Association Between Psychotic Experiences and Subsequent Suicidal Thoughts and Behaviors A Cross-National Analysis From the World Health Organization World Mental Health Surveys

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Bromet, Evelyn J. ^[1] ; Nock, Matthew K. ^[2] ; Saha, Sukanta ^[3] ; Lim, Carmen C. W. ^[3] ; Aguilar-Gaxiola, Sergio ^[4] ; Al-Hamzawi, Ali ^[5] ; Alonso, Jordi ^{[6, 7, 8]} ; Borges, Guilherme ^[9] ; Bruffaerts, Ronny ^[10] ; Degenhardt, Louisa ^[11] ; de Girolamo, Giovanni ^[12] ; de Jonge, Peter ^{[13, 14]} ; Florescu, Silvia ^[15] ; Gureje, Oye ^[16] ; Haro, Josep M. ^[17] ; He, Yanling ^[18] ; Hu, Chiyi ^[19] ; Karam, Elie G. ^{[20, 21]} ; Kovess-Masfety, Viviane ^[22] ; Lee, Sing ^[23] ; Lepine, Jean-Pierre ^[24] ; Mneimneh, Zeina ^[25] ; Navarro-Mateu, Fernando ^[26] ; Ojagbemi, Akin ^[27] ; Posada-Villa, Jose ^[28] ; Sampson, Nancy A. ^[29] ; Scott, Kate M. ^[30] ; Stagnaro, Juan C. ^[31] ; Viana, Maria C. ^[32] ; Xavier, Miguel ^[33] ; Kessler, Ronald C. ^[29] ; McGrath, John J. ^{[34, 35, 36]} ; Hlth, World Hlth Org World Mental

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^[1] SUNY Stony Brook, Sch Med, Dept Psychiat, Stony Brook, NY 11794 - USA

^[2] Harvard Univ, Dept Psychol, Cambridge, MA - USA

^[3] Univ Queensland, Queensland Brain Inst, Queensland Ctr Mental Hlth Res, Brisbane, Qld - Australia

^[4] Univ Calif Davis Hlth Syst, Ctr Reducing Hlth Dispar, Sacramento, CA - USA

^[5] Al Qadisiya Univ, Coll Med, Diwaniya Governorate - Iraq

^[6] Pompeu Fabra Univ, Barcelona - Spain

^[7] Inst Hosp Mar Invest Med, Hlth Serv Res Unit, Barcelona - Spain

^[8] Ctr Invest Biomed Red Epidemiol & Salud Publ, Barcelona - Spain

^[9] Natl Inst Psychiat Ramon Fuente, Mexico City, DF - Mexico

^[10] Katholieke Univ Leuven, Univ Psychiat Ctr, Campus Gasthuisberg, Leuven - Belgium

^[11] Univ New South Wales, Natl Drug & Alcohol Res Ctr, Sydney, NSW - Australia

^[12] St John God Clin Res Ctr, Ist Ricovero Cura Carattere Sci, Unit Epidemiol & Evaluat Psychiat, Brescia - Italy

^[13] Univ Groningen, Dev Psychol, Dept Psychol, Groningen - Netherlands

^[14] Univ Med Ctr Groningen, Dept Psychiat, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen - Netherlands

^[15] Natl Sch Publ Hlth Management & Profess Dev, Bucharest - Romania

^[16] Univ Coll Hosp, Dept Psychiat, Ibadan - Nigeria

^[17] Univ Barcelona, Ctr Invest Biomed Red Salud Mental, Parc Sanitari St Joan de Deu, Barcelona - Spain

^[18] Shanghai Jiao Tong Univ, Sch Med, Shanghai Mental Hlth Ctr, Shanghai - Peoples R China

^[19] Shenzhen Kangning Hosp, Shenzhen Inst Mental Hlth, Shenzhen - Peoples R China

^[20] Inst Dev Res Advocacy & Appl Care, Beirut - Lebanon

^[21] Balamand Univ, St George Hosp Univ, Med Ctr, Dept Psychiat & Clin Psychol, Fac Med, Beirut - Lebanon

^[22] Paris Descartes Univ, Ecole Hautes Etud Sante Publ, Paris - France

^[23] Chinese Univ Hong Kong, Dept Psychiat, Hong Kong, Hong Kong - Peoples R China

^[24] Univ Paris Descartes Paris Diderot, Hop Lariboisiere Fernand Widal, AP HP, INSERM, UMR S 1144, Paris - France

^[25] Univ Michigan, Survey Res Ctr, Ann Arbor, MI 48109 - USA

^[26] Ctr Invest Biomed Red Epidemiol & Salud Publ Murc, Inst Murciano Invest Biosanitaria Arrixaca, Serv Murciano Salud, Subdirecc Gen Planificac Innovac & Cronicidad, Uni, Murcia - Spain

^[27] Univ Ibadan, Coll Med, Dept Psychiat, Ibadan - Nigeria

^[28] Colegio Mayor de Cundinamarca Univ, Fac Social Sci, Bogota - Colombia

^[29] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA - USA

^[30] Univ Otago, Dept Psychol Med, Dunedin, Otago - New Zealand

^[31] Univ Buenos Aires, Fac Med, Dept Psiquiatria & Salud Mental, Buenos Aires, DF - Argentina

^[32] Univ Fed Espirito Santo, Dept Social Med, Vitoria - Brazil

^[33] Univ Nova Lisboa, Fac Ciencias Med, Dept Mental Hlth, Chron Dis Res Ctr, Lisbon - Portugal

^[34] Univ Queensland, Queensland Brain Inst, QBI Bldg 79\textbackslash{}, Brisbane, Qld 4072 - Australia

^[35] Univ Queensland, Queensland Ctr Mental Hlth Res, Brisbane, Qld - Australia

^[36] Aarhus Univ, Aarhus Sch Business & Social Sci, Natl Ctr Register Based Res, Aarhus - Denmark

• Tipo de documento: Artigo Científico
• Fonte: JAMA PSYCHIATRY; v. 74, n. 11, p. 1136-1144, NOV 2017.
• Citações Web of Science: 13

Resumo

IMPORTANCE Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across the life course or if mental disorders contribute to these associations. OBJECTIVE To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations. DESIGN, SETTING, AND PARTICIPANTS A total of 33 370 adult respondents across 19 countries from the World Health Organization World Mental Health Surveys were assessed for PEs, STBs (ie, ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onset of STBs. MAIN OUTCOMES AND MEASURES Prevalence and frequency of STBs with PEs, and odds ratios and 95% CIs. RESULTS Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5%(1.3), 10.8%(0.7), and 10.2%(0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95% CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95% CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95% CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively. CONCLUSIONS AND RELEVANCE Psychotic experiences are associated with elevated odds of subsequent STBs across the life course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs. (AU)

• Processo FAPESP: 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica
• Beneficiário: Laura Helena Silveira Guerra de Andrade
• Modalidade de apoio: Auxílio à Pesquisa - Temático