Background To date, the mechanisms that underlie the relationship between the onset of anxiety/depression symptoms and the risk of developing psychotic experiences (PEs) remain poorly understood. This study aimed to examine the direct and indirect effects of depression and anxiety on PEs through the mediating role of caffeine addiction symptoms. Method In total, 1447 young adults from the general population of Tunisia, aged 18–35 years, enrolled in this cross-sectional study and filled an online survey. A mixed convenience and snowball sampling technique was used to collect data. Results Caffeine addiction symptoms partially mediated the associations between depression and PEs and between anxiety and PEs. Depression and anxiety scores were associated with higher caffeine addiction symptoms (Beta = 0.37; p < 0.001 and Beta = 0.38; p < 0.001, respectively). In turn, caffeine addiction symptoms were associated with higher PEs (Beta = 0.29; p < 0.001 and Beta = 0.30; p < 0.001, respectively). Depression and anxiety scores were directly associated with PEs (Beta = 0.36; p < 0.001 and Beta = 0.32; p < 0.001, respectively). The R 2 values of both models showed that 29.0% and 26.7% of the variance in PEs is accounted for by caffeine addiction symptoms, respectively. Conclusion Young people presenting with depression and anxiety symptoms should be carefully assessed for caffeine intake in clinical practice, educated regarding the known health risks associated with this substance, and advised to limit excessive caffeine intake, which can, in turn, help prevent the occurrence of PEs.
Fekih-Romdhane et al. (Sat,) studied this question.