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

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Autor(es):
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McGrath, J. J. [1, 2, 3] ; Lim, C. C. W. [1, 3] ; Plana-Ripoll, O. [2] ; Holtz, Y. [1] ; Agerbo, E. [2, 4, 5] ; Momen, N. C. [2] ; Mortensen, P. B. [2, 4, 5] ; Pedersen, C. B. [2, 4, 5, 6] ; Abdulmalik, J. [7] ; Aguilar-Gaxiola, S. [8] ; Al-Hamzawi, A. [9] ; Alonso, J. [10, 11, 12] ; Bromet, E. J. [13] ; Bruffaerts, R. [14] ; Bunting, B. [15, 16] ; de Almeida, J. M. C. [17] ; de Girolamo, G. [18] ; De Vries, Y. A. [19, 20] ; Florescu, S. [21] ; Gureje, O. [7] ; Haro, J. M. [22, 23] ; Harris, M. G. [3, 24] ; Hu, C. [25, 26] ; Karam, E. G. [27, 28] ; Kawakami, N. [29] ; Kiejna, A. [30, 31] ; Kovess-Masfety, V. [32] ; Lee, S. [33] ; Mneimneh, Z. [34] ; Navarro-Mateu, F. [35] ; Orozco, R. [36] ; Posada-Villa, J. [37, 38] ; Roest, A. M. [39] ; Saha, S. [1, 3] ; Scott, K. M. [40] ; Stagnaro, J. C. [41] ; Stein, D. J. [42, 43, 44] ; Torres, Y. [45] ; Viana, M. C. [46] ; Ziv, Y. [47] ; Kessler, R. C. [48] ; de Jonge, P. [19, 20]
Número total de Autores: 42
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[1] Univ Queensland, Queensland Brain Inst, St Lucia, Qld 4072 - Australia
[2] Aarhus Univ, Natl Ctr Register based Res, Aarhus - Denmark
[3] Pk Ctr Mental Hlth, Queensland Ctr Mental Hlth Res, Wacol, Qld - Australia
[4] Aarhus Univ, Ctr Integrated Register Based Res, Aarhus - Denmark
[5] Lundbeck Fdn Initiat Integrat Psychiat Res iPSYCH, Aarhus - Denmark
[6] Aarhus Univ, Big Data Ctr Environm & Hlth, Aarhus - Denmark
[7] Univ Coll Hosp, Dept Psychiat, Ibadan - Nigeria
[8] UC Davis Hlth Syst, Ctr Reducing Hlth Dispar, Sacramento, CA - USA
[9] Al Qadisiya Univ, Coll Med, Diwaniya Governorate - Iraq
[10] Pompeu Fabra Univ UPF, Barcelona - Spain
[11] CIBER Epidemiol & Salud Publ CIBERESP, Barcelona - Spain
[12] IMIM Hosp del Mar Med Res Inst, Hlth Serv Res Unit, Barcelona - Spain
[13] SUNY Stony Brook, Sch Med, Dept Psychiat, Stony Brook, NY 11794 - USA
[14] Katholieke Univ Leuven UPC KUL, Univ Psychiat Ctr, Campus Gasthuisberg, Leuven - Belgium
[15] Ulster Univ, Sch Psychol, Coleraine, Londonderry - North Ireland
[16] Univ Nova Lisboa, Lisbon Inst Global Mental Hlth, Lisbon - Portugal
[17] Univ Nova Lisboa, NOVA Med Sch, Chron Dis Res Ctr CEDOC, Fac Ciencias Med, Lisbon - Portugal
[18] Ctr San Giovanni Dio Fatebenefratelli, IRCCS Ist, Brescia - Italy
[19] Univ Groningen, Dept Dev Psychol, Groningen - Netherlands
[20] Univ Med Ctr Groningen, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen - Netherlands
[21] Natl Sch Publ Hlth Management & Dev, Bucharest - Romania
[22] King Saud Univ, Coll Educ, Dept Psychol, Riyadh - Saudi Arabia
[23] Univ Barcelona, Parc Sanit Sant Joan Deu, CIBERSAM, Barcelona - Spain
[24] Univ Queensland, Sch Publ Hlth, Herston, Qld 4006 - Australia
[25] Shenzhen Inst Mental Hlth, Shenzhen - Peoples R China
[26] Shenzhen Kangning Hosp, Shenzhen - Peoples R China
[27] Inst Dev Res Advocacy & Appl Care IDRAAC, Beirut - Lebanon
[28] Balamand Univ, St George Hosp Univ, Dept Psychiat & Clin Psychol, Med Ctr, Fac Med, Beirut - Lebanon
[29] Univ Tokyo, Sch Publ Hlth, Dept Mental Hlth, Tokyo - Japan
[30] Wroclaw Med Univ, Wroclaw - Poland
[31] Univ Lower Silesia, Wroclaw - Poland
[32] Paris Descartes Univ, Ecole Hautes Etud Sante Publ EHESP, EA 4057, Paris - France
[33] Chinese Univ Hong Kong, Dept Psychiat, Tai Po, Hong Kong - Peoples R China
[34] Univ Michigan, Survey Res Ctr, Inst Social Res, Ann Arbor, MI 48109 - USA
[35] CIBERESP Murcia, UDIF SM, Serv Murciano Salud, IMIB Arrixaca, Murcia, Region De Murci - Spain
[36] Natl Inst Psychiat Ramon Fuente Muniz, Mexico City, DF - Mexico
[37] Cundinamarca Univ, Fac Social Sci, Colegio Mayor, Bogota - Colombia
[38] Cundinamarca Univ, Calle 28 5B 02, Bogota 11001000 - Colombia
[39] Univ Groningen, Dept Dev Psychol, Fac Behav & Social Sci, Groningen - Netherlands
[40] Univ Otago, Dunedin Sch Med, Dept Psychol Med, Dunedin - New Zealand
[41] Univ Buenos Aires, Fac Med, Dept Psiquiat & Salud Mental, Buenos Aires, DF - Argentina
[42] Groote Schuur Hosp, Cape Town - South Africa
[43] Univ Cape Town, South African Med Council, Res Unit Risk & Resilience Mental Disorders, Cape Town - South Africa
[44] Univ Cape Town, Dept Psychiat Mental Hlth, Cape Town - South Africa
[45] CES Univ, Ctr Excellence Res Mental Hlth, Medellin - Colombia
[46] Univ Fed Espirito Santo, Postgrad Program Publ Hlth, Dept Social Med, Vitoria, ES - Brazil
[47] Israeli Minist Hlth, Mental Hlth Serv, Jerusalem - Israel
[48] Harvard Med Sch, Dept Hlth Care Policy, Boston, MA 02115 - USA
Número total de Afiliações: 48
Tipo de documento: Artigo Científico
Fonte: EPIDEMIOLOGY AND PSYCHIATRIC SCIENCES; v. 29, 2020.
Citações Web of Science: 0
Resumo

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. (AU)

Processo FAPESP: 03/00204-3 - Estudo epidemiológico dos transtornos psiquiátricos na região metropolitana de São Paulo: prevalências, fatores de risco e sobrecarga social e econômica
Beneficiário:Laura Helena Silveira Guerra de Andrade Burdmann
Linha de fomento: Auxílio à Pesquisa - Temático