Background: Psychosis exists in the community as a continuum of severity. Here, we examine the correlates of self-reported psychotic symptoms in an urban catchment area of Iran. Sampling and Methods: Two thousand one hundred and fifty-eight participants (age 18–65 years) residing in southern Tehran (the capital city of Iran) were interviewed using the psychoticism and paranoia dimensions of the Symptom Checklist-90-Revised (SCL-90-R) to assess the severity of psychotic symptoms. Other dimensions of the SCL-90-R assessing nonpsychotic symptoms and a sociodemographic questionnaire were also used. Paykel’s Interview for Recent Life Events was used to assess stressful life events. Results: Independent associations were observed between younger age, female gender, stressful life events and dimensions of depression, anxiety, hostility, obsessive-compulsive symptoms and interpersonal sensitivity and psychoticism. Independent associations were also observed for marital problems, unemployment, stressful life events and dimensions of depression, anxiety, hostility, interpersonal sensitivity and phobic anxiety with paranoid ideation. There was also a trend toward an association between higher educational levels and the severity of psychotic symptoms, particularly paranoid ideation. Conclusions: Most of the previously accepted correlations for psychotic symptoms in the community were replicated. An unexpected association between paranoia and female gender, and a trend toward higher rates of psychotic symptoms in more educated participants, were in contrast with the studies in developed settings. The insufficient coverage of psychosis-relevant questions from the SCL-90-R for the entire psychotic diagnostic spectrum should be considered a limitation.

1.
Kendler KS, Gallagher TJ, Abelson JM, Kessler RC: Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. The National Comorbidity Survey. Arch Gen Psychiatry 1996;53:1022–1031.
2.
Van Os J, Hanssen M, Bijl RV, Ravelli A: Strauss (1969) revisited: a psychosis continuum in the general population? Schizophr Res 2000;29:11–20.
3.
Spauwen J, Krabbendam L, Lieb R, Wittchen HU, Van Os J: Sex differences in psychosis: normal or pathological? Schizophr Res 2003;1:45–49.
4.
Johns LC, Cannon M, Singleton N, Murray RM, Farrell M, Brugha T, Bebbington P, Jenkins R, Meltzer H: Prevalence and correlates of self-reported psychotic symptoms in the British population. Br J Psychiatry 2004;185:298–305.
5.
Scott J, Chant D, Andrews G, Mcgrath J: Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample. Psychol Med 2006;36:231–238.
6.
Verdoux H, Van Os J: Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophr Res 2002;54:59–65.
7.
Poulton R, Caspi A, Moffitt TE, Cannon M, Murray R, Harrington H: Children’s self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Arch Gen Psychiatry 2000;57:1053–1058.
8.
Welham J, Scott J, Williams G, Najman J, Bor W, O’Callaghan M, McGrath J: Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study. Psychol Med 2009;39:625–634.
9.
Olfson M, Lewis-Fernandez R, Weissman MM, Feder A Gameroff MJ, Pilowsky D, Fuentes M: Psychotic symptoms in an urban general medicine practice. Am J Psychiatry 2002;159:1412–1419.
10.
Mojtabai R: Psychotic-like experiences and interpersonal violence in the general population. Soc Psychiatry Psychiatr Epidemiol 2006;41:183–190.
11.
Kelleher I, Cannon M: Psychotic-like experiences in the general population: characterizing a high-risk group for psychosis. Psychol Med 2011;41:1–6.
12.
Bazargan M, Bazargan S, King L: Paranoid ideation among elderly African American persons. Gerontologist 2001;41:366–373.
13.
Freeman D, Dunn G, Garety PA, Bebbington P, Slater M, Kuipers E, Fowler D, Green C, Jordan J, Ray K: The psychology of persecutory ideation I: a questionnaire survey. J Nerv Ment Dis 2005;193:302–308.
14.
Wiles NJ, Zammit S, Bebbington P, Singleton N, Meltzer H, Lewis G: Self-reported psychotic symptoms in the general population: results from the longitudinal study of the British National Psychiatric Morbidity Survey. Br J Psychiatry 2006;188:519–526.
15.
Krabbendam L, Myin-Germrys I, de Graaf R, Vollebergh W, Nolen WA, Iedema J, Van Os J: Dimensions of depression, mania and psychosis in the general population. Arch Gen Psychiatry 2004;34:1177–1186.
16.
Yung AR, Buckby JA, Cosgrave EM, Killackey EJ, Baker K, Cotton SM, McGorry PD: Association between psychotic experiences and depression in a clinical sample over 6 months. Schizophr Res 2007;91:246–253.
17.
Yung AR, Buckby JA, Cotton SM, Cosgrave EM, Killackey EJ, Stanford C, Godfrey K: Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression, and disability. Schizophr Bull 2006;32:352–359.
18.
Ohayon MM: Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Res 2000;27:153–164.
19.
Freeman D, Garety PA, Bebbington P, Slater M, Kuipers E, Fowler D, Green C, Jordan J, Ray K, Dunn G: The psychology of persecutory ideation. II. A virtual reality experimental study. J Nerv Ment Dis 2005;193:309–315.
20.
Salokangas RK, Mcglashan TH: Early detection and intervention of psychosis. A review. Nord J Psychiatry 2008;62:92–105.
21.
Brugha T, Singleton N, Meltzer H, Bebbington P, Farrell M, Jenkins R, Coid J, Fryers T, Melzer D, Lewis G: Psychosis in the community and in prisons: a report from the British National Survey of psychiatric morbidity. Am J Psychiatry 2005;162:774–780.
22.
Nielssen O, Misrachi S: Prevalence of psychoses on reception to male prisons in New South Wales. Aust NZ J Psychiatry 2005;39:453–459.
23.
Nishida A, Tanii H, Nishimura Y, Kajiki N, Inoue K, Okada M, Sasaki T, Okazaki Y: Associations between psychotic-like experiences and mental health status and other psychopathologies among Japanese early teens. Schizophr Res 2008;99:125–133.
24.
Verdoux H, van Os J, Maurice-Tison S, Gay B, Salamon R, Bourgeois M: Is early adulthood a critical developmental stage for psychosis proneness? A survey of delusional ideation in normal subjects. Schizophr Res 1998;29:247–254.
25.
Cassano G, Pini S, Saettoni M, Rucci P, Dell’osso L: Occurrence and clinical correlates of psychiatric comorbidity in patients with psychotic disorders. J Clin Psychiatry 1998;59:60–68.
26.
Cassano GB, Pini S, Saettoni M, Dell’osso L: Multiple anxiety disorder comorbidity in patients with mood spectrum disorders with psychotic features. Am J Psychiatry 1999;156:474–476.
27.
Schafer MR, Klier CM, Papageorgiou K, Friedrich MH, Amminger GP: Early detection of psychotic disorders (in German). Neuropsychiatr 2007;21:37–44.
28.
Phillips KA: Psychosis in body dysmorphic disorder. J Psychiatr Res 2004;38:63–72.
29.
Van Der Zwaard R, De Leeuw AS, Van Dael F, Knook LM: ...with psychotic features? An investigation into the delusional nature of convictions in patients with non-psychotic disorders (in Dutch). Tijdschr Psychiatr 2006;48:461–466.
30.
Martin JA, Penn DL: Social cognition and subclinical paranoid ideation. Br J Clin Psychol 2001;40:261–265.
31.
Addington J, Penn D, Scott W, Woods SW, Addington D, Perkins DO: Social functioning in individuals at clinical high risk for psychosis. Schizophr Res 2008;99:119–124.
32.
Freeman D, Gittins M, Pugh K, Antley A, Slater M, Dunn G: What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychol Med 2008;38:1121–1132.
33.
Faghih-Nasiri L, Sharifi V, Hatmi Z, Sadeghianmehr Z, Mirkia SH, Darbooy SH, Effatpanah M, Mirsharifa SM: Prevalence of stressful factors and psychiatric symptoms among individuals under the care of Abouzar health and medical center. Adv Cogn Sci 2006;8:47–53.
34.
Derogatis LR: SCL90. Administration, Scoring and Procedures. Manual-1 for the R (revised) Version and Other Instruments of the Psychopathology Rating Scale Series. Chicago, Johns Hopkins University School of Medicine, 1977.
35.
Derogatis LR, Cleary PA: Confirmation of the dimensional structure of the SCL-90: a study in construct validity. J Clin Psychol 1977;33:981–989.
36.
Schmitz N, Hartkamp N, Kiuse J, Franke GH, Reister G, Tress W: The Symptom Check-List-90-R (SCL-90-R): a German validation study. Qual Life Res 2000;9:185–193.
37.
Pourshahbaz A: The relation between the evaluation of stressful life events rates and personality in the oncology patients; dissertation, Tehran Psychiatry Institute, Tehran, 1995.
38.
Eisen SV, Leff HS, Schaefer E: Implementing outcome systems: lessons from a test of the BASIS-32 and the SF-36. J Behav Health Serv Res 1999;26:18–27.
39.
Paykel ES: Methodological aspects of life events research. J Psychosom Res 1983;27:341–352.
40.
Mohajer M, Motaghipour Y, Katuzian B: Ranking for stressful life events: an investigation in a group of Shahid Beheshti university students. Pejouhesh 1990;14:33–48.
41.
Larøi F, Van der Linden M, DeFruyt F, van Os J, Aleman A: Associations between delusion proneness and personality structure in non-clinical participants: comparison between young and elderly samples. Psychopathology 2006;39:218–226.
42.
Van Winkel R, Stefanis NC, Myin-Germeys I: Psychosocial stress and psychosis. A review of the neurobiological mechanisms and the evidence for gene-stress interaction. Schizophr Bull 2008;34:1095–1105.
43.
Maric N, Krabbendam L, Vollebergh W, de Graaf R, van Os J: Sex differences in symptoms of psychosis in a non-selected, general population sample. Schizophr Res 2003;63:89–95.
44.
Scott J, Welham J, Martin G, Bor W, Najman J, O’Callaghan M, Williams G, Aird R, McGrath J: Demographic correlates of psychotic-like experiences in young Australian adults. Acta Psychiatr Scand 2008;118:230–237.
45.
López-Ilundain JM, Pérez-Nievas E, Otero M, Mata I: Peter’s delusions inventory in Spanish general population: internal reliability, factor structure and association with demographic variables (dimensionality of delusional ideation). Actas Esp Psiquiatr 2006;34:94–104.
46.
Freeman D, Pugh K, Antley A, Slater M, Bebbington P, Gittins M, Dunn G, Kuipers E, Fowler D, Garety P: Virtual reality study of paranoid thinking in the general population. Br J Psychiatry 2008;192:258–263.
47.
Freeman D, McManus S, Brugha T, Meltzer H, Jenkins R, Bebbington P: Concomitants of paranoia in the general population. Psychol Med 2010;24:1–14.
48.
Lundberg P, Cantor-Graae E, Kabakyenga J, Rukundo G, Ostergren PO: Prevalence of delusional ideation in a district in southwestern Uganda. Schizophr Res 2004;71:27–34.
49.
Yazdi AB, Bolhari J, Shah Mohammadi D: An epidemiological study of psychological disorders in a rural area (Meibod, Yazd) in Iran. Attitude Behav 1994;1:32–41.
50.
Olsen LR, Mortensen EL, Bech P: The SCL-90 and SCL-90R version validated by items response models in a Danish community sample. Acta Psychiatr Scand 2004;110:225–229.
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