title: Poverty, low education, and the expression of psychotic-like experiences in the general population of São Paulo, Brazil.
abstract: The aim of our study was to assess psychotic-like experiences in the general population aged 18-30 years old of the city of São Paulo, Brazil. A household survey was conducted with 1950 young-adults randomly drawn from the city's general population. The validated 92-item Portuguese version of the Prodromal Questionnaire (PQ) was used for face-to-face interviews. Latent class analysis was conducted. Mean age was of 24 years; 51.1% of the sample was of women. Mean total score on the PQ was 22.06 (SD=17.16). Considering a suggested cut-off of 14 in the positive subscale, 30.8% of individuals were above the threshold for ultra-high risk for psychosis detection. Latent class analysis resulted in a three classes clusterization. Class 1 (20%; n=390) had the highest overall PQ scores (mean=49.31,SD=10.783), class 2 (43%; n=835) had intermediate scores (mean=23.37,SD=6.56), and class 3 (37%; n=721) had the lowest scores (mean=5.81,SD=3.74). Class 1 had significantly more individuals with less education and significantly more individuals with lower socioeconomic class. Poverty and low education might be associated with the psychotic expression in the general population, amplifying their actions on the psychosis gradient in developing countries. The psychosis continuum might be constituted by three distinct quantitatively different classes.
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil. Electronic address: alexandre.loch@usp.br.
authors.forename: Alexandre Andrade
authors.initials: AA
authors.lastname: Loch
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Camille
authors.initials: C
authors.lastname: Chianca
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Tania Maria
authors.initials: TM
authors.lastname: Alves
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Elder Lanzani
authors.initials: EL
authors.lastname: Freitas
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Hortêncio
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Andrade
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Martinus Theodorus
authors.initials: MT
authors.lastname: van de Bilt
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Marcos Roberto
authors.initials: MR
authors.lastname: Fontoni
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil; Laboratory of Psychiatric Neuroimaging (LIM-21), Department & Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), Nuclear Medicine Center, University of Sao Paulo, Brazil.
authors.forename: Mauricio H
authors.initials: MH
authors.lastname: Serpa
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil.
authors.forename: Wagner Farid
authors.initials: WF
authors.lastname: Gattaz
authors.affiliation: Laboratory of Neuroscience - LIM 27, Department & Institute of Psychiatry, Faculty of Medicine, University of Sao Paulo, Brazil; University Hospital of Psychiatry, University of Zurich, Switzerland; Department of Psychiatry and Psychotherapy, Charité, University Medicine, Campus Mitte, Berlin, Germany.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty / Q000523:psychology*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: At risk mental state; Psychosis; Psychosis continuum; Schizophrenia; Ultra high risk