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Social support and delusional-like experiences: a nationwide population-based study

Published online by Cambridge University Press:  25 January 2012

S. Saha*
Affiliation:
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia
J. Scott
Affiliation:
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia Metro North Mental Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia The University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia Discipline of Psychiatry, University of Queensland, St Lucia, QLD, Australia
D. Varghese
Affiliation:
Princess Alexandra Hospital, Woolloongabba, QLD 4102, Australia
J. McGrath
Affiliation:
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia Discipline of Psychiatry, University of Queensland, St Lucia, QLD, Australia Queensland Brain Institute, University of Queensland, St Lucia, QLD, Australia
*
*Address for correspondence: Dr Sukanta Saha, Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD 4076, Australia. (Email: sukanta_saha@qcmhr.uq.edu.au)

Abstract

Background.

Population-based studies have identified that delusional-like experiences (DLEs) are common in the general population. While there is a large literature exploring the relationship between poor social support and risk of mental illness, there is a lack of empirical data examining the association of poor social support and DLEs. The aim of the study was to explore the association between social support and DLEs using a large, nationally representative community sample.

Methods.

Subjects were drawn from a national multistage probability survey of 8841 adults aged between 16 and 85 years. The Composite International Diagnostic Interview was used to identify DLEs, common psychiatric disorders and physical disorders. Eight questions assessed various aspects of social support with spouse/partners and other family and friends. We examined the relationship between DLEs and social support using logistic regression, adjusting for potential confounding factors.

Results.

Of the sample, 8.4% (n = 776) positively endorsed one or more DLEs. Individuals who (a) had the least contact with friends, or (b) could not rely on or confide in spouse/partner, family or friends were significantly more likely to endorse DLEs. The associations remained significant after adjusting for a range of potential confounding factors.

Conclusions.

DLEs are associated with impoverished social support in the general population. While we cannot exclude the possibility that the presence of isolated DLEs results in a reduction of social support, we speculate that poor social support may contribute in a causal fashion to the risk of DLEs.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2012

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References

Allardyce, J, Boydell, J (2006). Review: The wider social environment and schizophrenia. Schizophrenia Bulletin 32, 592598.CrossRefGoogle ScholarPubMed
An, AB (2004). Performing logistic regression on survey data with the new SURVEYLOGISTIC procedure. In Proceedings of the 27th Annual SAS Users Group International Conference 2004 (http://www2.sas.com/proceedings/sugi27/p258-27.pdf)Google Scholar
Armando, M, Nelson, B, Yung, AR, Ross, M, Birchwood, M, Girardi, P, Fiori Nastro, P (2010). Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophrenia Research 119, 258–225.CrossRefGoogle Scholar
Australian Bureau of Statistics (2008). National Survey of Mental Health and Welbeing: Summary of Results, 2007(Explanatory Notes). Cat No. 4326.0. Australian Bureau of Statistics: Canberra.Google Scholar
Barbui, C, Cipriani, A (2011). What are evidence-based treatment recommendations? Epidemiology and Psychiatric Sciences 20, 2931.CrossRefGoogle ScholarPubMed
Blanchard, JJ, Collins, LM, Aghevli, M, Leung, WW, Cohen, AS (2011). Social anhedonia and schizotypy in a community sample: the Maryland longitudinal study of schizotypy. Schizophrenia Bulletin 37, 587602.CrossRefGoogle Scholar
Brugha, TS, Wing, JK, Brewin, CR, MacCarthy, B, Lesage, A (1993). The relationship of social network deficits with deficits in social functioning in long-term psychiatric disorders. Social Psychiatry and Psychiatric Epidemiology 28, 218224.CrossRefGoogle ScholarPubMed
Cantor-Graae, E (2007). The contribution of social factors to the development of schizophrenia: a review of recent findings. Canadian Journal of Psychiatry 52, 277286.CrossRefGoogle Scholar
Cohen, AS, Najolia, GM, Brown, LA, Minor, KS (2011). The state-trait disjunction of anhedonia in schizophrenia: potential affective, cognitive and social-based mechanisms. Clinical Psychology Review 31, 440448.CrossRefGoogle ScholarPubMed
Cohen, S, Wills, TA (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin 98, 310357.CrossRefGoogle ScholarPubMed
Degenhardt, L, Hall, W (2001). The association between psychosis and problematical drug use among Australian adults: findings from the National Survey of Mental Health and Well-Being. Psychological Medicine 31, 659668.CrossRefGoogle ScholarPubMed
Degenhardt, L, Hall, W, Korten, A, Jablensky, A (2005). Use of a brief screening instrument for psychosis: Results of an ROC analysis. In NDARC Technical Report No. 210. National Drug and Alcohol Research Centre: Sydney.Google Scholar
Dominguez, MD, Saka, MC, Lieb, R, Wittchen, HU, Van Os, J (2010). Early expression of negative/disorganized symptoms predicting psychotic experiences and subsequent clinical psychosis: a 10-year study. American Journal of Psychiatry 167, 10751082.CrossRefGoogle Scholar
Erickson, DH, Beiser, M, Iacono, WG (1998). Social support predicts 5-year outcome in first-episode schizophrenia. Journal of Abnormal Psychology 107, 681685.CrossRefGoogle ScholarPubMed
Hanssen, M, Bak, M, Bijl, R, Vollebergh, W, Van Os, J (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology 44, 181191.CrossRefGoogle ScholarPubMed
Henderson, AS (1984). Interpreting the evidence on social support. Social Psychiatry 19, 4952.CrossRefGoogle ScholarPubMed
Henderson, S (1977). The social network, support and neurosis. The function of attachment in adult life. British Journal of Psychiatry 131, 185191.CrossRefGoogle ScholarPubMed
Henderson, S (1980). Personal networks and the schizophrenias. Australian and New Zealand Journal of Psychiatry 14, 255259.CrossRefGoogle ScholarPubMed
Kawachi, I, Berkman, LF (2001). Social ties and mental health. Journal of Urban Health 78, 458467.CrossRefGoogle ScholarPubMed
Kelleher, I, Cannon, M (2011). Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychological Medicine 41, 16.CrossRefGoogle Scholar
Krabbendam, L, Van Os, J (2005). Schizophrenia and urbanicity: a major environmental influence–conditional on genetic risk. Schizophrenia Bulletin 31, 795799.CrossRefGoogle Scholar
Kwapil, TR (1998). Social anhedonia as a predictor of the development of schizophrenia-spectrum disorders. Journal of Abnormal Psychology 107, 558565.CrossRefGoogle ScholarPubMed
Lincoln, TM (2007). Relevant dimensions of delusions: continuing the continuum versus category debate. Schizophrenia Research 93, 211220.CrossRefGoogle ScholarPubMed
Linscott, RJ, Van Os, J (2010). Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annual Review of Clinical Psychology 6, 391419.CrossRefGoogle ScholarPubMed
Meehl, P (1990). Toward an integrated theory of schizotaxia, schizotypy, and schizophrenia. Journal of Personality Disorders 41, 199.CrossRefGoogle Scholar
Oshima, N, Nishida, A, Fukushima, M, Shimodera, S, Kasai, K, Okazaki, Y, Sasaki, T (2010). Psychotic-like experiences (PLEs) and mental health status in twin and singleton Japanese high school students. Early Intervention in Psychiatry 4, 206213.CrossRefGoogle ScholarPubMed
Reininghaus, UA, Morgan, C, Simpson, J, Dazzan, P, Morgan, K, Doody, GA, Bhugra, D, Leff, J, Jones, P, Murray, R, Fearon, P, Craig, TK (2008). Unemployment, social isolation, achievement–expectation mismatch and psychosis: findings from the AESOP Study. Social Psychiatry and Psychiatric Epidemiology 43, 743751.CrossRefGoogle ScholarPubMed
Rust, KF, Rao, JN (1996). Variance estimation for complex surveys using replication techniques. Statistical Methods in Medical Research 5, 283310.CrossRefGoogle ScholarPubMed
Saha, S, Scott, J, Varghese, D, McGrath, J (2011 a). The association between physical health and delusional-like experiences: a general population study. PLoS ONE 6, e18566. doi:10.1371/journal.pone.0018566.CrossRefGoogle ScholarPubMed
Saha, S, Scott, JG, Johnston, AK, Slade, TN, Varghese, D, Carter, GL, McGrath, JJ (2011 b). The association between delusional-like experiences and suicidal thoughts and behaviour. Schizophrenia Research 132, 197202.CrossRefGoogle ScholarPubMed
Saha, S, Scott, JG, Varghese, D, McGrath, JJ (2011 c). The association between general psychological distress and delusional-like experiences: a large population-based study. Schizophrenia Research 127, 246251.CrossRefGoogle ScholarPubMed
Saha, S, Varghese, D, Slade, T, Degenhardt, L, Mills, K, McGrath, J, Scott, J (2011 d). The association between trauma and delusional-like experiences. Psychiatry Research 189, 259264.CrossRefGoogle ScholarPubMed
Scott, J, Chant, D, Andrews, G, McGrath, J (2006). Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample. Psychological Medicine 36, 231238.CrossRefGoogle Scholar
Scott, J, Chant, D, Andrews, G, Martin, G, McGrath, J (2007). Association between trauma exposure and delusional experiences in a large community-based sample. British Journal of Psychiatry 190, 339343.CrossRefGoogle Scholar
Slade, T, Johnston, A, Oakley Browne, MA, Andrews, G, Whiteford, H (2009). 2007 National Survey of Mental Health and Wellbeing: methods and key findings. Australia and New Zealand Journal of Psychiatry 43, 594605.CrossRefGoogle ScholarPubMed
Stip, E, Letourneau, G (2009). Psychotic symptoms as a continuum between normality and pathology. Canadian Journal of Psychiatry 54, 140151.CrossRefGoogle ScholarPubMed
Van Os, J, McGuffin, P (2003). Can the social environment cause schizophrenia? British Journal of Psychiatry 182, 291292.CrossRefGoogle ScholarPubMed
Van Os, J, Hanssen, M, Bijl, RV, Ravelli, A (2000). Strauss (1969) revisited: a psychosis continuum in the general population? Schizophrenia Research 45, 1120.CrossRefGoogle ScholarPubMed
Van Os, J, Krabbendam, L, Myin-Germeys, I, Delespaul, P (2005). The schizophrenia envirome. Current Opinion in Psychiatry 18, 141145.Google ScholarPubMed
Van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179195.CrossRefGoogle ScholarPubMed
Varghese, D, Scott, J, Welham, J, Bor, W, Najman, J, O'callaghan, M, Williams, G, McGrath, J (2009). Psychotic-like experiences in major depression and anxiety disorders: a population based survey in young adults. Schizophrenia Bulletin 37, 389393.CrossRefGoogle ScholarPubMed
Varghese, D, Saha, S, Scott, JD, Chan, RC, McGrath, JJ (2011). The association between family history of mental disorder and delusional-like experiences: a general population study. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 156B, 478483.CrossRefGoogle ScholarPubMed
Wittchen, HU, Burke, JD, Semler, G, Pfister, H, Von Cranach, M, Zaudig, M (1989). Recall and dating of psychiatric symptoms. Test–retest reliability of time-related symptom questions in a standardized psychiatric interview. Archives of General Psychiatry 46, 437443.CrossRefGoogle Scholar
Yung, AR, Buckby, JA, Cosgrave, EM, Killackey, EJ, Baker, K, Cotton, SM, Mcgorry, PD (2007). Association between psychotic experiences and depression in a clinical sample over 6 months. Schizophrenia Research 91, 246253.CrossRefGoogle Scholar