Psychotic experiences in the general population: A cross-national analysis based on 31 261 respondents from 18 countries

John J. McGrath, Sukanta Saha, Ali Al-Hamzawi, Jordi Alonso, Evelyn J. Bromet, Ronny Bruffaerts, José M. Caldas-de-Almeida, Wai Tat Chiu, Peter De Jonge, John Fayyad, Silvia Florescu, Oye Gureje, Josep Maria Haro, Chiyi Hu, Viviane Kovess-Masfety, Jean Pierre Lepine, Carmen C.W. Lim, Maria Elena Medina Mora, Fernando Navarro-Mateu, Susana OchoaNancy Sampson, Kate Scott, Maria Carmen Viana, Ronald C. Kessler

Research output: Contribution to journalArticlepeer-review

267 Citations (Scopus)


IMPORTANCE Community-based surveys find that many otherwise healthy individuals report histories of hallucinations and delusions. To date, most studies have focused on the overall lifetime prevalence of any of these psychotic experiences (PEs), which might mask important features related to the types and frequencies of PEs. OBJECTIVE To explore detailed epidemiologic information about PEs in a large multinational sample. DESIGN, SETTING, AND PARTICIPANTS We obtained data from theWorld Health Organization World Mental Health Surveys, a coordinated set of community epidemiologic surveys of the prevalence and correlates of mental disorders in representative household samples from 18 countries throughout the world, from 2001 through 2009. Respondents included 31 261 adults (18 years and older) who were asked about lifetime and 12-month prevalence and frequency of 6 types of PEs (2 hallucinatory experiences and 4 delusional experiences).We analyzed the data from March 2014 through January 2015. MAIN OUTCOMES AND MEASURES Prevalence, frequency, and correlates of PEs. RESULTS Mean lifetime prevalence (SE) of ever having a PE was 5.8% (0.2%), with hallucinatory experiences (5.2%[0.2%]) much more common than delusional experiences (1.3%[0.1%]). More than two-thirds (72.0%) of respondents with lifetime PEs reported experiencing only 1 type. Psychotic experiences were typically infrequent, with 32.2%of respondents with lifetime PEs reporting only 1 occurrence and 31.8%reporting only 2 to 5 occurrences. We found a significant relationship between having more than 1 type of PE and having more frequent PE episodes (Cochran-Armitage z = -10.0; P < .001). Lifetime prevalence estimates (SEs) were significantly higher among respondents in middle- and high-income countries than among those in low-income countries (7.2%[0.4%], 6.8% [0.3%], and 3.2%[0.3%], respectively; χ22 range, 7.1-58.2; P < .001 for each) and among women than among men (6.6%[0.2%] vs 5.0%[0.3%]; χ12 = 16.0; P < .001).We found significant associations with lifetime prevalence of PEs in the multivariate model among nonmarried compared with married respondents (χ22 = 23.2; P < .001) and among respondents who were not employed (χ24 = 10.6; P < .001) and who had low family incomes (χ32 = 16.9; P <.001). CONCLUSIONS AND RELEVANCE The epidemiologic features of PEs are more nuanced than previously thought. Research is needed that focuses on similarities and differences in the predictors of the onset, course, and consequences of distinct PEs.

Original languageEnglish
Pages (from-to)697-705
Number of pages9
JournalJAMA Psychiatry
Issue number7
Publication statusPublished - Jul 2015


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