Association between psychotic-like experiences and common mental disorders in a general adult population in Lagos, Nigeria.

BACKGROUND

Psychotic-like experiences (PLEs) are subclinical phenomena associated with psychiatric vulnerability. While linked to common mental health symptoms in high-income countries, their patterns in sub-Saharan Africa are underexplored.

OBJECTIVES

This study examined associations between clinically significant PLEs (CS-PLEs) and three domains of common mental health symptoms: depressive symptoms, anxiety symptoms, and somatic symptom burden among Nigerian adults. Secondary aims included exploring symptom severity gradients, demographic moderators, and functional impairment.

METHODS

Data from 11,246 adults in the Lagos State Mental Health Survey, a population-representative cross-sectional study, were analyzed. CS-PLEs were assessed using the Prodromal Questionnaire-Brief (PQ-B; distress score ≥ 6), and symptom domains via PHQ-9 (depression), GAD-7 (anxiety), and PHQ-15 (somatic symptoms). Weighted analyses, multivariable logistic regression, and interaction tests were conducted adjusting for demographics, cannabis use, disability, and family psychiatric history.

RESULTS

CS-PLEs occurred in 13.0 % of participants. Depressive symptom prevalence was higher among those with CS-PLEs (9.0 % vs. 6.4 %, p < 0.001), with a symptom severity gradient across PLE distress levels. In adjusted models, depressive symptoms remained associated with CS-PLEs (aOR = 1.32, 95 % CI: 1.07-1.63). Anxiety and somatic symptoms showed no significant association. Gender moderated depression-PLE associations, and education influenced anxiety-PLE links. Comorbid cases showed the highest functional disability.

CONCLUSIONS

The selective association between depressive symptoms and PLEs, especially among women, highlights that PLEs are transdiagnostic indicators of vulnerability with a significant disability impact in this urban African setting. Findings underscore the need for integrated, culturally responsive mental health screening in primary care.