Poverty, low education, and the expression of psychotic-like experiences in the general population of Sao Paulo, Brazil

The aim of our study was to assess psychotic-like experiences in the general population aged 18-30 years old of the city of Sao Paulo, Brazil. A household survey was conducted with 1950 young-adults randomly drawn from the city's general population. The validated 92-item Portuguese version of the Prodromal Questionnaire (PQ) was used for face-to-face interviews. Latent class analysis was conducted. Mean age was of 24 years; 51.1% of the sample was of women. Mean total score on the PQ was 22.06 (SD = 17.16). Considering a suggested cut-off of 14 in the positive subscale, 30.8% of individuals were above the threshold for ultra-high risk for psychosis detection. Latent class analysis resulted in a three classes clusterization. Class 1 (20%; n = 390) had the highest overall PQ scores (mean = 49.31,SD = 10.783), class 2 (43%; n = 835) had intermediate scores (mean = 23.37,SD = 6.56), and class 3 (37%; n=721) had the lowest scores (mean= 5.81,SD = 3.74). Class 1 had significantly more individuals with less education and significantly more individuals with lower socioeconomic class. Poverty and low education might be associated with the psychotic expression in the general population, amplifying their actions on the psychosis gradient in developing countries. The psychosis continuum might be constituted by three distinct quantitatively different classes.