross-National Data From the World Mental Health Survey.
abstract: Given the early age of onset (AOO) of psychotic disorders, it has been assumed that psychotic experiences (PEs) would have a similar early AOO. The aims of this study were to describe (a) the AOO distribution of PEs, (b) the projected lifetime risk of PEs, and (c) the associations of PE AOO with selected PE features.
  
  
  
  Data came from the WHO World Mental Health (WMH) surveys. A total of 31 261 adult respondents across 18 countries were assessed for lifetime prevalence of PE. Projected lifetime risk (at age 75 years) was estimated using a 2-part actuarial method. AOO distributions were described for the observed and projected estimates. We examined associations of AOO with PE type metric and annualized PE frequency.
  
  
  
  Projected lifetime risk for PEs was 7.8% (SE = 0.3), slightly higher than lifetime prevalence (5.8%, SE = 0.2). The median (interquartile range; IQR) AOO based on projected lifetime estimates was 26 (17-41) years, indicating that PEs commence across a wide age range. The AOO distributions for PEs did not differ by sex. Early AOO was positively associated with number of PE types (F = 14.1, P < .001) but negatively associated with annualized PE frequency rates (F = 8.0, P < .001).
  
  
  
  While most people with lifetime PEs have first onsets in adolescence or young adulthood, projected estimates indicate that nearly a quarter of first onsets occur after age 40 years. The extent to which late onset PEs are associated with (a) late onset mental disorders or (b) declining cognitive and/or sensory function need further research.
authors.affiliation: j.mcgrath@uq.edu.au.
authors.forename: John J
authors.initials: JJ
authors.lastname: McGrath
authors.forename: Sukanta
authors.initials: S
authors.lastname: Saha
authors.affiliation: Department of Psychiatry, College of Medicine, Qadisia University, Diwania Province, Iraq;
authors.forename: Ali O
authors.initials: AO
authors.lastname: Al-Hamzawi
authors.affiliation: IMIM-Hospital del Mar Medical Research Institute, Parc de Salut Mar, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain;
authors.forename: Jordi
authors.initials: J
authors.lastname: Alonso
authors.affiliation: Department/Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil;
authors.forename: Laura
authors.initials: L
authors.lastname: Andrade
authors.affiliation: National Institute of Psychiatry, Mexico City, Mexico and Metropolitan Autonomous University, Mexico City, Mexico;
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.affiliation: Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY;
authors.forename: Evelyn J
authors.initials: EJ
authors.lastname: Bromet
authors.affiliation: Centre for Mental Health, University of Melbourne, Melbourne, Australia;
authors.forename: Mark
authors.initials: M
authors.lastname: Oakley Browne
authors.affiliation: Universitair Psychiatrisch Centrum-Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuvan, Belgium;
authors.forename: Ronny
authors.initials: R
authors.lastname: Bruffaerts
authors.affiliation: Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal;
authors.forename: Jose M
authors.initials: JM
authors.lastname: Caldas de Almeida
authors.affiliation: Institute for Development, Research, Advocacy and Applied Care (IDRAAC), 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: IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy;
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Girolamo
authors.affiliation: Department of Psychiatry, University College Hospital, Ibadan, Nigeria;
authors.forename: Oye
authors.initials: O
authors.lastname: Gureje
authors.affiliation: Shenzhen Institute of Mental Health & Shenzhen Kanging Hospital, Shenzhen, China;
authors.forename: Chiyi
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
authors.affiliation: Ecole des Hautes Etudes en Santé Publique (EHESP), 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 INSERM UMR-S 1144, University Paris Diderot and Paris Descartes Paris, 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: IMIB-Arrixaca, CIBERESP-Murcia, Subdirección General de Salud Mental y Asistencia Psiquiátrica, Servicio Murciano de Salud, El Palmar (Murcia), Murcia, Spain;
authors.forename: Fernando
authors.initials: F
authors.lastname: Navarro-Mateu
authors.affiliation: National Institute of Health, Peru, Universidad Cayetano Hereidia, Lima, Peru;
authors.forename: Maria
authors.initials: M
authors.lastname: Piazza
authors.affiliation: Department of Health Care Policy, Harvard University, Boston, MA;
authors.forename: Nancy
authors.initials: N
authors.lastname: Sampson
authors.affiliation: El Bosque University, Bogota, Colombia;
authors.forename: José
authors.initials: J
authors.lastname: Posada-Villa
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Kendler
authors.affiliation: Department of Health Care Policy, Harvard University, Boston, MA;
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology*; D012306:Risk; D055815:Young Adult
keywords: World Mental Health Survey; age of onset; epidemiology; lifetime prevalence; psychotic experiences