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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
arts and humanities
Development of lifetime comorbidity in the World Health Organization World Mental Health Surveys
Archives of General Psychiatry, Volume 68, No. 1, Year 2011
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Description
Context: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. Objective: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health Surveys. Design: Nationally or regionally representative community surveys. Setting: Fourteen countries. Participants: A total of 21 229 survey respondents. Main Outcome Measures: First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the World Health Organization Composite International Diagnostic Interview. Results: Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (ie, internalizing or externalizing) associations were generally stronger than between-domain associations. Most time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity and oppositional defiant disorders (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. Conclusions: Thegoodfit of the latent variablemodelsuggests thatcommoncausal pathways account for most of the comorbidityamongthe disorders considered herein. These common pathways should be the focus of future research on the development of comorbidity, although several important pairwise associations that cannot be accounted for bylatentvariablesalsoexistthatwarrantfurtherfocusedstudy. © 2011 American Medical Association. All rights reserved.
Authors & Co-Authors
Kessler, Ronald C.
United States, Boston
Harvard Medical School
Ormel, Johan Hans
Netherlands, Groningen
Rijksuniversiteit Groningen
Petukhova, Maria V.
United States, Boston
Harvard Medical School
McLaughlin, Katie A.
United States, Boston
Harvard Medical School
Green, Jennifer Greif
United States, Boston
Harvard Medical School
Russo, Leo J.
United States
Shire Pharmaceuticals Research and Development
Stein, Dan J.
South Africa, Cape Town
University of Cape Town
Zaslavsky, Alan M.
United States, Boston
Harvard Medical School
Aguilar-Gaxiola, Sergio A.
United States, Davis
University of California, Davis
Alonso Caballero, J. L.
Spain, Madrid
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Andrade, Laura Helena Silveira Guerra
Brazil, Sao Paulo
Universidade de São Paulo
Benjet, Corina
Mexico, Mexico
Instituto Nacional de Psiquiatría Ramon de la Fuente
de Girolamo, Giovanni
Italy, Brescia
Irccs Centro San Giovanni Di Dio Fatebenefratelli
de Graaf, Ron
Netherlands, Utrecht
Trimbos Institute, Netherlands Institute of Mental Health and Addiction
Demyttenaere, Koen
Belgium, Leuven
Ku Leuven– University Hospital Leuven
Fayyad, John A.
Lebanon, Beirut
Saint George Hospital University Medical Center
Lebanon, Beirut
Advocacy and Applied Care Idraac
Haro, Josep Maria
Spain, Madrid
Centro de Investigación Biomédica en Red de Salud Mental
Hu, Chiyi
China, Shenzhen
Szu-shenzhen Kangning Hospital
Karam, Aimée Nasser
Lebanon, Beirut
Saint George Hospital University Medical Center
Lebanon, Beirut
Advocacy and Applied Care Idraac
Lee, Sing
Hong Kong, Hong Kong
Chinese University of Hong Kong
Lépine, Jean Pierre
France, Paris
Hôpital Lariboisiere Ap-hp
Matchsinger, Herbert
Germany, Leipzig
Universität Leipzig
Mihaescu-Pintia, Constanta
Romania, Bucharest
Scoala Nationala de Sanatate Publica si Management Sanitar, Bucharest
Posada-Villa, J. A.
Colombia, Bogota
Universidad Colegio Mayor de Cundinamarca
Sagar, Rajesh Pragna
India, New Delhi
All India Institute of Medical Sciences, new Delhi
Üstün, Tevfik Bedirhan Bedirhan
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 26
Authors: 26
Affiliations: 22
Identifiers
Doi:
10.1001/archgenpsychiatry.2010.180
ISSN:
0003990X
e-ISSN:
15383636
Research Areas
Mental Health
Study Design
Cross Sectional Study
Exploratory Study
Study Approach
Quantitative