1
|
Hassiotis A, Noor M, Bebbington P, Ali A, Wieland J, Qassem T. Borderline intellectual functioning and psychosis: Adult Psychiatric Morbidity Survey evidence - CORRIGENDUM. Br J Psychiatry 2024; 224:184. [PMID: 38347829 DOI: 10.1192/bjp.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/24/2024]
|
2
|
Rudra S, McManus S, Hassiotis A, Ali A. Mental health and service use of parents with and without borderline intellectual functioning. Psychol Med 2024; 54:1294-1308. [PMID: 37877259 DOI: 10.1017/s0033291723003136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND People with borderline intellectual functioning (BIF) encounter greater social adversities than the general population and have an increased prevalence of mental illness. However, little is known about the socio-demographic characteristics and mental health of parents with BIF. METHODS A secondary data analysis of the Adult Psychiatric Morbidity Survey 2014 was conducted. Logistic regression models were fitted to compare differences in socio-demographic, mental health and service-use characteristics between parents and non-parents with and without BIF, and to investigate if the relationship between parent status and mental health outcomes was modified by BIF status, sex, and employment. RESULTS Data from 6872 participants was analyzed; 69.1% were parents. BIF parents had higher odds of common mental disorder, severe mental illness, post-traumatic stress disorder, self-harm/suicide and were more likely to see their General Practitioner (GP) and to receive mental health treatment than non-BIF parents. BIF parents did not have a higher prevalence of mental health problems than BIF non-parents. Being a parent, after adjusting for BIF status and other confounders, was associated with increased odds of having a common mental disorder, visits to see a GP and treatment for mental health. Female parents had higher odds of treatment for mental health problems. CONCLUSIONS Being a parent is associated with elevated rates of common mental disorders. There is a higher burden of mental health problems and service use in people with BIF. A greater provision of specialist support services including ascertainment is indicated for this group.
Collapse
Affiliation(s)
| | - Sally McManus
- City University and NatCen Associate; NatCen Social Research, London, UK
| | | | - Afia Ali
- Queen Mary University of London, Wolfson Institute of Population Health, London, UK
| |
Collapse
|
3
|
Martin S, Del-Monte J. Metacognition and insight dynamics exploration in borderline personality disorder: Exploring the underlying dynamics. J Psychiatr Res 2023; 160:225-231. [PMID: 36863299 DOI: 10.1016/j.jpsychires.2023.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
Metacognition and Insight are related to hard-to-treat disorders and among them is Borderline Personality Disorder (BPD). We recruited 190 BPD patients and measured Insight, Metacognition, Impulsivity, and BPD traits. Results showed BPD's significant links with Insight and Metacognition. Metacognition significantly correlated with two Impulsivity dimensions, whereas Insight significantly correlated with most of them. Regressions analysis revealed a significant relationship between Insight and Metacognition on Impulsivity and Borderline traits. Mediation analysis proved the indirect effect of Metacognition/Insight on Borderline traits through Impulsivity at a significative level. Both seem relevant for research and therapeutic application in BPD following different dynamics even if the limitation of our study stands in its gender ratio and possible comorbidity issues. Urgency appears as a critical factor to assess, notably with Positive emotion-based impulsivity.
Collapse
Affiliation(s)
- Sylvia Martin
- Center for Research and Bioethics, Uppsala University, Sweden.
| | - Jonathan Del-Monte
- Nîmes University, Department of Clinical Psychology, France; Psychosocial Laboratory, Aix-Marseille University, France
| |
Collapse
|
4
|
Analysing trends of psychiatric disorders, treatment and service use across time in adults with borderline intellectual impairment: A cross-sectional study of private households. J Psychiatr Res 2022; 151:339-346. [PMID: 35533517 DOI: 10.1016/j.jpsychires.2022.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/08/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
Abstract
While there is evidence that mental health problems are more prevalent in people with borderline intellectual functioning (BIF) compared to the general population, it is not known to what extent this has varied or changed over time and whether there have been changes in access to services. This paper compares the prevalence rates of psychiatric disorders and monitors trends in treatment and services in this population compared to the general population. We conducted secondary analysis on the Adult Psychiatric Morbidity Surveys carried out in England in 2000, 2007 and 2014. The total sample analysed included 21,796 participants, with 12.8% of individuals identified with BIF (n = 2786). Regression models were used to examine trends in psychiatric disorders, treatment and service use across the three datasets. People with BIF had significantly higher odds of developing mood and anxiety disorders, psychosis, drug dependence and suicidal behaviour than the general population, increasing at each subsequent timepoint. They received significantly more pharmacological treatments than the general population but have had increasingly more access to general practitioners, community care and daycare services over time. This study shows increasing prevalence rates of several mental disorders in people with BIF. Access to day-care, community care and healthcare services has increased over time for this group but not formal psychiatric care. These changes over time underline some of the problems this population faces, emphasizing a need to recognize that this is a population often overlooked in research and clinical practice.
Collapse
|
5
|
Nieuwenhuis JG, Lepping P, Mulder NL, Nijman HLI, Veereschild M, Noorthoorn EO. Increased prevalence of intellectual disabilities in higher-intensity mental healthcare settings. BJPsych Open 2021; 7:e83. [PMID: 33883055 PMCID: PMC8086388 DOI: 10.1192/bjo.2021.28] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND It has been suggested that people with intellectual disabilities have a higher likelihood to develop psychiatric disorders, and that their treatment prognosis is relatively poor. AIMS We aimed to establish the prevalence of intellectual disability in different mental healthcare settings, and estimate percentage of cognitive decline. We hypothesised that the prevalence of intellectual disabilities increases with intensity of care. METHOD A cross-sectional study was conducted in different settings in a mental healthcare trust in the Netherlands. We used the Screener for Intelligence and Learning Disabilities (SCIL) to identify suspected mild intellectual disability (MID) or borderline intellectual functioning (BIF). We identified patients with a high level of education and low SCIL score to estimate which patients may have had cognitive decline. RESULTS We included 1213 consecutive patients. Over all settings, 41.4% of participating patients were positive for MID/BIF and 20.2% were positive for MID only. Prevalence of suspected MID/BIF increased by setting, from 27.1% in out-patient settings to 41.9% in flexible assertive community treatment teams and admission wards, to 66.9% in long-stay wards. Only 85 (7.1%) of all patients were identified as possibly having cognitive decline. Of these, 25.9% were in long-stay wards and had a diagnosis of schizophrenia or substance use disorder. CONCLUSIONS Low intellectual functioning is common in Dutch mental healthcare settings. Only a modest number of patients were identified as suffering from cognitive decline rather than suspected MID/BIF from birth. Therefore, we recommend improved screening of psychiatric patients for intellectual functioning at the start of treatment.
Collapse
Affiliation(s)
| | - Peter Lepping
- Centre for Mental Health and Society, Betsi Cadwaladr University, Wales, UK
| | - Niels L Mulder
- Department of Psychiatry, Erasmus University Rotterdam, the Netherlands
| | - Henk L I Nijman
- Behavioural Science Institute, Radboud University, the Netherlands
| | | | | |
Collapse
|
6
|
Papagavriel K, Jones R, Sheehan R, Hassiotis A, Ali A. The association between loneliness and common mental disorders in adults with borderline intellectual impairment. J Affect Disord 2020; 277:954-961. [PMID: 33065838 DOI: 10.1016/j.jad.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 07/17/2020] [Accepted: 09/01/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Loneliness is linked to a number of adverse health outcomes in the general population. There is a lack of evidence on the prevalence and impact of loneliness in people with borderline intellectual impairment. METHODS Data from the 2014 Adult Psychiatric Morbidity Survey, a national survey of England, was analysed using Weights-adjusted regression analyses to compare the prevalence of loneliness and the association between loneliness and socio-demographic and clinical variables in people with borderline intellectual impairment and the general population. RESULTS Data from 6877 participants were included. Ten percent (n = 671) of the sample had borderline intellectual impairment and their prevalence of loneliness was 24.5% compared to 18.4% in the general population. This difference was explained by exposure to social disadvantages. Associations were found in both groups between loneliness and being single, unemployed, low income, lower social support, feeling unsafe and discrimination in the past year. Loneliness was associated with lower wellbeing and higher rates of common mental disorders, suicidal thoughts and chronic physical disorders in both groups. Intellectual functioning moderated the relationship between loneliness and income (OR 1.82; 95%CI 1.06 to 3.11) and suicidal thoughts in the last week (OR 0.13; 95% CI 0.02 to 0.93). LIMITATIONS IQ was measured using the National Adult Reading Test (NART), which is only valid for English speakers and loneliness was measured using a single item. CONCLUSION Loneliness is more prevalent in people with borderline intellectual impairment. Interventions targeting social disadvantages (e.g. low income) may lead reduce loneliness and vulnerability to mental health problems.
Collapse
Affiliation(s)
- Katerina Papagavriel
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF London, UK.
| | - Rebecca Jones
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF London, UK.
| | - Rory Sheehan
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF London, UK.
| | - Angela Hassiotis
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF London, UK.
| | - Afia Ali
- Division of Psychiatry, University College London, 6th Floor, Maple House, 149 Tottenham Court Road, W1T 7NF London, UK.
| |
Collapse
|
7
|
Peltopuro M, Vesala HT, Ahonen T, Närhi VM. Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:923-933. [PMID: 32959413 DOI: 10.1111/jir.12783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The use of facilities such as disability pension, psychiatric care, health care and services for people with intellectual disabilities and borderline intellectual functioning (BIF) were compared with the general population and two other study groups comprising people with mild intellectual disabilities (MIDs) and learning problems (LPs). METHODS The population-based sample (N = 416,973), 'Finland-in-Miniature', was gathered in 1962 and followed until 1998. For the purpose of the present study, three groups were formed: BIF (n = 416), MID (n = 312) and LP (n = 284). The use of services was examined with the help of national registers. RESULTS As compared with the general population, people with BIF had been granted disability pension 2.7 times more often and had been patients in psychiatric care 3.4 times more often. They had also systematically used more services than people with LP. CONCLUSIONS People with BIF are at risk of inability to work and facing severe mental health problems. They also seem to have more severe psychiatric problems than people with MID and LP. There is, therefore, a crucial need for increasing the awareness in society of BIF. Although this study's follow-up data were collected about 20 years ago, it is still relevant because people with BIF are a neglected group and still face growing demands in school and work life with no marked changes in services.
Collapse
Affiliation(s)
- M Peltopuro
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - H T Vesala
- Finnish Association on Intellectual and Developmental Disabilities (FAIDD), Helsinki, Finland
| | - T Ahonen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
- Niilo Mäki Institute, University of Jyväskylä, Jyväskylä, Finland
| | - V M Närhi
- Department of Education, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
8
|
Karande S, Ramadoss D, Gogtay N. Economic burden of slow learners: A prevalence-based cost of illness study of its direct, indirect, and intangible costs. J Postgrad Med 2020; 65:219-226. [PMID: 31441438 PMCID: PMC6813681 DOI: 10.4103/jpgm.jpgm_105_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: The primary objective of this study was to evaluate the economic burden of slow learners (students with “borderline intellectual functioning”) by estimating its direct, indirect, and intangible costs. The secondary objective was to assess the impact of variables on the economic burden. Settings and Design: Cross-sectional, single-arm descriptive study. Setting: Learning disability clinic in a public medical college in Mumbai. Materials and Methods: The study cases (age ≥5 - 18 years) were recruited by nonprobability sampling. A structured questionnaire was used to interview the parent to collect data related to direct and indirect costs. Intangible costs data were collected by documenting the willingness-to-pay value using the contingent valuation technique. Statistical Analysis Used: A quantile regression model was used to assess the impact of predictor variables on the costs. Results: The direct, indirect, and intangible costs of slow learners were INR 6,065,915, 10,298,613, and 145,172,800, respectively. Indirect costs comprised 62.9% of the total costs. Expenditure on tuitions, medications, and remedial education comprised 57.38%, 16.18%, and 10.30% of the direct costs, respectively. The average annual total costs of slow learners were INR 3,544,880. The average annual learning disability clinic costs were INR 2,250,194. The average annual total costs per student were INR 57,951. Longer duration of poor school performance was predictive of higher direct and total costs. Conclusion: The economic burden of slow learners is enormous (intangible > indirect > direct costs). Tuitions are the most costly component of direct costs. Parental loss of earnings is the most costly component of indirect costs.
Collapse
Affiliation(s)
- S Karande
- Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
| | - D Ramadoss
- Department of Pediatrics, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
| | - N Gogtay
- Department of Clinical Pharmacology, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, Maharashtra, India
| |
Collapse
|
9
|
Hassiotis A, Brown E, Harris J, Helm D, Munir K, Salvador-Carulla L, Bertelli M, Baghdadli A, Wieland J, Novell-Alsina R, Cid J, Vergés L, Martínez-Leal R, Mutluer T, Ismayilov F, Emerson E. Association of Borderline Intellectual Functioning and Adverse Childhood Experience with adult psychiatric morbidity. Findings from a British birth cohort. BMC Psychiatry 2019; 19:387. [PMID: 31805899 PMCID: PMC6896708 DOI: 10.1186/s12888-019-2376-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/27/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND To examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity. METHODS We performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity. RESULTS Children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19; Mann-Whitney z = 31.74, p < 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104-0.141, all p < 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity. CONCLUSIONS The relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group.
Collapse
Affiliation(s)
- Angela Hassiotis
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF UK
- Camden & Islington Foundation Trust, St Pancras Hospital, London, UK
| | - Emma Brown
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London, W1T 7NF UK
| | - James Harris
- Developmental Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Bloomberg Children’s Center, The Johns Hopkins Hospital, Baltimore, MD USA
| | - David Helm
- Institute for Community Inclusion, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Kerim Munir
- Institute for Community Inclusion, Division of Developmental Medicine, Boston Children’s Hospital, Boston, MA USA
- Developmental Medicine Center, Division of Developmental Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
| | | | - Marco Bertelli
- CREA, Research and Clinical Centre, San Sebastiano Foundation, Florence, Italy
| | - Amaria Baghdadli
- Child and Adolescent Psychiatry Department, Montpellier Hospital University, Montpellier, France
| | - Jannelien Wieland
- Kristal Centre for Psychiatry and Intellectual Disability, Rivierduinen, Leiden, The Netherlands
| | - Ramon Novell-Alsina
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Jordi Cid
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Laura Vergés
- Mental Health and Intellectual Disability Specialized Service, Catalan Health Govenment. Martí i Julià Hospital, Girona, Spain
| | - Rafael Martínez-Leal
- Intellectual Disability and Developmental Disorders Research Unit (UNIVIDD), Fundació Villablanca, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Tuba Mutluer
- Department of Child and Adolescent Psychiatry, Koc University Hospital, Istanbul, Turkey
| | - Fuad Ismayilov
- Department of Psychiatry, Azerbaijan Medical University, Baku, Azerbaijan
| | - Eric Emerson
- Centre for Disability Research & Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| |
Collapse
|
10
|
Martin S, Del-Monte J, Graziani P. Impulsivity issues in borderline personality disorder and it's links with insight: the role of urgency. Heliyon 2019; 5:e02564. [PMID: 31667405 PMCID: PMC6812187 DOI: 10.1016/j.heliyon.2019.e02564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/27/2019] [Accepted: 09/30/2019] [Indexed: 12/03/2022] Open
Abstract
Objective Impulsivity plays a major role in a wide range of disorders including Borderline Personality Disorder. Another crucial clinical dimension is insight. This clinical dimension is linked with symptomatology and treatment issue. The present study aims to investigate the impact of positive and negative urgency on insight in Borderline Personality Disorder. Methods We recruited eighty-one women with Borderline Personality Disorder and assessed insight level and impulsivity scores using the Beck Cognitive insight scale and the UPPS-short form scale. Results Our results showed interesting links between positive urgency and insight quality. Conclusion Negative emotions play a fundamental role for the insight quality, but positive emotions are surprisingly related to clinical insight. We discuss the possible therapeutical impact of this results on treatment adaptation.
Collapse
Affiliation(s)
- Sylvia Martin
- Laboratory of Social Psychology (LPS), University of Aix-Marseille & Nîmes, France
| | - Jonathan Del-Monte
- Laboratory of Social Psychology (LPS), University of Aix-Marseille & Nîmes, France
| | - Pierluigi Graziani
- Laboratory of Social Psychology (LPS), University of Aix-Marseille & Nîmes, France
| |
Collapse
|
11
|
Stanfield AC, McKechanie AG, Lawrie SM, Johnstone EC, Owens DGC. Predictors of psychotic symptoms among young people with special educational needs. Br J Psychiatry 2019; 215:422-427. [PMID: 30693855 DOI: 10.1192/bjp.2018.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Psychotic symptoms and psychotic disorders occur at increased rates in adults with intellectual disability, including borderline intellectual functioning, compared with the general population. Little is known about the development of such symptoms in this population.AimsTo examine whether clinical factors predictive of psychotic disorder in a familial study of schizophrenia also apply to those with intellectual disability. METHOD Adolescents with special educational needs (SEN) were assessed with the Structured Interview for Schizotypy (SIS) and Childhood Behavioural Checklist (CBCL). These scores were used to prospectively divide participants based on their anticipated risk for psychotic disorder. A subsample were reassessed three times over 6 years, using the Positive and Negative Syndrome Scale (PANSS). RESULTS The SEN group were more symptomatic than controls throughout (Cohen's d range for PANSS subscale scores: 0.54-1.4, all P < 0.007). Over 6 years of follow-up, those above the SIS and CBCL cut-off values at baseline were more likely than those below to display morbid positive psychotic symptoms (odds ratio, 3.5; 95% CI 1.3-9.0) and develop psychotic disorder (odds ratio, 11.4; 95% CI 2.6-50.1). Baseline SIS and CBCL cut-off values predicted psychotic disorder with sensitivity of 0.67, specificity of 0.85, positive predictive value of 0.26 and negative predictive value of 0.97. CONCLUSIONS Adolescents with SEN have increased psychotic and non-psychotic symptoms. The personality and behavioural features associated with later psychotic disorder in this group are similar to those in people with familial loading. Relatively simple screening measures may help identify those in this vulnerable group who do and do not require monitoring for psychotic symptoms.Declaration of interestNone.
Collapse
Affiliation(s)
- Andrew C Stanfield
- Senior Clinical Research Fellow,Patrick Wild Centre,University of Edinburgh; andDivision of Psychiatry,University of Edinburgh,UK
| | - Andrew G McKechanie
- Clinical Research Fellow,Patrick Wild Centre,University of Edinburgh; andDivision of Psychiatry,University of Edinburgh,UK
| | - Stephen M Lawrie
- Professor of Psychiatry,Patrick Wild Centre,University of Edinburgh; andDivision of Psychiatry,University of Edinburgh,UK
| | - Eve C Johnstone
- Emeritus Professor of Psychiatry, Patrick Wild Centre,University of Edinburgh; andDivision of Psychiatry,University of Edinburgh,UK
| | - David G C Owens
- Professor of Psychiatry,Division of Psychiatry,University of Edinburgh,UK
| |
Collapse
|
12
|
Psychotic experiences and subjective cognitive complaints among 224 842 people in 48 low- and middle-income countries. Epidemiol Psychiatr Sci 2018; 29:e11. [PMID: 30585571 PMCID: PMC8061242 DOI: 10.1017/s2045796018000744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIMS Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. METHODS Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. RESULTS The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16-1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18-44 years OR = 1.19 (95% CI 1.17-1.20); 45-64 years OR = 1.15 (95% CI 1.12-1.17); ⩾65 years OR = 1.14 (95% CI 1.09-1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). CONCLUSIONS SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.
Collapse
|