J. J. McGrath, The University of Queensland, Australia
K. A. McLaughlin, University of Washington
S. Saha, The University of Queensland, Australia
S. Aguilar-Gaxiola, UC Davis Health System
A. Al-Hamzawi, Al-Qadisiya University
J. Alonso, IMIM-Hospital del Mar Medical Research Institute, Pompeu Fabra University,CIBER en Epidemiología y Salud Pública (CIBERESP)
R. Bruffaerts, Katholieke Universiteit Leuven (UPC-KUL)
G. de Girolamo, IRCCS St John of God Clinical Research Centre
P. de Jonge, Research Program Interdisciplinary Center Psychopathology and Emotion Regulation
O. Esan, University of Ibadan, Nigeria
S. Florescu, National School of Public Health
O. Gureje, University College Hospital
J. M. Haro, Universitat de Barcelona
C. Hu, Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital
E. G. Karam, Balamand University, St George Hospital University Medical Center, Institute for Development Research Advocacy and Applied Care (IDRAAC)
V. Kovess-Masfety, Ecole des Hautes Etudes en Santé Publique (EHESP)
S. Lee, The Chinese University of Hong Kong
J. P. Lepine, Hôpital Lariboisière Fernand Widal
C. C. W. Lim, Queensland Brain Institute, University of Otago
M. E. Medina-Mora, National Institute of Psychiatry Ramón de la Fuente
Z. Mneimneh, The University Of Michigan, DRAAC
B. E. Pennell, The University Of Michigan
M. Piazza, Universidad Cayetano Heredia, National Institute of Health
J. Posada-Villa, Colegio Mayor de Cundinamarca University
N. Sampson, Harvard Medical School
M. C. Viana, Federal University of Espírito Santo
M. Xavier, Chronic Diseases Research Center (CEDOC), Universidade Nova de Lisboa
E. J. Bromet, Stony Brook University School of Medicine
K. S. Kendler, Virginia Commonwealth University
R. C. Kessler, Harvard Medical School
WHO World Mental Health Survey Collaborators

Document Type


Original Publication Date






DOI of Original Publication



Originally published at

Date of Submission

June 2017


Although there is robust evidence linking childhood adversities (CAs) and an increased risk for psychotic experiences (PEs), little is known about whether these associations vary across the life-course and whether mental disorders that emerge prior to PEs explain these associations.

We assessed CAs, PEs and DSM-IV mental disorders in 23 998 adults in the WHO World Mental Health Surveys. Discrete-time survival analysis was used to investigate the associations between CAs and PEs, and the influence of mental disorders on these associations using multivariate logistic models.

Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs [odds ratio (OR) 2.3, 95% confidence interval (CI) 1.9–2.6]. CAs reflecting maladaptive family functioning (MFF), including abuse, neglect, and parent maladjustment, exhibited the strongest associations with PE onset in all life-course stages. Sexual abuse exhibited a strong association with PE onset during childhood (OR 8.5, 95% CI 3.6–20.2), whereas Other CA types were associated with PE onset in adolescence. Associations of other CAs with PEs disappeared in adolescence after adjustment for prior-onset mental disorders. The population attributable risk proportion (PARP) for PEs associated with all CAs was 31% (24% for MFF).

Exposure to CAs is associated with PE onset throughout the life-course, although sexual abuse is most strongly associated with childhood-onset PEs. The presence of mental disorders prior to the onset of PEs does not fully explain these associations. The large PARPs suggest that preventing CAs could lead to a meaningful reduction in PEs in the population.


© Cambridge University Press 2017

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VCU Psychiatry Publications