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Clinical significance of psychotic experiences in the context of sleep disturbance or substance use

Published online by Cambridge University Press:  08 March 2016

J. E. DeVylder  and
I. Kelleher
J. E. DeVylder*
Affiliation:
School of Social Work, University of Maryland, Baltimore, MD, USA
I. Kelleher
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Republic of Ireland
*
*Address for correspondence: J. E. DeVylder, Ph.D., School of Social Work, University of Maryland, 525 West Redwood Street, Baltimore, MD 21201, USA. (Email: [email protected])
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Abstract

Background

Psychotic experiences (PE) are commonly reported in the general population, where they are associated with elevated clinical need and functional impairment. Research studies typically exclude PE that occur in the context of sleep or substance use (PE-SS), based on the assumption that they are normative within these contexts. This is the first study to formally test clinical and functional outcomes associated with PE that occur in the context of sleep or substance use.

Method

Data from the Collaborative Psychiatric Epidemiology Surveys (n = 11 776) were used to assess the associations between both PE and PE-SS and a broad range of outcomes, including psychiatric co-morbidity, suicidal behavior, mental health treatment utilization and World Health Organization (WHO) domains of function, using logistic regression analyses. Lifetime PE and PE-SS were mutually exclusive categories, assessed using the WHO Composite International Diagnostic Interview psychosis screen.

Results

PE were associated with all 10 clinical and functional outcomes. Similarly, respondents reporting PE-SS had greater clinical need and impaired function relative to controls, which was significant for seven of the 10 outcome variables. When directly compared, the PE and PE-SS groups differed only in their associations with role function (greater impairment for PE) and self-care (greater impairment for PE-SS).

Conclusions

PE-SS were associated with a broad range of clinical and functional outcomes in this large general population sample. These associations were similar to those found for PE. Future studies should investigate relative differences between sleep- and substance-induced PE.

Keywords

Collaborative Psychiatric Epidemiology Surveysepidemiologypsychosissleepsubstance use
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 8 , June 2016 , pp. 1761 - 1767
Copyright
Copyright © Cambridge University Press 2016 

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