@article{05391d46daf34dd9b400463eb01a85fd,
title = "Comorbidity within mental disorders: A comprehensive analysis based on 145 990 survey respondents from 27 countries: Epidemiology and Psychiatric Sciences",
abstract = "AimsEpidemiological 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.MethodsThe 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.ResultsEach 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.ConclusionsSurvey 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. Copyright {\textcopyright} The Author(s), 2020. Published by Cambridge University Press.",
keywords = "Cross-sectional study, diagnosis and classification, epidemiology, population survey, adolescent, adult, aged, classification, comorbidity, cross-sectional study, Diagnostic and Statistical Manual of Mental Disorders, female, health survey, human, male, mental disease, middle aged, prevalence, proportional hazards model, psychosis, retrospective study, risk factor, young adult, Adolescent, Adult, Aged, Comorbidity, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Mental Disorders, Middle Aged, Prevalence, Proportional Hazards Models, Psychotic Disorders, Retrospective Studies, Risk Factors, Young Adult",
author = "J.J. McGrath and C.C.W. Lim and O. Plana-Ripoll and Y. Holtz and E. Agerbo and N.C. Momen and P.B. Mortensen and C.B. Pedersen and J. Abdulmalik and S. Aguilar-Gaxiola and A. Al-Hamzawi and J. Alonso and E.J. Bromet and R. Bruffaerts and B. Bunting and {De Almeida}, J.M.C. and {De Girolamo}, G. and {De Vries}, Y.A. and S. Florescu and O. Gureje and J.M. Haro and M.G. Harris and C. Hu and E.G. Karam and N. Kawakami and A. Kiejna and V. Kovess-Masfety and S. Lee and Z. Mneimneh and F. Navarro-Mateu and R. Orozco and J. Posada-Villa and A.M. Roest and S. Saha and K.M. Scott and J.C. Stagnaro and D.J. Stein and Y. Torres and M.C. Viana and Y. Ziv and R.C. Kessler and {De Jonge}, P.",
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year = "2020",
doi = "10.1017/S2045796020000633",
language = "English",
volume = "29",
journal = "Epidemiol. Psychiatr. Sci.",
issn = "2045-7960",
publisher = "Cambridge University Press",
}