Evidence for the early clinical relevance of hallucinatory-delusional states in the general population

R. Nuevo, J. van Os, C. Arango, S. Chatterji, J.L. Ayuso-Mateos

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters.

METHOD: General population-based household surveys of randomly selected adults between 18 and 65 years of age were carried out.

SETTING: 52 countries participating in the World Health Organization's World Health Survey were included.

PARTICIPANTS: 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated.

RESULTS: Compared with isolated delusions and hallucinations, co-occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92-0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0-3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5-14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3-22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9-12.4). Co-occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8-2.3).

CONCLUSION: The results suggest that the co-occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.

Original languageEnglish
Pages (from-to)482-493
Number of pages12
JournalActa Psychiatrica Scandinavica
Issue number6
Early online date4 Sept 2012
Publication statusPublished - Jun 2013


  • adolescent
  • unemployment
  • risk factors
  • comorbidity
  • cross-sectional studies
  • delusions
  • depression
  • hearing disorders
  • hallucinations
  • health status
  • health surveys
  • severity of illness index
  • psychotic disorders
  • violence
  • World Health Organization


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