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Epidemiology of depression with psychotic experiences and its association with chronic physical conditions in 47 low- and middle-income countries

Published online by Cambridge University Press:  27 October 2016

A. Koyanagi ,
H. Oh ,
B. Stubbs ,
J. M. Haro  and
J. E. DeVylder
A. Koyanagi*
Affiliation:
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
H. Oh
Affiliation:
University of California Berkeley School of Public Health, Berkeley, CA, USA Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, CA, USA
B. Stubbs
Affiliation:
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, UK
J. M. Haro
Affiliation:
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
J. E. DeVylder
Affiliation:
School of Social Work, University of Maryland, Baltimore, MD, USA
*
*Address for correspondence: A. Koyanagi, MD, MSc, Ph.D., Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona, Spain. (Email: [email protected])
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Abstract

Background

The co-existence of depression and psychotic experiences (PEs) is associated with more pronounced adverse health outcomes compared to depression alone. However, data on its prevalence and correlates are lacking in the general adult population, and there is no published data on its association with chronic physical conditions.

Method

Cross-sectional, community-based data from 201 337 adults aged ⩾18 years from 47 low- and middle-income countries from the World Health Survey were analyzed. The presence of past 12-month PE and DSM-IV depression was assessed with the Composite International Diagnostic Interview (CIDI). Information on six chronic medical conditions (chronic back pain, edentulism, arthritis, angina, asthma, diabetes) were obtained by self-report. Multivariable logistic regression analysis was performed.

Results

The crude overall prevalence of co-morbid depression/PEs was 2.5% [95% confidence interval (CI) 2.3–2.7%], with the age- and sex-adjusted prevalence ranging from 0.1% (Sri Lanka, Vietnam) to 9.03% (Brazil). Younger age, urban setting, current smoking, alcohol consumption, and anxiety were significant correlates of co-existing depression/PEs. Co-occurring depression/PEs was associated with significantly higher odds for arthritis, angina, and diabetes beyond that of depression alone after adjusting for sociodemographics, anxiety, and country, with odds ratios (depression/PEs v. depression only) being: arthritis 1.30 (95% CI 1.07–1.59, p = 0.0086); angina 1.40 (95% CI 1.18–1.67, p = 0.0002); diabetes 1.65 (95% CI 1.21–2.26, p = 0.0017).

Conclusions

The prevalence of co-existing depression/PEs was non-negligible in most countries. Our study suggests that when depression/PE or a chronic condition (e.g. arthritis, angina, diabetes) is detected, screening for the other may be important to improve clinical outcomes.

Keywords

Chronic conditionscommunity-baseddepressionlow- and middle-income countriespsychotic experience
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 3 , February 2017 , pp. 531 - 542
Copyright
Copyright © Cambridge University Press 2016 

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References

Alonso, J, Buron, A, Bruffaerts, R, He, Y, Posada-Villa, J, Lepine, JP, Angermeyer, MC, Levinson, D, de Girolamo, G, Tachimori, H, Mneimneh, ZN, Medina-Mora, ME, Ormel, J, Scott, KM, Gureje, O, Haro, JM, Gluzman, S, Lee, S, Vilagut, G, Kessler, RC, Von Korff, M (2008). Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatrica Scandinavica 118, 305–314.Google Scholar
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Beaglehole, R, Bonita, R, Horton, R, Adams, C, Alleyne, G, Asaria, P, Baugh, V, Bekedam, H, Billo, N, Casswell, S, Cecchini, M, Colagiuri, R, Colagiuri, S, Collins, T, Ebrahim, S, Engelgau, M, Galea, G, Gaziano, T, Geneau, R, Haines, A, Hospedales, J, Jha, P, Keeling, A, Leeder, S, Lincoln, P, McKee, M, Mackay, J, Magnusson, R, Moodie, R, Mwatsama, M, Nishtar, S, Norrving, B, Patterson, D, Piot, P, Ralston, J, Rani, M, Reddy, KS, Sassi, F, Sheron, N, Stuckler, D, Suh, I, Torode, J, Varghese, C, Watt, J (2011). Priority actions for the non-communicable disease crisis. Lancet 377, 1438–1447.Google Scholar
Cifuentes, M, Sembajwe, G, Tak, S, Gore, R, Kriebel, D, Punnett, L (2008). The association of major depressive episodes with income inequality and the human development index. Social Science and Medicine 67, 529–539.Google Scholar
Cooper, L, Peters, L, Andrews, G (1998). Validity of the composite international diagnostic interview (CIDI) psychosis module in a psychiatric setting. Journal of Psychiatric Research 32, 361–368.Google Scholar
De Hert, M, Cohen, D, Bobes, J, Cetkovich-Bakmas, M, Leucht, S, Ndetei, DM, Newcomer, JW, Uwakwe, R, Asai, I, Moller, HJ, Gautam, S, Detraux, J, Correll, CU (2011 a). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry 10, 138–151.Google Scholar
De Hert, M, Correll, CU, Bobes, J, Cetkovich-Bakmas, M, Cohen, D, Asai, I, Detraux, J, Gautam, S, Moller, HJ, Ndetei, DM, Newcomer, JW, Uwakwe, R, Leucht, S (2011 b). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry 10, 52–77.Google Scholar
DeVylder, JE, Burnette, D, Yang, LH (2014). Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples. Psychological Medicine 44, 3503–3513.CrossRefGoogle ScholarPubMed
DeVylder, JE, Hilimire, MR (2015). Screening for psychotic experiences: social desirability biases in a non-clinical sample. Early Intervention in Psychiatry 9, 331–334.Google Scholar
Ferrari, AJ, Charlson, FJ, Norman, RE, Patten, SB, Freedman, G, Murray, CJ, Vos, T, Whiteford, HA (2013). Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Medicine 10, e1001547.CrossRefGoogle ScholarPubMed
Hosseinpoor, AR, Bergen, N, Kunst, A, Harper, S, Guthold, R, Rekve, D, d'Espaignet, ET, Naidoo, N, Chatterji, S (2012). Socioeconomic inequalities in risk factors for non-communicable diseases in low-income and middle-income countries: results from the World Health Survey. BMC Public Health 12, 912.Google Scholar
Johnson, J, Horwath, E, Weissman, MM (1991). The validity of major depression with psychotic features based on a community study. Archives of General Psychiatry 48, 1075–1081.Google Scholar
Kessler, RC, Ustun, TB (2004). The world mental health (WMH) survey initiative version of the World Health Organization (WHO) composite international diagnostic interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.Google Scholar
Kouidrat, Y, Amad, A, Lalau, JD, Loas, G (2014). Eating disorders in schizophrenia: implications for research and management. Schizophrenia Research and Treatment 2014, 791573.Google Scholar
Koyanagi, A, Garin, N, Olaya, B, Ayuso-Mateos, JL, Chatterji, S, Leonardi, M, Koskinen, S, Tobiasz-Adamczyk, B, Haro, JM (2014). Chronic conditions and sleep problems among adults aged 50 years or over in nine countries: a multi-country study. PLoS ONE 9, e114742.Google Scholar
Koyanagi, A, Oh, H, Stickley, A, Haro, JM, DeVylder, J (2016 a). Risk and functional significance of psychotic experiences among individuals with depression in 44 low- and middle-income countries. Psychological Medicine 46, 2655–2665.CrossRefGoogle ScholarPubMed
Koyanagi, A, Stickley, A, Haro, JM (2016 b). Psychotic-like experiences and disordered eating in the English general population. Psychiatry Research 241, 26–34.Google Scholar
Krabbendam, L, Myin-Germeys, I, Hanssen, M, de Graaf, R, Vollebergh, W, Bak, M, van Os, J (2005). Development of depressed mood predicts onset of psychotic disorder in individuals who report hallucinatory experiences. British Journal of Clinical Psychology 44, 113–125.Google Scholar
Linscott, RJ, van Os, J (2013). An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine 43, 1133–1149.Google Scholar
Loerbroks, A, Herr, RM, Subramanian, S, Bosch, JA (2012). The association of asthma and wheezing with major depressive episodes: an analysis of 245 727 women and men from 57 countries. International Journal of Epidemiology 41, 1436–1444.Google Scholar
Moreno, C, Nuevo, R, Chatterji, S, Verdes, E, Arango, C, Ayuso-Mateos, JL (2013). Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey. World Psychiatry 12, 251–257.Google Scholar
Moussavi, S, Chatterji, S, Verdes, E, Tandon, A, Patel, V, Ustun, B (2007). Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet 370, 851–858.Google Scholar
Murray, CJ, et al. (2012). Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380, 2197–2223.Google Scholar
Muscatell, KA, Eisenberger, NI (2012). A social neuroscience perspective on stress and health. Social and Personality Psychology Compass 6, 890–904.Google Scholar
Nuevo, R, Chatterji, S, Verdes, E, Naidoo, N, Arango, C, Ayuso-Mateos, JL (2012). The continuum of psychotic symptoms in the general population: a cross-national study. Schizophrenia Bulletin 38, 475–485.Google Scholar
Oh, H, DeVylder, J (2015). Psychotic symptoms predict health outcomes even after adjusting for substance use, smoking and co-occurring psychiatric disorders: findings from the NCS-R and NLAAS. World Psychiatry 14, 101–102.CrossRefGoogle ScholarPubMed
Ohayon, MM, Schatzberg, AF (2002). Prevalence of depressive episodes with psychotic features in the general population. American Journal of Psychiatry 159, 1855–1861.Google Scholar
Padhy, SK, Sarkar, S, Davuluri, T, Patra, BN (2014). Urban living and psychosis–an overview. Asian Journal of Psychiatry 12, 17–22.Google Scholar
Rose, GA (1962). The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bulletin of the World Health Organization 27, 645–658.Google Scholar
Rosmond, R, Bjorntorp, P (2000). The hypothalamic-pituitary-adrenal axis activity as a predictor of cardiovascular disease, type 2 diabetes and stroke. Journal of Internal Medicine 247, 188–197.Google Scholar
Saha, S, Scott, J, Varghese, D, McGrath, J (2011 a). The association between physical health and delusional-like experiences: a general population study. PLoS ONE 6, e18566.Google Scholar
Saha, S, Scott, JG, Varghese, D, McGrath, JJ (2011 b). The association between general psychological distress and delusional-like experiences: a large population-based study. Schizophrenia Research 127, 246–251.Google Scholar
Saha, S, Scott, J, Varghese, D, McGrath, J (2012). Anxiety and depressive disorders are associated with delusional-like experiences: a replication study based on a National Survey of Mental Health and Wellbeing. BMJ Open 2(3), e001001.Google Scholar
Scott, KM, Lim, C, Al-Hamzawi, A, Alonso, J, Bruffaerts, R, Caldas-de-Almeida, JM, Florescu, S, de Girolamo, G, Hu, C, de Jonge, P, Kawakami, N, Medina-Mora, ME, Moskalewicz, J, Navarro-Mateu, F, O'Neill, S, Piazza, M, Posada-Villa, J, Torres, Y, Kessler, RC (2016). Association of mental disorders with subsequent chronic physical conditions: world mental health surveys from 17 countries. JAMA Psychiatry 73, 150–158.Google Scholar
Sharifi, V, Eaton, WW, Wu, LT, Roth, KB, Burchett, BM, Mojtabai, R (2015). Psychotic experiences and risk of death in the general population: 24–27 year follow-up of the Epidemiologic Catchment Area study. British Journal of Psychiatry 207, 30–36.Google Scholar
Thase, ME (2016). Managing medical comorbidities in patients with depression to improve prognosis. Journal of Clinical Psychiatry 77(Suppl. 1), 22–27.Google Scholar
Thompson, KN, Phillips, LJ, Komesaroff, P, Yuen, HP, Wood, SJ, Pantelis, C, Velakoulis, D, Yung, AR, McGorry, PD (2007). Stress and HPA-axis functioning in young people at ultra high risk for psychosis. Journal of Psychiatric Research 41, 561–569.Google Scholar
Varghese, D, Saha, S, Scott, JD, Chan, RC, McGrath, JJ (2011 a). The association between family history of mental disorder and delusional-like experiences: a general population study. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 156B, 478–483.Google Scholar
Varghese, D, Scott, J, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, McGrath, J (2011 b). Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophrenia Bulletin 37, 389–393.Google Scholar
Walker, ER, McGee, RE, Druss, BG (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 72, 334–341.Google Scholar
Weiser, M, van Os, J, Davidson, M (2005). Time for a shift in focus in schizophrenia: from narrow phenotypes to broad endophenotypes. British Journal of Psychiatry 187, 203–205.CrossRefGoogle ScholarPubMed
Werbeloff, N, Drukker, M, Dohrenwend, BP, Levav, I, Yoffe, R, van Os, J, Davidson, M, Weiser, M (2012). Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Archives of General Psychiatry 69, 467–475.Google Scholar
Wigman, JT, van Nierop, M, Vollebergh, WA, Lieb, R, Beesdo-Baum, K, Wittchen, HU, van Os, J (2012). Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity--implications for diagnosis and ultra-high risk research. Schizophrenia Bulletin 38, 247–257.Google Scholar
Wong, KO, Hunter Rowe, B, Douwes, J, Senthilselvan, A (2013). Asthma and wheezing are associated with depression and anxiety in adults: an analysis from 54 countries. Pulmonary Medicine 2013, 929028.Google Scholar
WHO (2002). International Guide for Monitoring Alcohol Consumption and Related Harm. Geneva: World Health Organization.Google Scholar
Yung, AR, Buckby, JA, Cosgrave, EM, Killackey, EJ, Baker, K, Cotton, SM, McGorry, PD (2007). Association between psychotic experiences and depression in a clinical sample over 6 months. Schizophrenia Research 91, 246–253.Google Scholar