Clinical significance of psychotic experiences in the context of sleep disturbance or substance use

2016 ◽  
Vol 46 (8) ◽  
pp. 1761-1767 ◽  
Author(s):  
J. E. DeVylder ◽  
I. Kelleher
Keyword(s):  
Substance Use ◽  
General Population ◽  
Mental Health Treatment ◽  
Functional Outcomes ◽  
Population Sample ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Psychotic Experiences ◽  
Co Morbidity

BackgroundPsychotic experiences (PE) are commonly reported in the general population, where they are associated with elevated clinical need and functional impairment. Research studies typically exclude PE that occur in the context of sleep or substance use (PE-SS), based on the assumption that they are normative within these contexts. This is the first study to formally test clinical and functional outcomes associated with PE that occur in the context of sleep or substance use.MethodData from the Collaborative Psychiatric Epidemiology Surveys (n = 11 776) were used to assess the associations between both PE and PE-SS and a broad range of outcomes, including psychiatric co-morbidity, suicidal behavior, mental health treatment utilization and World Health Organization (WHO) domains of function, using logistic regression analyses. Lifetime PE and PE-SS were mutually exclusive categories, assessed using the WHO Composite International Diagnostic Interview psychosis screen.ResultsPE were associated with all 10 clinical and functional outcomes. Similarly, respondents reporting PE-SS had greater clinical need and impaired function relative to controls, which was significant for seven of the 10 outcome variables. When directly compared, the PE and PE-SS groups differed only in their associations with role function (greater impairment for PE) and self-care (greater impairment for PE-SS).ConclusionsPE-SS were associated with a broad range of clinical and functional outcomes in this large general population sample. These associations were similar to those found for PE. Future studies should investigate relative differences between sleep- and substance-induced PE.

scholarly journals The Moderating Effects of Coping Strategies on Major Depression in the General Population

2002 ◽  
Vol 47 (2) ◽  
pp. 167-173 ◽  
Author(s):  
JianLi Wang ◽  
Scott B Pat ten
Keyword(s):  
Major Depression ◽  
General Population ◽  
Coping Strategies ◽  
Life Stress ◽  
Depressive Disorders ◽  
Short Form ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Moderating Effects

Objectives: To evaluate the moderating effects of various coping strategies on the as sociation between stressors and the prevalence of major depression in the general population. Methods: Subjects from the Alberta buy- incomponent of the 1994 –1995 National Population Health Survey (NPHS) were included in the analysis ( n = 1039). Each subject was asked 8 questions about coping strategies that dealt with unexpected stress from family problems and personal crises. Major depression was measured using the World Health Organization's (WHO) Composite International Diagnostic Interview-Short Form (CIDI- SF) for major depression. The im pacts of coping strategies in relation to psychological stres sors on the prevalence of major depression were de ter mined by examining interactions between coping and life stress on major depression using logistic regression modelling. Results: No robust impact of coping strategies in relation to various categories of stress evaluated in the NPHS was observed. There was evidence that the use of “pray and seek religious help” and “talks to others about the situations” as coping strategies by women moderated the risk of major depression in the presence of financial stress and relation ship stress (with a partner). Using emotional expression as a coping strategy by women might de crease the risk of major depression in the presence of 1 or more re cent life events, personal stress, relationship stress (with a partner), and environmental stress. Conclusion: Different coping strategies may have a differential impact on the prevalence of major depression in specific circumstances. These findings may be important both to prevent and to treat depressive disorders.

Dimensions of depression, mania and psychosis in the general population

2004 ◽  
Vol 34 (7) ◽  
pp. 1177-1186 ◽  
Author(s):  
L. KRABBENDAM ◽  
I. MYIN-GERMEYS ◽  
R. DE GRAAF ◽  
W. VOLLEBERGH ◽  
W. A. NOLEN ◽  
...  
Keyword(s):  
General Population ◽  
Sleep Problems ◽  
Population Sample ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Clinical Samples ◽  
Underlying Structure ◽  
Strongly Correlated ◽  
Symptom Dimensions ◽  
Symptoms Of Depression

Background. In order to investigate whether correlated but separable symptom dimensions that have been identified in clinical samples also have a distribution in the general population, the underlying structure of symptoms of depression, mania and psychosis was studied in a general population sample of 7072 individuals.Method. Data were obtained from the three measurements of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Symptoms of depression, mania and the positive symptoms of psychosis were assessed using the Composite International Diagnostic Interview. Confirmatory factor-analysis was used to test statistically the fit of hypothesized models of one, two, three or seven dimensions.Results. The seven-dimensional model comprising core depression, sleep problems, suicidal thoughts, mania, paranoid delusions, first-rank delusions and hallucinations fitted the data best, whereas the unidimensional model obtained the poorest fit. This pattern of results could be replicated at both follow-up measurements. The results were similar for the subsamples with and without a lifetime DSM-III-R diagnosis. The seven dimensions were moderately to strongly correlated, with correlations ranging from 0·18 to 0·73 (mean 0·45).Conclusions. In the general population, seven correlated but separable dimensions of experiences exist that resemble dimensions of psychopathology seen in clinical samples with severe mental illness. The substantial correlations between these dimensions in clinical and non-clinical samples may suggest that there is aetiological overlap between the different dimensions regardless of level of severity and diagnosable disorder.

Self-rated general health and psychiatric disorders in a general population sample

2005 ◽  
Vol 20 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Ulrich John ◽  
Christian Meyer ◽  
Hans-Jürgen Rumpf ◽  
Anja Schumann ◽  
Horst Dilling ◽  
...  
Keyword(s):  
General Population ◽  
Psychiatric Disorders ◽  
General Health ◽  
Somatoform Disorders ◽  
Population Sample ◽  
Participation Rate ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Diagnostic And Statistical Manual

AbstractThe purpose of this study was to explore the relationships between nicotine and alcohol dependence, depressive, anxiety and somatoform disorders with self-rated general health (GH). A cohort study of a random sample of the non-institutionalised general population aged 18–64 with a participation rate of 70.2% was carried out in a German area (n = 4075 at baseline). A follow-up of tobacco smokers or heavy drinkers (n = 1083, 79.4% of those who had given consent to be followed-up) was conducted 30 months after baseline measurement. The assessments included self-ratings of GH and Diagnostic and Statistical Manual (DSM-IV) diagnoses based on the Composite International Diagnostic Interview. The results show that nicotine dependence, anxiety disorders and somatoform disorders moderately predicted self-rated GH at follow-up (general linear model, R2 = 0.12). We conclude that psychiatric disorders may contribute to the prediction of a low self-rated GH.

scholarly journals Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication

2007 ◽  
Vol 38 (1) ◽  
pp. 15-28 ◽  
Author(s):  
A. M. Ruscio ◽  
T. A. Brown ◽  
W. T. Chiu ◽  
J. Sareen ◽  
M. B. Stein ◽  
...  
Keyword(s):  
Social Phobia ◽  
Functional Impairment ◽  
Household Survey ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
World Health ◽  
Treatment Seeking ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity

BackgroundDespite heightened awareness of the clinical significance of social phobia, information is still lacking about putative subtypes, functional impairment, and treatment-seeking. New epidemiologic data on these topics are presented from the National Comorbidity Survey Replication (NCS-R).MethodThe NCS-R is a nationally representative household survey fielded in 2001–2003. The World Health Organization (WHO) Composite International Diagnostic Interview Version 3.0 (CIDI 3.0) was used to assess 14 performance and interactional fears and DSM-IV social phobia.ResultsThe estimated lifetime and 12-month prevalence of social phobia are 12.1% and 7.1% respectively. Performance and interactional fears load onto a single latent factor, and there is little evidence for distinct subtypes based either on the content or the number of fears. Social phobia is associated with significant psychiatric co-morbidity, role impairment, and treatment-seeking, all of which have a dose–response relationship with number of social fears. However, social phobia is the focus of clinical attention in only about half of cases where treatment is obtained. Among non-co-morbid cases, those with the most fears were least likely to receive social phobia treatment.ConclusionsSocial phobia is a common, under-treated disorder that leads to significant functional impairment. Increasing numbers of social fears are associated with increasingly severe manifestations of the disorder.

scholarly journals Prevalence and predictors of psychotropic medication use: results from the Northern Ireland Study of Health and Stress

2014 ◽  
Vol 24 (6) ◽  
pp. 542-552 ◽  
Author(s):  
T. Benson ◽  
S. O'Neill ◽  
S. Murphy ◽  
F. Ferry ◽  
B. Bunting
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
General Population ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Household Survey ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Policy Implications ◽  
World Health

Background.To identify the predictors of psychotropic medication use and to determine rates and patterns of use in Northern Ireland (NI) among the general population and various subgroups.Method.Analysis of data from the NI Study of Health and Stress, a representative household survey undertaken between 2004 and 2008 with 4340 individuals. Respondents were asked about prescribed psychotropic medication use in the previous 12 months along with a series of demographic questions and items regarding experience of traumatic life events. Mental health disorders were assessed using the World Health Organization's Composite International Diagnostic Interview.Results.Females, individuals aged 50–64 years old, those who were previously married, and those who had experienced a traumatic lifetime event were more likely to have taken any psychotropic medication. Use of any psychotropic medication in the population in the previous 12 months was 14.9%. Use among individuals who met the criteria for a 12-month mental health disorder was 38.5%. Almost one in ten individuals (9.4%) had taken an antidepressant.Conclusions.Compared with other countries, NI has high proportions of individuals using psychotropic medication in both the general population and those who met the criteria for a 12-month mental disorder. However, these results still suggest possible under treatment of mental disorders in the country. In addition, rates of use in those with no disorder are relatively high. The predictors of medication use are similar to findings in other countries. Possible research and policy implications are discussed.

scholarly journals Adolescent development of psychosis as an outcome of hearing impairment: a 10-year longitudinal study

2010 ◽  
Vol 41 (3) ◽  
pp. 477-485 ◽  
Author(s):  
M. van der Werf ◽  
V. Thewissen ◽  
M. D. Dominguez ◽  
R. Lieb ◽  
H. Wittchen ◽  
...  
Keyword(s):  
Hearing Impairment ◽  
Developmental Stages ◽  
Population Sample ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Psychotic Symptoms ◽  
Multiple Time ◽  
Psychotic Experiences ◽  
Multiple Time Points ◽  
Social Vulnerabilities

BackgroundIt has long been acknowledged that hearing impairment may increase the risk for psychotic experiences. Recent work suggests that young people in particular may be at risk, indicating a possible developmental mechanism.MethodThe hypothesis that individuals exposed to hearing impairment in early adolescence would display the highest risk for psychotic symptoms was examined in a prospective cohort study of a population sample of originally 3021 adolescents and young adults aged 14–24 years at baseline, in Munich, Germany (Early Developmental Stages of Psychopathology Study). The expression of psychosis was assessed at multiple time points over a period of up to 10 years, using a diagnostic interview (Munich Composite International Diagnostic Interview; CIDI) administered by clinical psychologists.ResultsHearing impairment was associated with CIDI psychotic symptoms [odds ratio (OR) 2.04, 95% confidence interval (CI) 1.10–3.81], particularly more severe psychotic symptoms (OR 5.66, 95% CI 1.64–19.49). The association between hearing impairment and CIDI psychotic symptoms was much stronger in the youngest group aged 14–17 years at baseline (OR 3.28, 95% CI 1.54–7.01) than in the older group aged 18–24 years at baseline (OR 0.82, 95% CI 0.24–2.84).ConclusionsThe finding of an age-specific association between hearing impairment and psychotic experiences suggests that disruption of development at a critical adolescent phase, in interaction with other personal and social vulnerabilities, may increase the risk for psychotic symptoms.

A general population comparison of the Composite International Diagnostic Interview (CIDI) and the Schedules for Clinical Assessment in Neuropsychiatry (SCAN)

2001 ◽  
Vol 31 (6) ◽  
pp. 1001-1013 ◽  
Author(s):  
T. S. BRUGHA ◽  
R. JENKINS ◽  
N. TAUB ◽  
H. MELTZER ◽  
P. E. BEBBINGTON
Keyword(s):  
General Population ◽  
Clinical Assessment ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Order Effects ◽  
Structured Interviews ◽  
Diagnostic Thresholds ◽  
Co Morbidity ◽  
Structured Diagnostic Interview ◽  
Almost All

Background. In psychiatric surveys of the general population, there has been considerable discrepancy between diagnoses obtained by fully structured interviews and those established by systematic semi-structured clinical evaluation. The Composite International Diagnostic Interview (CIDI) is an example of the first type of interview widely used in general population surveys. We compared its performance in diagnosing current depressive and anxiety disorders with the Schedules for Clinical Assessment in Neuropsychiatry (SCAN), a semi-structured diagnostic interview administered by clinically trained interviewers.Methods. Household addresses in Leicestershire, UK, were randomly sampled and 860 adults were screened with the Revised Clinical Interview Schedule. Adults with too few symptoms to fulfil diagnostic criteria for study disorders were excluded to increase the proportion re-interviewed who met such criteria. Repeat diagnostic interviews with the CIDI and SCAN, ordered randomly, were sought from eligible screen positive respondents. Recalibrated CIDI prevalence estimates were derived from the SCAN classification using Bayesian statistics.Results. Concordance ranged between ‘poor’ and ‘fair’ across almost all types of study disorders, and for co-morbidity. Concordance was somewhat better for severity of depression and when lower diagnostic thresholds were used for depression. Interview order effects were suggested with lower concordance when CIDI followed SCAN. Recalibration reduced the prevalence of depressive or anxiety disorder from 9·0 to 6·2%.Conclusions. Community psychiatric surveys using structured diagnostic interview data must be interpreted cautiously. They should include an element of clinical re-appraisal so findings can be adjusted for estimation differences between fully structured and clinical assessments.

Social support and delusional-like experiences: a nationwide population-based study

2012 ◽  
Vol 21 (2) ◽  
pp. 203-212 ◽  
Author(s):  
S. Saha ◽  
J. Scott ◽  
D. Varghese ◽  
J. McGrath
Keyword(s):  
Social Support ◽  
General Population ◽  
Community Sample ◽  
Composite International Diagnostic Interview ◽  
Population Based ◽  
Diagnostic Interview ◽  
Confounding Factors ◽  
Poor Social Support ◽  
Physical Disorders ◽  
The Relationship

Background.Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community sample.Methods.Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse/partners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors.Results.Of the sample, 8.4% (n = 776) positively endorsed one or more DLEs. Individuals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse/partner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors.Conclusions.DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.

Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey

1996 ◽  
Vol 168 (S30) ◽  
pp. 17-30 ◽  
Author(s):  
R. C. Kessler ◽  
C. B. Nelson ◽  
K. A. McGonagle ◽  
J. Liu ◽  
M. Swartz ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
General Population ◽  
Depressive Disorder ◽  
Composite International Diagnostic Interview ◽  
Population Data ◽  
Diagnostic Interview ◽  
Prior History ◽  
Major Depressive ◽  
National Comorbidity Survey ◽  
The Us

General population data are presented on the prevalence and correlates of comorbidity between DSM–III–R major depressive disorder (MDD) and other DSM–III–R disorders. The data come from the US National Comorbidity Survey, a large general population survey of persons aged 15–54 years in the non-institutionalised civilian population. Diagnoses are based on a modified version of the Composite International Diagnostic Interview (CIDI). The analysis shows that most cases of lifetime MDD are secondary, in the sense that they occur in people with a prior history of another DSM–III–R disorder. Anxiety disorders are the most common primary disorders. The time-lagged effects of most primary disorders on the risk of subsequent MDD continue for many years without change in magnitude. Secondary MDD is, in general, more persistent and severe than pure or primary MDD. This has special public health significance because lifetime prevalence of secondary MDD has increased in recent cohorts, while the prevalence of pure and primary depression has remained unchanged.

scholarly journals Cross-cultural differences in the epidemiology of unexplained fatigue syndromes in primary care

2003 ◽  
Vol 182 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Petros Skapinakis ◽  
Glyn Lewis ◽  
Venetsanos Mavreas
Keyword(s):  
Primary Care ◽  
Secondary Analysis ◽  
Composite International Diagnostic Interview ◽  
Developed Countries ◽  
Diagnostic Interview ◽  
World Health ◽  
Less Developed Countries ◽  
Cross Cultural Differences ◽  
International Data ◽  
Health Organization

BackgroundUnexplained fatigue has been extensively studied but most of the samples used were from Western countries.AimsTo present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.MethodSecondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.ResultsThe prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17–4.33) and 15.05 (95% CI 10.85–20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.ConclusionsIn less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.

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