The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23,998 respondents from 17 countries
Identifieur interne : 000241 ( Main/Curation ); précédent : 000240; suivant : 000242The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23,998 respondents from 17 countries
Auteurs : J. J. Mcgrath ; K. A. Mclaughlin [États-Unis] ; S. Saha ; S. Aguilar-Gaxiola [États-Unis] ; A. Al-Hamzawi [Iraq] ; J. Alonso [Espagne] ; R. Bruffaerts [Belgique] ; G. De Girolamo [Italie] ; P. De Jonge [Pays-Bas] ; O. Esan [Nigeria] ; S. Florescu [Roumanie] ; O. Gureje [Nigeria] ; J. M. Haro [Espagne] ; C. Hu [République populaire de Chine] ; E. G. Karam [Liban] ; V. Kovess-Masfety [France] ; S. Lee [Hong Kong] ; J. Lepine [France] ; C. C. W. Lim [Nouvelle-Zélande] ; M. E. Medina-Mora [Mexique] ; Z. Mneimneh [Liban] ; B. Pennell [États-Unis] ; M. Piazza [Pérou] ; J. Posada-Villa [Colombie] ; N. Sampson [États-Unis] ; M. C. Viana [Brésil] ; M. Xavier [Portugal] ; E. J. Bromet [États-Unis] ; K. S. Kendler [États-Unis] ; R. C. Kessler [États-Unis]Source :
- Psychological medicine [ 0033-2917 ] ; 2017.
Abstract
Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.
We assessed CAs, PEs and DSM-IV mental disorders in 23,998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.
Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs (OR =2.3, 95%CI=1.9–2.6). CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR= 8.5, 95%CI=3.6–20.2), whereas other CA types were associated with PE onset in adolescence. Associations of Other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).
Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.
Url:
DOI: 10.1017/S0033291716003263
PubMed: 28065209
PubMed Central: 5590103
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J. J. Mcgrath<affiliation><nlm:aff id="A1">Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland</nlm:aff>
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</affiliation>
<affiliation><nlm:aff id="A1">Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland</nlm:aff>
<wicri:noCountry code="subfield">University of Queensland</wicri:noCountry>
</affiliation>
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<wicri:regionArea>Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut</wicri:regionArea>
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<country xml:lang="fr">Nouvelle-Zélande</country>
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<author><name sortKey="Medina Mora, M E" sort="Medina Mora, M E" uniqKey="Medina Mora M" first="M. E." last="Medina-Mora">M. E. Medina-Mora</name>
<affiliation wicri:level="1"><nlm:aff id="A19">National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico</nlm:aff>
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<author><name sortKey="Mneimneh, Z" sort="Mneimneh, Z" uniqKey="Mneimneh Z" first="Z." last="Mneimneh">Z. Mneimneh</name>
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<country xml:lang="fr">Liban</country>
<wicri:regionArea>Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA; IDRAAC, Beirut</wicri:regionArea>
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<author><name sortKey="Piazza, M" sort="Piazza, M" uniqKey="Piazza M" first="M." last="Piazza">M. Piazza</name>
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<author><name sortKey="Posada Villa, J" sort="Posada Villa, J" uniqKey="Posada Villa J" first="J." last="Posada-Villa">J. Posada-Villa</name>
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<country xml:lang="fr">Colombie</country>
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<author><name sortKey="Sampson, N" sort="Sampson, N" uniqKey="Sampson N" first="N." last="Sampson">N. Sampson</name>
<affiliation wicri:level="2"><nlm:aff id="A24">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
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<author><name sortKey="Viana, M C" sort="Viana, M C" uniqKey="Viana M" first="M. C." last="Viana">M. C. Viana</name>
<affiliation wicri:level="1"><nlm:aff id="A25">Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
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<author><name sortKey="Xavier, M" sort="Xavier, M" uniqKey="Xavier M" first="M." last="Xavier">M. Xavier</name>
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<author><name sortKey="Bromet, E J" sort="Bromet, E J" uniqKey="Bromet E" first="E. J." last="Bromet">E. J. Bromet</name>
<affiliation wicri:level="2"><nlm:aff id="A27">Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA</nlm:aff>
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<wicri:regionArea>Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York</wicri:regionArea>
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<author><name sortKey="Kendler, K S" sort="Kendler, K S" uniqKey="Kendler K" first="K. S." last="Kendler">K. S. Kendler</name>
<affiliation wicri:level="1"><nlm:aff id="A28">Department of Psychiatry Virginia Commonwealth University, United States</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychiatry Virginia Commonwealth University</wicri:regionArea>
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<author><name sortKey="Kessler, R C" sort="Kessler, R C" uniqKey="Kessler R" first="R. C." last="Kessler">R. C. Kessler</name>
<affiliation wicri:level="2"><nlm:aff id="A24">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The association between childhood adversities and subsequent first onset of psychotic experiences: a cross-national analysis of 23,998 respondents from 17 countries</title>
<author><name sortKey="Mcgrath, J J" sort="Mcgrath, J J" uniqKey="Mcgrath J" first="J. J." last="Mcgrath">J. J. Mcgrath</name>
<affiliation><nlm:aff id="A1">Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland</nlm:aff>
<wicri:noCountry code="subfield">University of Queensland</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Mclaughlin, K A" sort="Mclaughlin, K A" uniqKey="Mclaughlin K" first="K. A." last="Mclaughlin">K. A. Mclaughlin</name>
<affiliation wicri:level="4"><nlm:aff id="A2">Department of Psychology, University of Washington, Seattle, Washington, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychology, University of Washington, Seattle, Washington</wicri:regionArea>
<placeName><region type="state">Washington (État)</region>
<settlement type="city">Seattle</settlement>
</placeName>
<orgName type="university">Université de Washington</orgName>
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<author><name sortKey="Saha, S" sort="Saha, S" uniqKey="Saha S" first="S." last="Saha">S. Saha</name>
<affiliation><nlm:aff id="A1">Queensland Centre for Mental Health Research, and Queensland Brain Institute, University of Queensland</nlm:aff>
<wicri:noCountry code="subfield">University of Queensland</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Aguilar Gaxiola, S" sort="Aguilar Gaxiola, S" uniqKey="Aguilar Gaxiola S" first="S." last="Aguilar-Gaxiola">S. Aguilar-Gaxiola</name>
<affiliation wicri:level="2"><nlm:aff id="A3">Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California</wicri:regionArea>
<placeName><region type="state">Californie</region>
</placeName>
</affiliation>
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<author><name sortKey="Al Hamzawi, A" sort="Al Hamzawi, A" uniqKey="Al Hamzawi A" first="A." last="Al-Hamzawi">A. Al-Hamzawi</name>
<affiliation wicri:level="1"><nlm:aff id="A4">College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq</nlm:aff>
<country xml:lang="fr">Iraq</country>
<wicri:regionArea>College of Medicine, Al-Qadisiya University, Diwaniya governorate</wicri:regionArea>
<wicri:noRegion>Diwaniya governorate</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Alonso, J" sort="Alonso, J" uniqKey="Alonso J" first="J." last="Alonso">J. Alonso</name>
<affiliation wicri:level="3"><nlm:aff id="A5">Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain; Pompeu Fabra University (UPF), Barcelona, Spain; and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bruffaerts, R" sort="Bruffaerts, R" uniqKey="Bruffaerts R" first="R." last="Bruffaerts">R. Bruffaerts</name>
<affiliation wicri:level="1"><nlm:aff id="A6">Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven</wicri:regionArea>
<wicri:noRegion>Leuven</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="De Girolamo, G" sort="De Girolamo, G" uniqKey="De Girolamo G" first="G." last="De Girolamo">G. De Girolamo</name>
<affiliation wicri:level="1"><nlm:aff id="A7">IRCCS St John of God Clinical Research Centre, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>IRCCS St John of God Clinical Research Centre, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia</wicri:regionArea>
<wicri:noRegion>Brescia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="De Jonge, P" sort="De Jonge, P" uniqKey="De Jonge P" first="P." last="De Jonge">P. De Jonge</name>
<affiliation wicri:level="4"><nlm:aff id="A8">Department of Developmental Psychology, Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Developmental Psychology, Research Program Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, Groningen</wicri:regionArea>
<placeName><settlement type="city">Groningue</settlement>
<region nuts="2" type="province">Groningue (province)</region>
<settlement type="city">Groningue (ville)</settlement>
</placeName>
<orgName type="university">Université de Groningue</orgName>
</affiliation>
</author>
<author><name sortKey="Esan, O" sort="Esan, O" uniqKey="Esan O" first="O." last="Esan">O. Esan</name>
<affiliation wicri:level="4"><nlm:aff id="A9">Department of Psychiatry, University of Ibadan, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Psychiatry, University of Ibadan</wicri:regionArea>
<placeName><settlement type="city">Ibadan</settlement>
<region type="region">État d'Oyo</region>
</placeName>
<orgName type="university">Université d'Ibadan</orgName>
</affiliation>
</author>
<author><name sortKey="Florescu, S" sort="Florescu, S" uniqKey="Florescu S" first="S." last="Florescu">S. Florescu</name>
<affiliation wicri:level="1"><nlm:aff id="A10">National School of Public Health, Management and Professional Development, Bucharest, Romania</nlm:aff>
<country xml:lang="fr">Roumanie</country>
<wicri:regionArea>National School of Public Health, Management and Professional Development, Bucharest</wicri:regionArea>
<wicri:noRegion>Bucharest</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Gureje, O" sort="Gureje, O" uniqKey="Gureje O" first="O." last="Gureje">O. Gureje</name>
<affiliation wicri:level="1"><nlm:aff id="A11">Department of Psychiatry, University College Hospital, Ibadan, Nigeria</nlm:aff>
<country xml:lang="fr">Nigeria</country>
<wicri:regionArea>Department of Psychiatry, University College Hospital, Ibadan</wicri:regionArea>
<wicri:noRegion>Ibadan</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Haro, J M" sort="Haro, J M" uniqKey="Haro J" first="J. M." last="Haro">J. M. Haro</name>
<affiliation wicri:level="4"><nlm:aff id="A12">Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
<settlement type="city">Barcelone</settlement>
</placeName>
<orgName type="university">Université de Barcelone</orgName>
</affiliation>
</author>
<author><name sortKey="Hu, C" sort="Hu, C" uniqKey="Hu C" first="C." last="Hu">C. Hu</name>
<affiliation wicri:level="3"><nlm:aff id="A13">Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen</wicri:regionArea>
<placeName><settlement type="city">Shenzhen</settlement>
<region type="province">Guangdong</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Karam, E G" sort="Karam, E G" uniqKey="Karam E" first="E. G." last="Karam">E. G. Karam</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon</nlm:aff>
<country xml:lang="fr">Liban</country>
<wicri:regionArea>Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut</wicri:regionArea>
<wicri:noRegion>Beirut</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kovess Masfety, V" sort="Kovess Masfety, V" uniqKey="Kovess Masfety V" first="V." last="Kovess-Masfety">V. Kovess-Masfety</name>
<affiliation wicri:level="3"><nlm:aff id="A15">Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057 Paris Descartes University, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lee, S" sort="Lee, S" uniqKey="Lee S" first="S." last="Lee">S. Lee</name>
<affiliation wicri:level="4"><nlm:aff id="A16">Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong</nlm:aff>
<country xml:lang="fr">Hong Kong</country>
<wicri:regionArea>Department of Psychiatry, Chinese University of Hong Kong, Tai Po</wicri:regionArea>
<orgName type="university">Université chinoise de Hong Kong</orgName>
<placeName><settlement type="city">Sha Tin</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lepine, J" sort="Lepine, J" uniqKey="Lepine J" first="J." last="Lepine">J. Lepine</name>
<affiliation wicri:level="3"><nlm:aff id="A17">Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes, Paris, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris INSERM UMR-S 1144, University Paris Diderot and Paris Descartes, Paris</wicri:regionArea>
<placeName><region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Lim, C C W" sort="Lim, C C W" uniqKey="Lim C" first="C. C. W." last="Lim">C. C. W. Lim</name>
<affiliation wicri:level="1"><nlm:aff id="A18">Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia, and Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, New Zealand</nlm:aff>
<country xml:lang="fr">Nouvelle-Zélande</country>
<wicri:regionArea>Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia, and Department of Psychological Medicine, Dunedin School of Medicine, University of Otago</wicri:regionArea>
<wicri:noRegion>University of Otago</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Medina Mora, M E" sort="Medina Mora, M E" uniqKey="Medina Mora M" first="M. E." last="Medina-Mora">M. E. Medina-Mora</name>
<affiliation wicri:level="1"><nlm:aff id="A19">National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>National Institute of Psychiatry Ramón de la Fuente, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mneimneh, Z" sort="Mneimneh, Z" uniqKey="Mneimneh Z" first="Z." last="Mneimneh">Z. Mneimneh</name>
<affiliation wicri:level="1"><nlm:aff id="A20">Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA; IDRAAC, Beirut, Lebanon</nlm:aff>
<country xml:lang="fr">Liban</country>
<wicri:regionArea>Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA; IDRAAC, Beirut</wicri:regionArea>
<wicri:noRegion>Beirut</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Pennell, B" sort="Pennell, B" uniqKey="Pennell B" first="B." last="Pennell">B. Pennell</name>
<affiliation wicri:level="2"><nlm:aff id="A21">Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan</wicri:regionArea>
<placeName><region type="state">Michigan</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Piazza, M" sort="Piazza, M" uniqKey="Piazza M" first="M." last="Piazza">M. Piazza</name>
<affiliation wicri:level="1"><nlm:aff id="A22">Universidad Cayetano Heredia, Lima, Peru; National Institute of Health, Lima, Peru</nlm:aff>
<country xml:lang="fr">Pérou</country>
<wicri:regionArea>Universidad Cayetano Heredia, Lima, Peru; National Institute of Health, Lima</wicri:regionArea>
<wicri:noRegion>Lima</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Posada Villa, J" sort="Posada Villa, J" uniqKey="Posada Villa J" first="J." last="Posada-Villa">J. Posada-Villa</name>
<affiliation wicri:level="1"><nlm:aff id="A23">Colegio Mayor de Cundinamarca University, Bogota, Colombia</nlm:aff>
<country xml:lang="fr">Colombie</country>
<wicri:regionArea>Colegio Mayor de Cundinamarca University, Bogota</wicri:regionArea>
<wicri:noRegion>Bogota</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sampson, N" sort="Sampson, N" uniqKey="Sampson N" first="N." last="Sampson">N. Sampson</name>
<affiliation wicri:level="2"><nlm:aff id="A24">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Viana, M C" sort="Viana, M C" uniqKey="Viana M" first="M. C." last="Viana">M. C. Viana</name>
<affiliation wicri:level="1"><nlm:aff id="A25">Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea>Department of Social Medicine, Federal University of Espírito Santo, Vitoria</wicri:regionArea>
<wicri:noRegion>Vitoria</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Xavier, M" sort="Xavier, M" uniqKey="Xavier M" first="M." last="Xavier">M. Xavier</name>
<affiliation wicri:level="1"><nlm:aff id="A26">Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon, Portugal</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea>Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056 Lisbon</wicri:regionArea>
<wicri:noRegion>1169-056 Lisbon</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bromet, E J" sort="Bromet, E J" uniqKey="Bromet E" first="E. J." last="Bromet">E. J. Bromet</name>
<affiliation wicri:level="2"><nlm:aff id="A27">Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kendler, K S" sort="Kendler, K S" uniqKey="Kendler K" first="K. S." last="Kendler">K. S. Kendler</name>
<affiliation wicri:level="1"><nlm:aff id="A28">Department of Psychiatry Virginia Commonwealth University, United States</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychiatry Virginia Commonwealth University</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kessler, R C" sort="Kessler, R C" uniqKey="Kessler R" first="R. C." last="Kessler">R. C. Kessler</name>
<affiliation wicri:level="2"><nlm:aff id="A24">Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts</wicri:regionArea>
<placeName><region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Psychological medicine</title>
<idno type="ISSN">0033-2917</idno>
<idno type="eISSN">1469-8978</idno>
<imprint><date when="2017">2017</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
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<profileDesc><textClass></textClass>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">We assessed CAs, PEs and DSM-IV mental disorders in 23,998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs (OR =2.3, 95%CI=1.9–2.6). CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR= 8.5, 95%CI=3.6–20.2), whereas other CA types were associated with PE onset in adolescence. Associations of Other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.</p>
</sec>
</div>
</front>
</TEI>
</record>
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