Psychological Medicine

Original Articles

Psychosis prevalence and physical, metabolic and cognitive co-morbidity: data from the second Australian national survey of psychosis

V. A. Morgana1a2 c1, J. J. McGratha3a4, A. Jablenskya2, J. C. Badcocka5a6, A. Waterreusa1, R. Busha7, V. Carra8a9, D. Castlea10a11, M. Cohena12a13, C. Galletlya14a15a16, C. Harveya10a17, B. Hockinga18, P. McGorrya10a19a20, A. L. Neila21, S. Sawa22, S. Shaha1, H. J. Staina23a24 and A. Mackinnona19a20

a1 Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia

a2 Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Crawley, WA, Australia

a3 Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia

a4 Queensland Centre for Mental Health Research, Brisbane, QLD, Australia

a5 School of Psychology, The University of Western Australia, Crawley, Western Australia

a6 Clinical Research Centre, North Metropolitan Health Service-Mental Health, Mount Claremont, WA, Australia

a7 School of Population Health, The University of Queensland, Ipswich, QLD, Australia

a8 School of Psychiatry, The University of New South Wales, Sydney, NSW, Australia

a9 Schizophrenia Research Institute, Sydney, NSW, Australia

a10 Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia

a11 St Vincent's Hospital, Melbourne, VIC, Australia

a12 Hunter New England Mental Health, Newcastle, NSW, Australia

a13 School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia

a14 School of Medicine, University of Adelaide, Adelaide, SA, Australia

a15 Ramsay Health Care (SA) Mental Health Services, Adelaide, SA, Australia

a16 Northern Sector, Adelaide Metro Mental Health Directorate, Adelaide, SA, Australia

a17 Psychosocial Research Centre, North West Area Mental Health Services, Coburg, VIC, Australia

a18 SANE Australia, Melbourne, VIC, Australia

a19 Orygen Youth Health Research Centre, Melbourne, VIC, Australia

a20 Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia

a21 Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia

a22 Australian Government Department of Health and Ageing, Canberra, ACT, Australia

a23 Centre for Rural and Remote Mental Health, University of Newcastle, Newcastle, NSW, Australia

a24 School of Medicine, Pharmacy and Health, Durham University, Durham, UK


Background There are insufficient data from nationwide surveys on the prevalence of specific psychotic disorders and associated co-morbidities.

Method The 2010 Australian national psychosis survey used a two-phase design to draw a representative sample of adults aged 18–64 years with psychotic disorders in contact with public treatment services from an estimated resident population of 1 464 923 adults. This paper is based on data from 1642 participants with an International Classification of Diseases (ICD)-10 psychotic disorder. Its aim is to present estimates of treated prevalence and lifetime morbid risk of psychosis, and to describe the cognitive, physical health and substance use profiles of participants.

Results The 1-month treated prevalence of psychotic disorders was 3.10 cases per 1000 population aged 18–64 years, not accounting for people solely accessing primary care services; lifetime morbid risk was 3.45 per 1000. Mean premorbid intelligence quotient was approximately 0.5 s.d.s below the population mean; current cognitive ability (measured with a digit symbol coding task) was 1.6 s.d.s below the population mean. For both cognitive tests, higher scores were significantly associated with better independent functioning. The prevalence of the metabolic syndrome was high, affecting 60.8% of participants, and pervasive across diagnostic groups. Of the participants, two-thirds (65.9%) were current smokers, 47.4% were obese and 32.4% were sedentary. Of the participants, half (49.8%) had a lifetime history of alcohol abuse/dependence and 50.8% lifetime cannabis abuse/dependence.

Conclusions Our findings highlight the need for comprehensive, integrative models of recovery to maximize the potential for good health and quality of life for people with psychotic illness.

(Received August 21 2013)

(Revised November 05 2013)

(Accepted November 09 2013)

(Online publication January 02 2014)

Key words

  • Bipolar disorder;
  • schizo-affective disorder;
  • schizophrenia;
  • speed of information processing;
  • substance abuse


c1 Address for correspondence: V. A. Morgan, Ph.D., Neuropsychiatric Epidemiology Research Unit M571, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, 35 Stirling Highway, Crawley 6009, WA, Australia. (Email:

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