Article

The prevalence and correlates of nonaffective psychosis in the National Comorbidity Survey Replication (NCS-R).

Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA.
Biological Psychiatry (Impact Factor: 9.47). 11/2005; 58(8):668-76. DOI: 10.1016/j.biopsych.2005.04.034
Source: PubMed

ABSTRACT To estimate the prevalence and correlates of clinician-diagnosed DSM-IV nonaffective psychosis (NAP) in a national household survey.
Data came from the United States National Comorbidity Survey Replication (NCS-R). A screen for NAP was followed by blinded sub-sample clinical reappraisal interviews. Logistic regression was used to impute clinical diagnoses to respondents who were not re-interviewed. The method of Multiple Imputation (MI) was used to estimate prevalence and correlates.
Clinician-diagnosed NAP was well predicted by the screen (area under the curve [AUC] = .80). The MI prevalence estimate of NAP (standard error in parentheses) is 5.0 (2.6) per 1000 population lifetime and 3.0 (2.2) per 1000 past 12 months. The vast majority (79.4%) of lifetime and 12-month (63.7%) cases met criteria for other DSM-IV hierarchy-free disorders. Fifty-eight percent of 12-month cases were in treatment, most in the mental health specialty sector.
The screen for NAP in the NCS-R greatly improved on previous epidemiological surveys in reducing false positives, but coding of open-ended screening scale responses was still needed to achieve accurate prediction. The lower prevalence estimate than in total-population incidence studies raises concerns that systematic nonresponse bias causes downward bias in survey prevalence estimates of NAP.

Download full-text

Full-text

Available from: Margaret Guyer, Jul 20, 2014
0 Followers
 · 
137 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: School-related difficulties have received relatively little attention as environmental risk factors for psychotic experiences (PEs), despite being characterized by marginalization and social defeat during critical periods of psychological development. This study examined both childhood age relative to one׳s classmates and school mobility as risk factors for adult psychotic experiences in the National Comorbidity Survey-Replication (NCS-R). Weighted logistic regression models were used to explore the hypotheses that lifetime psychotic experiences reported on the World Health Organization psychosis screen would be more prevalent among those younger than their classmates during childhood and for those with frequent school mobility. Younger perceived relative age (odds ratio (OR)=2.05, 95% confidence interval=1.43-2.95) was independently associated with psychotic experiences in the fully adjusted model, but school mobility was not. School-related risk factors for psychosis provide promising points for community-level intervention, and support the claim that environmental factors characterized by disadvantage and marginalization contribute to psychosis etiology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 01/2015; 226(1). DOI:10.1016/j.psychres.2015.01.017 · 2.68 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective. To examine racial-ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African-Americans, Asians, Caribbean Blacks, and Latinos living in the USA.Design. Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n > 100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms.Results. African-Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p p p p supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms.Conclusion. Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self-reported attributions/understandings for these symptoms on a psychosis screening instrument. Ethnic/racial differences could result from culturally sanctioned beliefs and idioms of distress that deserve more attention in conducting culturally informed and responsive screening, assessment and treatment.
    Ethnicity and Health 06/2014; 20(3):1-20. DOI:10.1080/13557858.2014.921888 · 1.28 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives This article offers new evidence on whether stalking damages the mental health of female victims. This study advances the literature by accounting for age of initial stalking victimization, mental health status prior to being stalked, and exposure to other forms of traumatic victimization. Methods Using logistical analysis, we utilize data drawn from three large national data sets. ResultsWe find that being the victim of stalking as a young adult, ages 18–45, significantly increases the odds of initial onset of psychological distress; however, this is not the case for victims ages 12–17. Conclusions Stalking has emerged as a deeply disturbing public issue because of its prevalence and the fear it creates in victims. Unfortunately, little is known about the psychological consequences of being stalked because the emerging literature typically is based on small, nonrandom samples. Our findings highlight the benefits of reducing stalking and the importance of supporting victims.
    Social Science Quarterly 09/2013; 95(2). DOI:10.1111/ssqu.12058 · 0.99 Impact Factor