Is delusional- like experience linked to social adversity? Europ Psy:Jan:13

29.01.2013

Delusional-like experiences (DLE) are common in general population.DLE is associated with mental disorders including psychosis.Stress is considered as one of the mechanisms that contribute to DLE.  No surprise as low socio economic status is a risk factor for broadly defined mental disorder. Studies from Australia and UK have shown that DLE is associated with social disadvantage.( Scott e2008, Morgan 2009).

Individual level disadvantages as well as area level disadvantages ( like ethnic density, general deprivation, social fragmentation,  reduced social capital and cohesion)  are linked with risk of psychosis. This study from Australia by Saha et al  investigated whether the is also the case with DLE.

The participants (around 9000) were from the national face-to-face household survey of  community residents aged between 16 and 85 years (Australian National Survey of Mental Health and Wellbeing 2007)  . Three questions from the CIDI diagnostic interview were used to assess DLE by  trained interviewers. (1.‘‘Have you ever felt that your thoughts were being directly interfered with or controlled by another person?’’ 2. ‘‘Have you ever had a feeling that people were too interested in you?’’ 3. ‘‘Do you ever have any special powers that most people lack?’ )

Results

8.4% endorsed one or more DLE. This was more in young age groups, never married/widowed/separated/divorced, migrants and those living in rented houses. Those living in disadvantaged areas were more likely to endorse DLE. Both Individual and area level indicators of social disadvantage were associated with increased DLE.

Limitations: Cross sectional study , hence direction of causality cannot be established. Only three questions were used to detect DLE. (No questions on hallucinatory experiences).  Area level assessment was done in a small catchment area only.

Summary of the article:

Socio-economic disadvantage and delusional-like experiences: A nationwidepopulation-based study.

Saha S, Scott JG, Varghese D, McGrath JJ. Eur Psychiatry. 2013 Jan;28(1):59-63.

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