Department of Economics and Business Economics

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

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • J J McGrath
  • C C W Lim, University of Queensland, The Park Centre for Mental Health
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  • O Plana-Ripoll
  • Y Holtz, University of Queensland
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  • E Agerbo
  • N C Momen
  • P B Mortensen
  • C B Pedersen
  • J Abdulmalik, University College Hospital, Ibadan
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  • S Aguilar-Gaxiola, Center for Reducing Health Disparities, University of California-Davis Health System, Sacramento.
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  • A Al-Hamzawi, Al-Qadisiya University
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  • J Alonso, Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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  • E J Bromet, Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA.
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  • R Bruffaerts, Royal observatory of Belgium, Ringlaan 3, B-1180 Brussel, Belgium
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  • B Bunting, Univ Ulster, Ulster University, Sch Environm Sci
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  • J M C de Almeida, 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.
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  • G de Girolamo, Humanitas Clinical and Research Institute, National Research Council of Italy, Rozzano, Italy.
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  • Y A De Vries, University Medical Center Groningen, University of Groningen, Groningen
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  • S Florescu, National School of Public Health
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  • O Gureje, University College Hospital, Ibadan
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  • J M Haro, King Saud Univ, King Saud University, Coll Sci, Dept Zool
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  • M G Harris, The University of Queensland Diamantina Institute, University of Queensland, Australia.
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  • C Hu, Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, China.
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  • E G Karam, Balamand University
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  • N Kawakami, The University of Tokyo
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  • A Kiejna, Wroclaw Medical University, University of Lower Silesia, Wroclaw, Poland.
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  • V Kovess-Masfety, University Paris Descartes, Paris
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  • S Lee, Chinese University of Hong Kong
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  • Z Mneimneh, Univ Michigan, University of Michigan System, University of Michigan, Leinweber Ctr Theoret Phys
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  • F Navarro-Mateu, Liver Unit, Hospital Clínic de Barcelona, University de Barcelona, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro d'Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBEReHD), Barcelona, Spain.
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  • R Orozco, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
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  • J Posada-Villa, Colegio Mayor de Cundinamarca University
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  • A M Roest, Faculty of Behavioural and Social Sciences, Department of Clinical Developmental Psychology, VU University Amsterdam, Netherlands., University Medical Center Groningen, University of Groningen, Groningen, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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  • S Saha, Queensland Brain Institute, The University of Queensland, Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia., Neuroscience Research Australia, Sydney, Australia., Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Richlands, 4076, Queensland, Australia., Queensland Centre for Schizophrenia Mental Health Research, The Park, Centre for Mental Health, Wacol, Australia., Univ Queensland, University of Queensland, Queensland Brain Inst
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  • K M Scott, Univ Otago, University of Otago, Dept Zool
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  • J C Stagnaro, GCS ARGENTINA
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  • D J Stein, Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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  • Y Torres, CES University
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  • M C Viana, Federal University of Espírito Santo (UFES)
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  • Y Ziv, Israel Transplant Center, State of Israel Ministry of Health, Tel-Aviv, Israel.
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  • R C Kessler, Harvard School of Dental Medicine and Harvard Medical School
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  • P de Jonge, University Medical Center Groningen, University of Groningen, Groningen

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.

Original languageEnglish
Article numbere153
JournalEpidemiology and Psychiatric Sciences
Volume29
ISSN2045-7960
DOIs
Publication statusPublished - 2020

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