Exploring psychotic symptoms among substance-naïve individuals and recent abstainers without a psychosis diagnosis: A cross-country study across Kenya, Uganda, Ethiopia, and South Africa

Psychotic symptoms are of increasing interest in mental health due to their predictive value for future psychotic disorders. While these symptoms are prevalent in the general population, their occurrence varies globally. This study aimed to explore the prevalence and factors associated with psychotic symptoms among individuals identified as substance-naïve and recent abstainers without a history of psychosis. A cross-sectional analysis was conducted on 11,686 participants who reported no lifetime substance use, no substance use in the previous three months, and did not have a diagnosis of psychosis. The study utilized the Psychosis Screening Questionnaire to estimate the one-year prevalence of psychotic symptoms and their associations with demographic and clinical attributes. Results revealed a 3.5 % overall prevalence of psychotic symptoms with 2.9 % prevalence among substance naïve and 4.3 % among recent abstainers. Factors associated with psychotic symptoms were age, being female, having chronic medical conditions, encountering traumatic life events being divorced or separated and lower education levels which positively correlated with symptom scores. There is a need for future investigations and longitudinal studies to uncover the underlying mechanisms and impacts of psychotic symptoms.