Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-23T14:24:55.868Z Has data issue: false hasContentIssue false

The 12-month prevalence of psychotic experiences and their association with clinical outcomes in Hong Kong: an epidemiological and a 2-year follow up studies

Published online by Cambridge University Press:  29 May 2020

Sherry Kit Wa Chan*
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
Kaspar Kit Wai Lee
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong
Veronica Hei Yan Chan*
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Herbert H. Pang
Affiliation:
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Corine Sau Man Wong
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Christy Lai Ming Hui
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Wing Chung Chang
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
Edwin Ho Ming Lee
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Wai Chi Chan*
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Eric Fuk Chi Cheung
Affiliation:
Kwong Wah Hospital, Kowloon, Hong Kong
Helen Fung Kum Chiu
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong
Tin Po Chiang
Affiliation:
Castle Peak Hospital, Hong Kong
Ming Lam
Affiliation:
Castle Peak Hospital, Hong Kong
Joseph Tak Fai Lau
Affiliation:
Center for Health Behaviours Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong
Roger Man King Ng
Affiliation:
Kowloon Hospital, Hong Kong SAR, Hong Kong
Se Fong Hung
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong
Linda Chiu Wa Lam
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong
Eric Yu Hai Chen
Affiliation:
Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
*
Author for correspondence: Sherry Kit Wa Chan, E-mail: kwsherry@gmail.com
Author for correspondence: Sherry Kit Wa Chan, E-mail: kwsherry@gmail.com
Author for correspondence: Sherry Kit Wa Chan, E-mail: kwsherry@gmail.com

Abstract

Background

The relationship between the subtypes of psychotic experiences (PEs) and common mental health symptoms remains unclear. The current study aims to establish the 12-month prevalence of PEs in a representative sample of community-dwelling Chinese population in Hong Kong and explore the relationship of types of PEs and common mental health symptoms.

Method

This is a population-based two-phase household survey of Chinese population in Hong Kong aged 16–75 (N = 5719) conducted between 2010 and 2013 and a 2-year follow-up study of PEs positive subjects (N = 152). PEs were measured with Psychosis Screening Questionnaire (PSQ) and subjects who endorsed any item on the PSQ without a clinical diagnosis of psychotic disorder were considered as PE-positive. Types of PEs were characterized using a number of PEs (single v. multiple) and latent class analysis. All PE-positive subjects were assessed with common mental health symptoms and suicidal ideations at baseline and 2-year follow-up. PE status was also assessed at 2-year follow-up.

Results

The 12-month prevalence of PEs in Hong Kong was 2.7% with 21.1% had multiple PEs. Three latent classes of PEs were identified: hallucination, paranoia and mixed. Multiple PEs and hallucination latent class of PEs were associated with higher levels of common mental health symptoms. PE persistent rate at 2-year follow-up was 15.1%. Multiple PEs was associated with poorer mental health at 2-year follow-up.

Conclusions

Results highlighted the transient and heterogeneous nature of PEs, and that multiple PEs and hallucination subtype of PEs may be specific indices of poorer common mental health.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, J., Saha, S., Lim, C. C., Aguilar-Gaxiola, S., Al-Hamzawi, A., Benjet, C., … Florescu, S. (2018). The association between psychotic experiences and health-related quality of life: A cross-national analysis based on World Mental Health Surveys. Schizophrenia Research, 201, 4653.CrossRefGoogle ScholarPubMed
Bebbington, P., & Nayani, T. (1995). The psychosis screening questionnaire. International Journal of Methods in Psychiatric Research, 5(1), 1119.Google Scholar
Beck, A. T., Brown, G. K., & Steer, R. A. (1997). Psychometric characteristics of the Scale for Suicide Ideation with psychiatric outpatients. Behaviour Research and Therapy, 35(11), 10391046.CrossRefGoogle ScholarPubMed
Borsboom, D. (2017). A network theory of mental disorders. World Psychiatry, 16(1), 513.CrossRefGoogle ScholarPubMed
Census and Statistics Department (2016). Population by-census: Main results. Hong Kong: Publications Unit of C&SD.Google Scholar
Chang, W. C., Wong, C. S. M., Chen, E. Y. H., Lam, L. C. W., Chan, W. C., Ng, R. M. K., … Lam, M. (2017). Lifetime prevalence and correlates of schizophrenia-spectrum, affective, and other non-affective psychotic disorders in the Chinese adult population. Schizophrenia Bulletin, 43(6), 12801290.CrossRefGoogle ScholarPubMed
Coid, J. W., Hu, J., Kallis, C., Ping, Y., Zhang, J., Hu, Y., … Kirkbride, J. B. (2018). Urban birth, urban living, and work migrancy: Differential effects on psychotic experiences among young Chinese men. Schizophrenia Bulletin, 44(5), 11231132.CrossRefGoogle ScholarPubMed
Collip, D., Wigman, J. T., Lin, A., Nelson, B., Oorschot, M., Vollebergh, W. A., … Myin-Germeys, I. (2013). Dynamic association between interpersonal functioning and positive symptom dimensions of psychosis over time: A longitudinal study of healthy adolescents. Schizophrenia Bulletin, 39(1), 179185.CrossRefGoogle ScholarPubMed
DeVylder, J. E., Burnette, D., & Yang, L. H. (2014). Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples. Psychological Medicine, 44(16), 35033513.CrossRefGoogle ScholarPubMed
Dziak, J. J., Lanza, S. T., & Tan, X. (2014). Effect size, statistical power, and sample size requirements for the bootstrap likelihood ratio test in latent class analysis. Structural Equation Modeling: A Multidisciplinary Journal, 21(4), 534552.CrossRefGoogle ScholarPubMed
Gale, C. K., Wells, J. E., McGee, M. A., & Oakley Browne, M. A. (2011). A latent class analysis of psychosis-like experiences in the New Zealand Mental Health Survey. Acta Psychiatrica Scandinavica, 124(3), 205213.CrossRefGoogle ScholarPubMed
Gray, M. J., Litz, B. T., Hsu, J. L., & Lombardo, T. W. (2004). Psychometric properties of the life events checklist. Assessment, 11(4), 330341.CrossRefGoogle ScholarPubMed
Jenkins, R., Bebbington, P., Brugha, T., Farrell, M., Gill, B., Lewis, G., … Petticrew, M. (2003). The National Psychiatric Morbidity Surveys of Great Britain – strategy and methods. International Review of Psychiatry, 15(1–2), 513.CrossRefGoogle ScholarPubMed
Kaymaz, N., Drukker, M., Lieb, R., Wittchen, H. U., Werbeloff, N., Weiser, M., … Van Os, J. (2012). Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychological Medicine, 42(11), 22392253.CrossRefGoogle ScholarPubMed
Kelleher, I., Keeley, H., Corcoran, P., Lynch, F., Fitzpatrick, C., Devlin, N., … Arseneault, L. (2012a). Clinicopathological significance of psychotic experiences in non-psychotic young people: Evidence from four population-based studies. The British Journal of Psychiatry, 201(1), 2632.CrossRefGoogle Scholar
Kelleher, I., Lynch, F., Harley, M., Molloy, C., Roddy, S., Fitzpatrick, C., & Cannon, M. (2012b). Psychotic symptoms in adolescence index risk for suicidal behavior: Findings from 2 population-based case-control clinical interview studies. Archives of General Psychiatry, 69(12), 12771283.CrossRefGoogle Scholar
Lam, L. C. W., Chan, W. C., Wong, C. S. M., Chen, E. Y. H., Ng, R. M. K., Lee, E. H. M., … Chiu, H. F. K. (2014). The Hong Kong mental morbidity survey: Background and study design. East Asian Archives of Psychiatry, 24(1), 3036.Google Scholar
Lam, L. C. W., Wong, C. S. M., Wang, M. J., Chan, W. C., Chen, E. Y. H., Ng, R. M. K., … Lam, M. (2015). Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: The Hong Kong Mental Morbidity Survey (HKMMS). Social Psychiatry and Psychiatric Epidemiology, 50(9), 13791388.CrossRefGoogle Scholar
Lee, K. W., Chan, K. W., Chang, W. C., Lee, E. H. M., Hui, C. L. M., & Chen, E. Y. H. (2016). A systematic review on definitions and assessments of psychotic-like experiences. Early Intervention in Psychiatry, 10(1), 316.CrossRefGoogle ScholarPubMed
Lewis, G., Pelosi, A. J., Araya, R., & Dunn, G. (1992). Measuring psychiatric disorder in the community: A standardized assessment for use by lay interviewers. Psychological Medicine, 22(2), 465486.CrossRefGoogle ScholarPubMed
Linscott, R. J., & 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(6), 11331149.CrossRefGoogle ScholarPubMed
Mamah, D., Owoso, A., Mbwayo, A. W., Mutiso, V. N., Muriungi, S. K., Khasakhala, L. I., … Ndetei, D. M. (2013). Classes of psychotic experiences in Kenyan children and adolescents. Child Psychiatry & Human Development, 44(3), 452459.CrossRefGoogle ScholarPubMed
McGrath, J. J., Saha, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., Bruffaerts, R., … Florescu, S. (2015). Psychotic experiences in the general population: A cross-national analysis based on 31 261 respondents from 18 countries. JAMA Psychiatry, 72(7), 697705.CrossRefGoogle ScholarPubMed
Muthén, B. O., Muthén, L. K., & Asparouhov, T. (2017). Regression and mediation analysis using mplus. Los Angeles, CA: Muthén & Muthén.Google Scholar
Navarro-Mateu, F., Alonso, J., Lim, C. C., Saha, S., Aguilar-Gaxiola, S., Al-Hamzawi, A., … Degenhardt, L. (2017). The association between psychotic experiences and disability: Results from the WHO World Mental Health Surveys. Acta Psychiatrica Scandinavica, 136(1), 7484.CrossRefGoogle ScholarPubMed
Nuevo, R., Chatterji, S., Verdes, E., Naidoo, N., Arango, C., & Ayuso-Mateos, J. L. (2012). The continuum of psychotic symptoms in the general population: A cross-national study. Schizophrenia Bulletin, 38(3), 475485.CrossRefGoogle ScholarPubMed
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535569.CrossRefGoogle Scholar
Oh, H., Koyanagi, A., Kelleher, I., & DeVylder, J. (2018). Psychotic experiences and disability: Findings from the Collaborative Psychiatric Epidemiology Surveys. Schizophrenia Research, 193, 343347.CrossRefGoogle ScholarPubMed
Perez, J., & Jones, P. B. (2019). Breaking the web: Life beyond the at-risk mental state for psychosis. Psychological Medicine, 16 https://doi.org/10.1017/ S0033291719002605.Google ScholarPubMed
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.CrossRefGoogle ScholarPubMed
Saunders, J. B., Aasland, O. G., Babor, T. F., De la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791804.CrossRefGoogle Scholar
Shevlin, M., Murphy, J., Dorahy, M. J., & Adamson, G. (2007). The distribution of positive psychosis-like symptoms in the population: A latent class analysis of the National Comorbidity Survey. Schizophrenia Research, 89(1–3), 101109.CrossRefGoogle ScholarPubMed
So, E., Kam, I., & Lam, L. (2004). The Chinese Bilingual SCID-I/P project: Stage 3--multi-site inter-rater reliability. East Asian Archives of Psychiatry, 14(3), 1926.Google Scholar
Stochl, J., Khandaker, G. M., Lewis, G., Perez, J., Goodyer, I. M., Zammit, S., … Jones, P. B. (2015). Mood, anxiety and psychotic phenomena measure a common psychopathological factor. Psychological Medicine, 45(7), 14831493.Google Scholar
van Os, J., Hanssen, M., Bijl, R. V., & Ravelli, A. (2000). Strauss (1969) revisited: A psychosis continuum in the general population? Schizophrenia Research, 45(1–2), 1120.CrossRefGoogle ScholarPubMed
van Os, J., & Linscott, R. J. (2012). Introduction: The extended psychosis phenotype—relationship with schizophrenia and with ultrahigh risk status for psychosis. Schizophrenia Bulletin, 38(2), 227230.CrossRefGoogle Scholar
van Os, J., Linscott, R. J., Myin-Germeys, I., Delespaul, P., & Krabbendam, L. J. P. M. (2009). A systematic review and meta-analysis of the psychosis continuum: Evidence for a psychosis proneness–persistence–impairment model of psychotic disorder. Psychological Medicine, 39(2), 179195.CrossRefGoogle ScholarPubMed
van Os, J., & Reininghaus, U. (2016). Psychosis as a transdiagnostic and extended phenotype in the general population. World Psychiatry, 15(2), 118124.CrossRefGoogle ScholarPubMed
Wang, C., Wang, Q., Li, X., Zhang, Y., Wei, W., Deng, W., … Li, T. (2019). Rural birth/upbringing and childhood adversities are associated with psychotic experiences in university students in China. Schizophrenia Research, 209, 105112.CrossRefGoogle ScholarPubMed
Wigman, J. T. W., van Winkel, R., Raaijmakers, Q. A., Ormel, J., Verhulst, F. C., Reijneveld, S. A., … Vollebergh, W. A. (2011). Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: A 6-year longitudinal general population study. Psychological Medicine, 41(11), 23172329.CrossRefGoogle ScholarPubMed
World Bank Country and Lending Groups. (2019). Retrieved December 10, 2019, from https://datahelpdesk.worldbank.org/knowledgebase/articles/906519.Google Scholar
Yung, A. R., Yuen, H. P., McGorry, P. D., Phillips, L. J., Kelly, D., Dell'Olio, M., … Godfrey, K. (2005). Mapping the onset of psychosis: The comprehensive assessment of at-risk mental states. Australian and New Zealand Journal of Psychiatry, 39(11-12), 964971.CrossRefGoogle ScholarPubMed
Zammit, S., Kounali, D., Cannon, M., David, A. S., Gunnell, D., Heron, J., … Lewis, G. (2013). Psychotic experiences and psychotic disorders at age 18 in relation to psychotic experiences at age 12 in a longitudinal population-based cohort study. American Journal of Psychiatry, 170(7), 742750.CrossRefGoogle Scholar
Supplementary material: File

Chan et al. supplementary material

Tables S1-S5

Download Chan et al. supplementary material(File)
File 28.5 KB