Schizophrenia Bulletin Advance Access published online on August 17, 2009
Schizophrenia Bulletin, doi:10.1093/schbul/sbp083
Psychotic-Like Experiences in Major Depression and Anxiety Disorders: A Population-Based Survey in Young Adults
2 Department of Psychiatry, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia
3 Department of Psychiatry, University of Queensland, St Lucia, Queensland 4072, Australia
4 Child and Youth Mental Health Service, Royal Children's Hospital, Herston, Queensland 4029, Australia
5 Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia
6 Mater Children's Hospital, South Brisbane, Queensland 4101, Australia
7 School of Population Health, University of Queensland, Herston, Queensland 4029, Australia
8 Queensland Brain Institute, University of Queensland, St Lucia, Queensland 4076, Australia
1 To whom correspondence should be addressed; tel: +61-7-3271-8694, fax: +61-7-3271-8698, e-mail: john_mcgrath{at}qcmhr.uq.edu.au.
Objective: Population-based surveys have confirmed that psychotic-like experiences are prevalent in the community. However, it is unclear if these experiences are associated with common mental disorders. The aim of this study was to examine the prevalence of psychotic-like experiences in those with affective and anxiety disorders. Methods: Subjects were drawn from the Mater-University of Queensland Study of Pregnancy. Delusion-like experiences were assessed with the Peters Delusional Inventory (PDI). The Composite International Diagnostic Interview (CIDI) was used to identify individuals with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) lifetime diagnoses of major depression, anxiety disorder, substance use/dependence, and psychotic disorders. The influence of affective and anxiety disorders on PDI and CIDI psychosis-related items’ scores were assessed with logistic regression, with adjustments for age, sex, and the presence of the other comorbid psychiatric diagnoses. Results: Having either a lifetime diagnosis of major depressive disorder or an anxiety disorder was associated with significantly higher PDI total scores (highest vs lowest quartile adjusted odds ratios [ORs] and 95% confidence intervals [CIs] = 4.43, 3.09–6.36; 3.08, 2.26–4.20, respectively). The odds of endorsing any CIDI hallucination or delusion item was increased in those with a major depressive or anxiety disorder. The presence of current anxiety disorder symptoms was significantly associated with PDI score (OR = 5.81, 95% CI = 3.68–9.16). Conclusion: While psychotic-like experiences are usually associated with psychotic disorders, individuals with depression and anxiety are also more likely to report these symptoms compared with well individuals. Psychotic-like experiences are associated with a range of common mental disorders.
Keywords: psychotic-like experience / depression / anxiety / epidemiology / birth cohort