Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries.
Por:
McGrath JJ, Lim CCW, Plana-Ripoll O, Holtz Y, Agerbo E, Momen NC, Mortensen PB, Pedersen CB, Abdulmalik J, Aguilar-Gaxiola S, Al-Hamzawi A, Alonso J, Bromet EJ, Bruffaerts R, Bunting B, de Almeida JMC, de Girolamo G, De Vries YA, Florescu S, Gureje O, Haro JM, Harris MG, Hu C, Karam EG, Kawakami N, Kiejna A, Kovess-Masfety V, Lee S, Mneimneh Z, Navarro-Mateu F, Orozco R, Posada-Villa J, Roest AM, Saha S, Scott KM, Stagnaro JC, Stein DJ, Torres Y, Viana MC, Ziv Y, Kessler RC and de Jonge P
Publicada:
12 ago 2020
Ahead of Print:
12 ago 2020
Resumen:
AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Filiaciones:
McGrath JJ:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
Queensland Brain Institute, University of Queensland, St Lucia QLD 4072, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
Lim CCW:
Queensland Brain Institute, University of Queensland, St Lucia QLD 4072, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
Plana-Ripoll O:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
Holtz Y:
Queensland Brain Institute, University of Queensland, St Lucia QLD 4072, Australia
Agerbo E:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
Momen NC:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
Mortensen PB:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
Pedersen CB:
National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
Big Data Centre for Environment and Health, Aarhus University, Aarhus, Denmark
Abdulmalik J:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Aguilar-Gaxiola S:
Center for Reducing Health Disparities, UC Davis Health System, Sacramento, California, USA
Al-Hamzawi A:
College of Medicine, Al-Qadisiya University, Diwaniya governorate, Iraq
Alonso J:
Health Services Research Unit, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
Pompeu Fabra University (UPF), Barcelona, Spain
Bromet EJ:
Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, New York, USA
Bruffaerts R:
Universitair Psychiatrisch Centrum - Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
Bunting B:
School of Psychology, Ulster University, Londonderry, UK
de Almeida JMC:
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
de Girolamo G:
IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
De Vries YA:
Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands
Florescu S:
National School of Public Health, Management and Development, Bucharest, Romania
Gureje O:
Department of Psychiatry, University College Hospital, Ibadan, Nigeria
Haro JM:
Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
Harris MG:
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
Hu C:
Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China
Karam EG:
Department of Psychiatry and Clinical Psychology, St George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon
Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon
Kawakami N:
Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
Kiejna A:
Wroclaw Medical University
University of Lower Silesia, Wroclaw, Poland
Kovess-Masfety V:
Ecole des Hautes Etudes en Santé Publique (EHESP), EA 4057, Paris Descartes University, Paris, France
Lee S:
Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
Mneimneh Z:
Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
Navarro-Mateu F:
UDIF-SM, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Región de Murcia, Spain
Orozco R:
National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
Posada-Villa J:
Colegio Mayor de Cundinamarca University, Faculty of Social Sciences,Bogota, Colombia
Cundinamarca University, calle 28 # 5B 02, Bogotá, 11001000 (zip), Colombia
Roest AM:
Faculty of Behavioural and Social Sciences, Department Developmental Psychology, University of Groningen, Groningen, the Netherlands
Saha S:
Queensland Brain Institute, University of Queensland, St Lucia QLD 4072, Australia
Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Queensland, Australia
Scott KM:
Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
Stagnaro JC:
Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Argentina
Stein DJ:
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
Torres Y:
Center for Excellence on Research in Mental Health, CES University, Medellin, Colombia
Viana MC:
Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitoria, Brazil
Ziv Y:
Mental Health Services, Israeli Ministry of Health, Jerusalem, Israel
Kessler RC:
Department of Health Care Policy, Harvard Medical School, BostonMA, USA
de Jonge P:
Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, Groningen, the Netherlands
Green Published, Green Submitted, gold
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