Evidence for the early clinical relevance of hallucinatory-delusional states in the general population
Article first published online: 4 SEP 2012
© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Acta Psychiatrica Scandinavica
Volume 127, Issue 6, pages 482–493, June 2013
How to Cite
Nuevo, R., Van Os, J., Arango, C., Chatterji, S. and Ayuso-Mateos, J. L. (2013), Evidence for the early clinical relevance of hallucinatory-delusional states in the general population. Acta Psychiatrica Scandinavica, 127: 482–493. doi: 10.1111/acps.12010
- Issue published online: 12 MAY 2013
- Article first published online: 4 SEP 2012
- Accepted for publication July 13, 2012
- psychotic disorders;
- risk factors
Nuevo R, Van Os J, Arango C, Chatterji S, Ayuso-Mateos JL. Evidence for the early clinical relevance of hallucinatory-delusional states in the general population.
Objective: To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters.
Method: General population-based household surveys of randomly selected adults between 18 and 65 years of age were carried out. Setting: 52 countries participating in the World Health Organization’s World Health Survey were included. Participants: 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated.
Results: Compared with isolated delusions and hallucinations, co-occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92–0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0–3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5–14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3–22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9–12.4). Co-occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8–2.3).
Conclusion: The results suggest that the co-occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.