Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries.

Journal: Epidemiology and psychiatric sciences

Volume: 29

Issue: 

Year of Publication: 2020

Affiliated Institutions:  National Centre for Register-based Research, Aarhus University, Aarhus, Denmark. Queensland Brain Institute, University of Queensland, St Lucia QLD , Australia. Department of Psychiatry, University College Hospital, Ibadan, Nigeria. Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA. College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq. Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain. Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA. Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium. School of Psychology, Ulster University, Londonderry, UK. Lisbon Institute of Global Mental Health and Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal. IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. Department of Developmental Psychology, University of Groningen, Groningen, the Netherlands. National School of Public Health, Management and Development, Bucharest, Romania. Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia. Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China. Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon. Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan. Wroclaw Medical University; University of Lower Silesia, Wroclaw, Poland. Ecole des Hautes Etudes en Santé Publique (EHESP), EA , Paris Descartes University, Paris, France. Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA. UDIF-SM, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Región de Murcia, Spain. National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico. Colegio Mayor de Cundinamarca University, Faculty of Social Sciences,Bogota, Colombia. Faculty of Behavioural and Social Sciences, Department Developmental Psychology, University of Groningen, Groningen, the Netherlands. Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina. Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, Republic of South Africa. Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia. Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil. Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel. Department of Health Care Policy, Harvard Medical School, BostonMA, USA.

Abstract summary 

Epidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys.The WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women.Each prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2-110.8, interquartile range = 6.0-19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1-2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs.Survey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.

Authors & Co-authors:  McGrath J J JJ Lim C C W CCW Plana-Ripoll O O Holtz Y Y Agerbo E E Momen N C NC Mortensen P B PB Pedersen C B CB Abdulmalik J J Aguilar-Gaxiola S S Al-Hamzawi A A Alonso J J Bromet E J EJ Bruffaerts R R Bunting B B de Almeida J M C JMC de Girolamo G G De Vries Y A YA Florescu S S Gureje O O Haro J M JM Harris M G MG Hu C C Karam E G EG Kawakami N N Kiejna A A Kovess-Masfety V V Lee S S Mneimneh Z Z Navarro-Mateu F F Orozco R R Posada-Villa J J Roest A M AM Saha S S Scott K M KM Stagnaro J C JC Stein D J DJ Torres Y Y Viana M C MC Ziv Y Y Kessler R C RC de Jonge P P

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Caspi A and Moffitt TE (2018) All for one and one for all: mental disorders in one dimension. American Journal of Psychiatry 175, 831–844.
Authors :  42
Identifiers
Doi : e153
SSN : 2045-7979
Study Population
Men
Mesh Terms
Adolescent
Other Terms
Cross-sectional study;diagnosis and classification;epidemiology;population survey
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England