Skip to main content

Advertisement

SpringerLink
Log in

Prevalence, risk factors, and comorbidities of psychotic experiences in Afghanistan: a highly stressful environment

  • Research
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objectives

To estimate the prevalence and demographic, psychiatric, and trauma-focused correlates of psychotic experiences (PEs) in the Afghan general population.

Methods

Data were drawn from a cross-sectional household survey implemented in eight regions of Afghanistan (N = 4445). The CIDI structured instrument was administered to adults to assess psychiatric disorders and psychotic experiences; life events and PTSD were assessed using validated instruments. Weighted multivariate models integrated socio-demographics, regions, traumas as determinants of PE.

Results

PEs were frequently reported in the Afghan population: 27.50% of the population reported a lifetime PE. PEs were more common among specific ethnic groups, and were associated with lower income in adjusted regression models. PEs were associated with mental health problems including major depressive disorders (OR = 3.43), PTSD (OR = 5.08), generalized anxiety (OR = 4.2); lifetime suicidal attempts (OR 6.04), lifetime suicidal thoughts (OR = 3.42), addiction (OR = 2.18); and psychological distress and impairment due to mental health (OR = 2.95 and 2.46, respectively).

Conclusion

Psychotic experiences in the Afghan general population confirm general population findings in other countries, that psychotic experiences are common and associated with economic and social marginalization, and part of a continuum of mental health problems experienced in populations. Efforts to reduce and treat psychotic experiences within a broad array of psychiatric conditions are needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and materials

Authors elected to not share data.

References

  1. Linscott RJ, van Os J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 43(6):1133–1149. https://doi.org/10.1017/S0033291712001626

    Article  CAS  PubMed  Google Scholar 

  2. Nuevo R, Chatterji S, Verdes E, Naidoo N, Arango C, Ayuso-Mateos JL (2012) The continuum of psychotic symptoms in the general population: a cross-national study. Schizophr Bull 38(3):475–485. https://doi.org/10.1093/schbul/sbq099

    Article  PubMed  Google Scholar 

  3. McGrath JJ, Saha S, Al-Hamzawi A et al (2015) Psychotic experiences in the general population: a cross-national analysis based on 31,261 respondents from 18 countries. JAMA Psychiat 72(7):697–705. https://doi.org/10.1001/jamapsychiatry.2015.0575

    Article  Google Scholar 

  4. Kovess-Masfety V, Saha S, Lim CCW et al (2018) Psychotic experiences and religiosity: data from the WHO World Mental Health Surveys. Acta Psychiatr Scand 137(4):306–315. https://doi.org/10.1111/acps.12859

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Scott KM, Saha S, Lim CCW et al (2018) Psychotic experiences and general medical conditions: a cross-national analysis based on 28 002 respondents from 16 countries in the WHO World Mental Health Surveys. Psychol Med 48(16):2730–2739. https://doi.org/10.1017/S0033291718000363

    Article  PubMed  PubMed Central  Google Scholar 

  6. Moreno C, Nuevo R, Chatterji S, Verdes E, Arango C, Ayuso-Mateos JL (2013) Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO world health survey. World Psychiatry: Off J World Psychiatr Assoc (WPA) 12(3):251–257. https://doi.org/10.1002/wps.20070

    Article  Google Scholar 

  7. De Vylder JE, Burnette D, Yang LH (2014) Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples. Psychol Med - Lond 44(16):3503–3513

    Article  Google Scholar 

  8. Bromet EJ, Nock MK, Saha S et al (2017) Association between psychotic experiences and subsequent suicidal thoughts and behaviors: a cross-national analysis from the World Health Organization World Mental Health Surveys. JAMA Psychiat 74(11):1136–1144. https://doi.org/10.1001/jamapsychiatry.2017.2647

    Article  Google Scholar 

  9. McGrath JJ, Saha S, Al-Hamzawi A et al (2016) The Bidirectional associations between psychotic experiences and DSM-IV mental disorders. Am J Psychiatry 173(10):997–1006. https://doi.org/10.1176/appi.ajp.2016.15101293

    Article  PubMed  PubMed Central  Google Scholar 

  10. Degenhardt L, Saha S, Lim CCW et al (2018) The associations between psychotic experiences and substance use and substance use disorders: findings from the World Health Organization World Mental Health Surveys. Addiction 113(5):924–934. https://doi.org/10.1111/add.14145

    Article  PubMed  PubMed Central  Google Scholar 

  11. Navarro-Mateu F, Alonso J, Lim CCW et al (2017) The association between psychotic experiences and disability: results from the WHO World Mental Health Surveys. Acta Psychiatr Scand 136(1):74–84. https://doi.org/10.1111/acps.12749

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Alonso J, Saha S, Lim CCW et al (2018) The association between psychotic experiences and health-related quality of life: a cross-national analysis based on World Mental Health Surveys. Schizophr Res 201:46–53. https://doi.org/10.1016/j.schres.2018.04.044

    Article  PubMed  PubMed Central  Google Scholar 

  13. McGrath JJ, Saha S, Lim CCW et al (2017) Trauma and psychotic experiences: transnational data from the World Mental Health Survey. Br J Psychiatry. https://doi.org/10.1192/bjp.bp.117.205955

    Article  PubMed  PubMed Central  Google Scholar 

  14. De Vylder JE, Smith ME, Sharpe T et al (2017) Psychotic experiences in the context of police victimization: data from the survey of police-public encounters. Schizophr Bull 43(5):993–1001. https://doi.org/10.1093/schbul/sbx038

    Article  Google Scholar 

  15. Kovess-Masfety V, Keyes K, Karam E, Sabawoon A, Sarwari BAA (2021) National survey on depressive and anxiety disorders in Afghanistan: a highly traumatized population. BMC Psychiatry 21(1):1–12

    Article  Google Scholar 

  16. Kovess-Masfety V, Keyes K, Karam E, Sabawoon A, Sarwari BA (2021) A national survey on depressive and anxiety disorders in Afghanistan: a highly traumatized population. BMC Psychiatry 21(1):314. https://doi.org/10.1186/s12888-021-03273-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Amowitz LLH, Heisler M, Iacopino V (2003) A population-based assessment of Women’s mental health and attitudes toward Women’s human rights in Afghanistan. J Women’s Health 12(6):577–587. https://doi.org/10.1089/154099903768248285

    Article  Google Scholar 

  18. Ware JE, Kosinski M, Dewey JE, Gandek B (2000) SF-36 health survey: manual and interpretation guide: Quality Metric Inc

  19. Weathers FW, Blake DD, Schnurr PP, Kaloupek DG, Marx BP, Keane TM (2013) The Life Events Checklist for DSM-5 (LEC-5). USA: the National Center for PTSD

  20. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP (2013) The PTSD Checklist for DSM-5 (PCL-5): the National Center for PTSD

  21. Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL (2015) The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Trauma Stress 28(6):489–498. https://doi.org/10.1002/jts.22059[publishedOnlineFirst:2015/11/26]

    Article  PubMed  Google Scholar 

  22. Benjet C, Bromet E, Karam EG et al (2016) The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med 46(2):327–343. https://doi.org/10.1017/S0033291715001981

    Article  CAS  PubMed  Google Scholar 

  23. Patten SB (1997) Performance of the composite international diagnostic interview short form for major depression in community and clinical samples. Chronic Dis Can 18(3):109–112

    CAS  PubMed  Google Scholar 

  24. Pez O, Gilbert F, Bitfoi A et al (2010) Validity across translations of short survey psychiatric diagnostic instruments: CIDI-SF and CIS-R versus SCID-I/NP in four European countries. Soc Psychiatry Psychiatr Epidemiol 45(12):1149–1159. https://doi.org/10.1007/s00127-009-0158-6[publishedOnlineFirst:2009/11/04]

    Article  PubMed  Google Scholar 

  25. Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey initiative version of the World Health Organization (WHO) composite international diagnostic interview (CIDI). Int J Methods Psychiatr Res 13(2):93–121. https://doi.org/10.1002/mpr.168

    Article  PubMed  Google Scholar 

  26. Larøi F, Luhrmann TM, Bell V et al (2014) Culture and hallucinations: overview and future directions. Schizophr Bull 40:S213–S220

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kent G, Wahass S (1996) The content and characteristics of auditory hallucinations in Saudi Arabia and the UK: a cross-cultural comparison. Acta Psychiatr Scand 94(6):433–437. https://doi.org/10.1111/j.1600-0447.1996.tb09886.x

    Article  CAS  PubMed  Google Scholar 

  28. Noort A, Beekman ATF, Braam AW (2020) Religious hallucinations and religious delusions among older adults in treatment for psychoses in the Netherlands. Religions 11(10):1–16

    Article  Google Scholar 

  29. Yates K, Lång U, Cederlöf M et al (2019) Association of psychotic experiences with subsequent risk of suicidal ideation, suicide attempts, and suicide deaths: a systematic review and meta-analysis of longitudinal population studies. JAMA Psychiat 76(2):180–189. https://doi.org/10.1001/jamapsychiatry.2018.3514

    Article  Google Scholar 

  30. Karam EG, Friedman MJ, Hill ED et al (2014) Cumulative traumas and risk thresholds: 12-month PTSD in the world mental health (WMH) surveys. Depress Anxiety 31(2):130–142. https://doi.org/10.1002/da.22169

    Article  PubMed  Google Scholar 

  31. Cottler LB, Ajinkya S, Goldberger BA et al (2014) Prevalence of drug and alcohol use in urban Afghanistan: epidemiological data from the Afghanistan National Urban Drug Use Study (ANUDUS). Lancet Glob Health 2(10):e592-600. https://doi.org/10.1016/S2214-109X(14)70290-6

    Article  PubMed  Google Scholar 

  32. Kovess-Masfety VS (2018) National mental health survey and assessment of mental health services. Paris Conseil Santé

Download references

Funding

Funding was provided by the European Union Grant: (Directorate-General for Development and Cooperation) EuropeAid/137-728/DH/SER/AF/, Conseil Santé Contract service N°DCI-ASIE2015/371-619.

Author information

Authors and Affiliations

  1. LPPS, University of Paris Cité, Paris, France

    V. Kovess-Masfety

  2. Mailman School of Public Health, Columbia University, New York, NY, USA

    V. Kovess-Masfety, A. Sabawoon & K. Keyes

  3. Governance Institute of Afghanistan (GI-A), Kabul, Afghanistan

    A. Sabawoon

  4. Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon

    E. Karam

  5. Faculty of Medicine, Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center University of Balamand, Beirut, Lebanon

    E. Karam

Authors
  1. V. Kovess-Masfety
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Sabawoon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Keyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Karam
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

VK-M designed the study , analyzed the results, and prepared the draft AS co-designed the study and collected the data KK participated to the analyses and to the draft EK participated to the draft and analyses All authors reviewed the manuscript.

Corresponding author

Correspondence to V. Kovess-Masfety.

Ethics declarations

Conflict of interest

The authors declared to have no conflicts of interest.

Ethical approval

The project was approved by the Afghanistan Institutional Review Board, National Public Health Institute, Ministry of Public health the 12/31/2016:IRB n° 3,355,421; a consent for participation was required from each person.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kovess-Masfety, V., Sabawoon, A., Keyes, K. et al. Prevalence, risk factors, and comorbidities of psychotic experiences in Afghanistan: a highly stressful environment. Soc Psychiatry Psychiatr Epidemiol 59, 99–109 (2024). https://doi.org/10.1007/s00127-023-02539-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-023-02539-4

Keywords

Search

Navigation