The cross-national structure of mental disorders: results from the World Mental Health Surveys.
Journal: Psychological medicine
Volume: 48
Issue: 12
Year of Publication: 2019
Affiliated Institutions:
Developmental Psychology,Department of Psychology,Rijksuniversiteit Groningen,Groningen,Netherlands.
Department of Psychiatry,Interdisciplinary Center Psychopathology and Emotion Regulation,University Medical Center Groningen,Groningen,Netherlands.
Department of Psychological Medicine,University of Otago,Dunedin, Otago,New Zealand.
Center for Reducing Health Disparities,UC Davis Health System,Sacramento, California,USA.
Health Services Research Unit,IMIM-Hospital del Mar Medical Research Institute,Barcelona,Spain.
Núcleo de Epidemiologia Psiquiátrica - LIM ,Instituto de Psiquiatria Hospital das Clinicas da Faculdade de Medicina da Universidade,de São Paulo,Brazil.
School of Psychology,Ulster University,Londonderry,UK.
Department of Information,Evidence and Research, World Health Organization,Geneva,Switzerland.
National School of Public Health,Management and Development,Bucharest,Romania.
Department of Psychiatry,University College Hospital,Ibadan,Nigeria.
Department of Psychiatry and Clinical Psychology,St George Hospital University Medical Center, Balamand University,Faculty of Medicine,Beirut,Lebanon.
Department of Psychiatry,Chinese University of Hong Kong,Tai Po,Hong Kong.
National Institute of Psychiatry Ramon de la Fuente Muñiz,Mexico City,Mexico.
Institute of Psychiatry and Neurology,Warsaw,Poland.
UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud; IMIB-Arrixaca; CIBERESP-Murcia,Murcia,Spain.
Survey Research Center,Institute for Social Research,University of Michigan,Ann Arbor, Michigan,USA.
Universidad Cayetano Heredia,Lima,Peru.
Colegio Mayor de Cundinamarca University, Faculty of Social Sciences,Bogota,Colombia.
Center for Excellence on Research in Mental Health, CES University,Medellin,Colombia.
Department of Health Care Policy,Harvard Medical School,Boston, Massachusetts,USA.
Abstract summary
The patterns of comorbidity among mental disorders have led researchers to model the underlying structure of psychopathology. While studies have suggested a structure including internalizing and externalizing disorders, less is known with regard to the cross-national stability of this model. Moreover, little data are available on the placement of eating disorders, bipolar disorder and psychotic experiences (PEs) in this structure.We evaluated the structure of mental disorders with data from the World Health Organization Composite International Diagnostic Interview, including 15 lifetime mental disorders and six PEs. Respondents (n = 5478-15 499) were included from 10 high-, middle- and lower middle-income countries across the world aged 18 years or older. Confirmatory factor analyses (CFAs) were used to evaluate and compare the fit of different factor structures to the lifetime disorder data. Measurement invariance was evaluated with multigroup CFA (MG-CFA).A second-order model with internalizing and externalizing factors and fear and distress subfactors best described the structure of common mental disorders. MG-CFA showed that this model was stable across countries. Of the uncommon disorders, bipolar disorder and eating disorder were best grouped with the internalizing factor, and PEs with a separate factor.These results indicate that cross-national patterns of lifetime common mental-disorder comorbidity can be explained with a second-order underlying structure that is stable across countries and can be extended to also cover less common mental disorders.
Authors & Co-authors:
de Jonge Peter P
Wardenaar Klaas J KJ
Lim Carmen C W CCW
Aguilar-Gaxiola Sergio S
Alonso Jordi J
Andrade Laura Helena LH
Bunting Brendan B
Chatterji Somnath S
Ciutan Marius M
Gureje Oye O
Karam Elie G EG
Lee Sing S
Medina-Mora Maria Elena ME
Moskalewicz Jacek J
Navarro-Mateu Fernando F
Pennell Beth-Ellen BE
Piazza Marina M
Posada-Villa José J
Torres Yolanda Y
Kessler Ronald C RC
Scott Kate K
Study Outcome
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