Scholarly works in Psychiatry

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Author: search.filters.author.Alonso, J.

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    Childhood generalized specific phobia as an early marker of internalizing psychopathology across the lifespan: results from the World Mental Health Surveys
    (BioMed Central (BMC), 2019) de Vries, Y. A.; Al-Hamzawi, A.; Alonso, J.; Borges, G.; Bruffaerts, R.; Bunting, B.; Caldas-de-Almeida, J. M.; Cia, A. H.; De Girolamo, G.; Dinolova, R. V.; Esan, O. B.; Florescu, S.; Gureje, O.; Haro, J. M.; Hu, C.; Karam, E. G.; Karam, A.; Kawakami, N.; Kiejna, A.; Kovess-Masfety, V.; WHO World Mental Health Survey Collaborators
    Background: Specific phobia (SP) is a relatively common disorder associated with high levels of psychiatric comorbidity. Because of its early onset, SP may be a useful early marker of internalizing psychopathology, especially if generalized to multiple situations. This study aimed to evaluate the association of childhood generalized SP with comorbid internalizing disorders. Methods: We conducted retrospective analyses of the cross-sectional population-based World Mental Health Surveys using the Composite International Diagnostic Interview. Outcomes were lifetime prevalence, age of onset, and persistence of internalizing disorders; past-month disability; lifetime suicidality; and 12-month serious mental illness. Logistic and linear regressions were used to assess the association of these outcomes with the number of subtypes of childhood-onset (< 13 years) SP. Results: Among 123,628 respondents from 25 countries, retrospectively reported prevalence of childhood SP was 5.9%, 56% of whom reported one, 25% two, 10% three, and 8% four or more subtypes. Lifetime prevalence of internalizing disorders increased from 18.2% among those without childhood SP to 46.3% among those with one and 75.6% those with 4+ subtypes (OR=2.4, 95% CI 2.3–2.5, p< 0.001). Conclusions: This large international study shows that childhood-onset generalized SP is related to adverse outcomes in the internalizing domain throughout the life course. Comorbidity, persistence, and severity of internalizing disorders all increased with the number of childhood SP subtypes. Although our study cannot establish whether SP is causally associated with these poor outcomes or whether other factors, such as a shared underlying vulnerability, explain the association, our findings clearly show that childhood generalized SP identifies an important target group for early intervention.
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    The association between psychotic experiences and health-related quality of life. A cross-national analysis based on World Mental Health Surveys
    (Elsevier, 2018) Alonso, J.; Saha, S.; Lim, C. C. W.; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Benjet, C.; Bromet, E. J.; Degenhardt, L.; de Girolamo, G.; Esan, O.B.; Florescu, S.; Gureje, O.; Haro, J. M.; Hu, C.; Karam, E. G.; Karam, G.; Kovess- Masfety, V.; Lepine, J. P.; Lee, S.; Mneimneh, Z.; WHO World Mental Health Survey Collaborators
    Psychotic experiences (PEs)are associated with arrange of mental and physical disorders, and disability, but little is known about the association between PEs and aspects of health-related quality of life (HRQoL). We aimed to investigate the association between PEs and five HRQoL indicators with various adjustments. Using data from the WHO World Mental Health surveys (n = 33,370 adult respondents from 19 countries), we assessed for PEs and five HRQoL indicators (self-rated physical or mental health, perceived level of stigma (embarrassment and discrimination), and social network burden). Logistic regression models that adjusted for socio-demographic characteristics, 21 DSM-IV mental disorders, and 14 general medical conditions were used to investigate the associations between the variables of interest. We also investigated dose-response relationships between PE related metrics (number of types and frequency of episodes) and the HRQoL indicators. Those with a history of PEs had increased odds of poor perceived mental (OR = 1.5, 95% CI = 1.2–1.9) and physical health (OR = 1.3, 95% CI =1.0–1.7) after adjustment for the presence of any mental or general medical conditions. Higher levels of perceived stigma and social network burden were also associated with PEs in the adjusted models. Dose response associations between PE type and frequency metrics and subjective physical and mental health were non-significant, except those with more PE types had increased odds of reporting higher discrimination (OR=2.2,95%CI=1.3–3.5). Our findings provide novel insights into how those with PEs perceive their health status.
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    The association between childhood adversities and subsequent first onset of psychotic experiences: a cross- national analysis of 23 998 respondents from 17 countries
    (Cambridge University Press, 2017) McGrath, J.J.; McLaughlin, K.A.; Saha, S.; Aguilar-Gaxiola, S.; Al-Hamzawi, A.; Alonso, J.; Bruffaerts, R.; de Girolamo, G.; de Jonge, P.; Esan, O.B.; Florescu, S.; Gureje, O.; Haro, J.M.; Hu, C.; Karam, E.G.; Kovess-Masfety, V.; Lee, S.; Lepine, J.P.; Lim, C.C.; Medina-Mora, M.E.; Mneimneh, Z.; Pennell, B. E.; Pennell, B. E.; Piazza, M.; Posada-Villa, J.; Sampson, N.; Viana, M.C.; Xavier, M.; Bromet, E.J.; Kendler, K.S.; Kessler, R.C.
    Background—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. Methods—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. Results—Exposure to CAs was common, and those who experienced any CAs had increased odds of later PEs (OR =2.3, 95%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). Conclusions—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.