Abstract
BackgroundStudies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. No comparable studies have been undertaken in low-income, post-conflict countries. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD.MethodsThe Psychosis Screening Questionnaire and the Harvard Trauma Questionnaire (assessing trauma exposure and PTSD) were administered in an epidemiological survey of 1245 adults (response rate 80.6%) in a rural and an urban setting in Timor Leste. We defined PSQ screen-positive cases as those people reporting at least one psychotic-like symptom (paranoia, hallucinations, strange experiences, thought interference, hypomania).ResultsThe prevalence of PSQ screen-positive cases was 12 percent and these persons were more disabled. PSQ cases were more likely to reside in the urban area, experienced higher levels of trauma exposure and a greater prevalence of PTSD. PTSD only partially mediated the relationship between trauma exposure and psychotic-like symptoms.ConclusionsPsychotic-like symptoms may be prevalent in countries exposed to mass conflict. The cultural and contextual meaning of psychotic-like symptoms requires further inquiry in low-income, post-conflict settings such as Timor Leste.
Highlights
Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and posttraumatic stress disorder (PTSD)
Our findings suggested a relationship between increasing levels of Potentially traumatic experiences (PTEs) exposure and Psychosis Screening Questionnaire (PSQ) screen-positive cases, even after adjusting for socio-demographic variables
Our analysis provided some support for the role of PTSD in mediating the link between PTEs and PSQ screen-positive cases
Summary
Studies in developed countries indicate that psychotic-like symptoms are prevalent in the community and are related to trauma exposure and PTSD. This study aimed to assess the prevalence of psychotic-like symptoms in conflict-affected Timor Leste and to examine whether symptoms were associated with trauma and PTSD. Past studies suggest that psychotic-like symptoms are associated with being female, low levels of social support, alcohol [5] and cannabis use [6], and a family history of mental illness [5,6]. Trauma exposure appears to be associated with psychotic-like symptoms [8,9,10,11,12,13,14], with some studies indicating a dose-effect relationship [2,15]. Posttraumatic stress disorder (PTSD) may mediate the relationship between trauma and psychotic-like symptoms [13]
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