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General population has low lifetime prevalence of psychotic experiences

Approximately two-thirds of the general population that report psychotic episodes only experience one to five episodes during their lifetime, according to data from a cross-national analysis.

“A recent meta-analysis based on 61 studies reported that the median lifetime prevalence of [psychotic experiences] was 7.2%. Because this prevalence is substantially higher than the lifetime morbid risk for psychotic disorders, such as schizophrenia (mean morbid risk, 0.7%), the field of psychiatric epidemiology has been forced to rethink how [psychotic experiences] fit into the epidemiologic landscape of psychotic disorders,” study researcher John J. McGrath, MD, PhD, of the Queensland Centre for Mental Health Research in Wacol, Australia, and colleagues wrote.

Researchers used data from the WHO World Mental Health surveys, a series of population-based surveys administered throughout the world, to examine epidemiologic information on psychotic experiences across a multinational cohort. Data from 18 countries were collected from 2001 through 2009. Researchers excluded individuals with possible or diagnosed schizophrenia, psychosis, manic depression and/or mania. The final study cohort included 31,261 survey respondents.

Lifetime prevalence of at least one psychotic experience was 5.8%. Lifetime prevalence of at least one hallucinatory experience was 5.2%. Approximately 1.3% of the cohort reported at least one delusional experience during their lifetime.

Women had a significantly higher lifetime prevalence of psychotic experiences (6.6% vs. 5%; P < .001), including hallucinatory experiences (5.9% vs. 4.3%; P < .001) compared with men.

Lifetime prevalence of psychotic, hallucinatory and delusional experiences was significantly higher among individuals in middle- and high-income countries vs. low-income countries (P < .001 for both).

Being a homemaker or reporting other employment (eg, looking for work or disabled) (P < .001), being non-married (P < .001) and having lower household income (P < .001) increased risk for psychotic, hallucinatory and delusional experiences.

Individuals aged 18 to 29 years were more likely to report delusional experiences vs. those aged older than 60 years, though age was unrelated regarding psychotic and hallucinatory experiences.

Of those who reported experiencing psychotic episodes, 32.2% reported only one psychotic episode during their lifetime and 31.8% reported two to five episodes. Thus, researchers inferred that these experiences occurred only one to five times among an estimated two-thirds of individuals who experienced psychotic episodes during their lifetime.

“Although the lifetime prevalence of [psychotic experiences] is 5.8%, these events are typically rare. For nearly one-third of individuals who have [psychotic experiences] (ie, 32.2%), these events were solitary,” McGrath and colleagues wrote. “The research community needs to leverage this fine-grained information to better determine how [psychotic experiences] reflect risk status.” – by Amanda Oldt

Disclosure: McGrath reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.