Estudio de prevalencia de las psicosis no afectivas y características asociadas en la Región de Murcia

Resumo

Title: "Study of the prevalence of Non-affective Psychosis and associated characteristics in the Region of Murcia". Aims: To estimate the prevalence of NAP, and of schizophrenia, in the general population of the Region of Murcia and to analyze the characteristics of people with psychosis. Methods: This study is part of the PEGASUS-Murcia project ("Psychiatric Inquiry to General Population in Southeast Spain-Murcia"), a cross-sectional study in a representative sample of the adult population of the Region of Murcia. The diagnostic instrument used was the CIDI 3.0 (Composite International Diagnostic Interview). Those participants who scored 3 or more in two of the questions of the positive psychotic dimension of the CAPE-42 (Community Assessment of Psychic Experiences), were hospitalized for psychiatric reasons and / or received psychotropic medication during the last year were considered as "probable psychosis "and were re-interviewed by telephone by a psychiatrist with clinical experience using the SCID-1 (Structured Clinical Interview for Psychotic Disorders of the DSM-IV) to confirm the diagnosis of Psychosis. Sociodemographic variables included sex, age, years of education, marital status, economic and employment status, and living in an urban or rural environment. Twelve chronic physical illnesses and the presence of affective, anxiety or substance use disorders, as well as exposure to adverse childhood experiences (ACE) (including physical and sexual abuse, among others) were evaluated. Perceived disability was measured using the WHODAS-II (WHO Disability Assessment Schedule II). The prevalence of NAP was calculated in percentages with its 95% confidence interval (95% CI) for both the general population and by sex. To assess a possible selection bias by the non-reinterviewees, their characteristics were compared with those who accepted using Student's t-test and Chi-square. For the analysis of the characteristics of the participants with psychosis, it was compared with a control group, made up of the participants who were not considered "probable psychosis", using various multiple logistic regression models. The odds ratio (OR) and its 95% CI were calculated. A p-value less than or equal to 0.05 was accepted in all statistical tests. Results: Of a total of 2621 individuals interviewed in the PEGASUS study, 373 people presented criteria of "probable psychosis". 234 telephone interviews were completed with the SCID-I (response rate: 62.7%). A total of 12 subjects (10 men and 2 women) were diagnosed with Non-Affective Psychosis, of which 10 met the diagnostic criteria for Schizophrenia (8 men and 2 women) and 2 men with brief psychotic disorder. The estimated NAP prevalence-life was 0.59% (95% CI: 0.23, 1.53), for Schizophrenia 0.41 (0.14, 1.14). The sociodemographic variables associated with the NAP were male sex, another marital status other than married / living together and other work situations other than working. No association has been found between the diagnosis of NAP and comorbidity with chronic medical diseases, but it has been found with comorbidity with Affective Disorders but not with anxiety disorders or substance abuse disorders. The antecedents of ACE described by participants with a diagnosis of NAP are physical abuse and physical illness in childhood. Regarding the relationship between NAP and disability, only an association was found with the increase in disability associated with social interaction. Conclusions: Prevalence studies of NAP and their characterization in representative samples of the general population provide useful data for planning mental health services.