Psychotic experiences and risk of death in the general population: 24-27 year follow-up of the Epidemiologic Catchment Area study

Abstract

Background Psychotic experiences are common in the general population and are associated with adverse psychiatric and social outcomes, even in the absence of a psychotic disorder. Aims To examine the association between psychotic experiences and mortality over a 24-27 year period. Method We used data on 15 049 adult participants from four sites of the Epidemiologic Catchment Area baseline survey in the USA in the early 1980s, linked to the National Death Index and other sources of vital status up until 2007. Psychotic experiences were assessed by the Diagnostic Interview Schedule. Results Lifetime psychotic experiences at baseline (n = 855; weighted prevalence, 5.5%) were significantly associated with all-cause mortality at follow-up after adjustment for sociodemographic characteristics and psychiatric diagnoses, including schizophrenia spectrum disorders (P<0.05). Baseline psychotic experiences were associated with over 5 years' shorter median survival time. Among the underlying causes of death, suicide had a particularly high hazard ratio (9.16, 95% CI 3.19-26.29). Conclusions Future research needs to explore the association of psychotic experiences with physical health and lifestyle factors that may mediate the relationship of psychotic experiences with mortality.