Correlates of Psychotic Like Experiences among Young Adults during the Covid19 Pandemic across Four Countries

Background We aimed to identify predictors and specific country factors associated with psychotic-like experiences (PLEs), and to examine whether depressive and anxiety symptoms, and sleep problems mediates the relationship between daily reported COVID-19 death number and PLEs. Methods A total of 854 participants completed online questionnaires assessing PLEs, depressive and anxiety symptoms, and sleep problems using Community Assessment of Psychic Experiences-42-Positive Subscale (CAPE-42-Pos), Patient Health Questionnaire (PHQ), Generalized Anxiety Disorder-7 (GAD), and Pittsburg Sleep Quality Index (PSQI). Psychiatric/COVID-19 infection history and cigarette/alcohol/substance use, daily new COVID-19 cases/deaths were noted on survey date. Association rule mining and PROCESS Macro Mediation analysis were applied. Results COVID-19 death toll and PSQI had a non-linear, PHQ and GAD had a linear relationship with PLEs. Cigarette usage increased, but alcohol usage decreased PLEs risk. PHQ-Total score partially mediated the association between COVID-19-related death toll and CAPE-Pos-Total score. Rule mining revealed that in Turkey, substance/cigarette use and suicidality; in Nigeria, sleep problems and depression; in India, suicidality and sleep disturbances; and in Spain, COVID-19 history and psychiatric symptoms were strongly associated with high CAPE scores. Conclusions Reported death number, depressive and anxiety symptoms, and sleep disturbances could be used to predict PLEs. As a mediating factor, depressive symptoms could be an important target for preventing PLEs during pandemics. However, country-specific risk factors should also be considered for targeted interventions.