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Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being

  • Gavin Andrews (a1), Tim Slade (a1) and Cathy Issakidis (a1)

Abstract

Background

Comorbidity in epidemiological surveys of mental disorders is common and of uncertain importance.

Aims

To explore the correlates of current comorbidity.

Method

Data from the Australian National Survey of Mental Health and Well-Being were used to evaluate the relationships between comorbidity, disability and service utilisation associated with particular mental disorders.

Results

The number of current comorbid disorders predicted disability, distress, neuroticism score and service utilisation. Comorbidity is more frequent than expected, which might be due to the effect of one disorder on the symptom level of another, or to the action of common causes on both. The combination of affective and anxiety disorders was more predictive of disability and service utilisation than any other two or three group combinations. When people nominated their principal disorder as the set of symptoms that troubled them the most, the affective and anxiety disorders together were associated with four-fifths of the disability and service utilisation.

Conclusions

To make clinical interventions more practical, current comorbidity is best reduced to a principal disorder and subsidiary disorders.

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Copyright

Corresponding author

Professor Gavin Andrews, Clinical Research Unit for Anxiety and Depression, 299 Forbes Street, Darlinghurst, NSW 2010, Australia. Fax: +61 29332 4316; e-mail: gavina@crufad.unsw.edu.au

Footnotes

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Declaration of interest

None. Funding detailed in Acknowledgements.

Footnotes

References

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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Andrews, G. (1996) Comorbidity and the general neurotic syndrome. British Journal of Psychiatry, 168 (suppl. 30), 7684.
Andrews, G. & Slade, T. (2002) Agoraphobia without panic disorder is part of the panic disorder syndrome. Journal of Nervous and Mental Disease, in press.
Andrews, G., Henderson, S. & Hall, W. (2001a) Prevalence, comorbidity, disability and service utilisation. Overview of the Australian National Mental Health Survey. British Journal of Psychiatry, 178, 145153.
Andrews, G., Issakidis, C. & Carter, G. (2001b) Shortfall in mental health service utilisation. British Journal of Psychiatry, 179, 417425.
Andrews, G., Issakidis, C., & Slade, T. (2001c) The clinical significance of mental disorders. In National Comorbidity Project (eds Teesson, M. & Burns, L.), publ. no. 2807. Canberra: Commonwealth Department of Health and Aged Care.
Angst, J. (1996) Comorbidity of mood disorders: a longitudinal prospective study. British Journal of Psychiatry, 168 (suppl. 30), 3137.
Bijl, R. V., Ravelli, A. & van Zessen, G. (1998) Prevalence of psychiatric disorders in the general population: results of the Netherlands Mental Health Survey and incidence study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology, 33, 587595.
Boyd, J. H., Burke, J. D., Gruenberg, E., et al (1984) Exclusion criteria of DSM–III: a study of co–occurrence of hierarchy–free syndromes. Archives of General Psychiatry, 41, 983989.
Eysenck, S. B. G., Eysenck, K. H. J. & Barrett, P. (1985) A revised version of the psychoticism scale. Personality and Individual Differences, 6, 2129.
Hollander, E. & Wong, C. M. (1995) Obsessive compulsive spectrum disorders. Journal of Clinical Psychiatry, 56 (suppl. 4), 36.
Jablensky, A., McGrath, J., Herrman, H., et al (2000) Psychotic disorders in urban areas. Australian and New Zealand Journal of Psychiatry, 34, 221236.
Kendler, K. S. (1996) Major depression and generalised anxiety disorder. Same genes, partly different environments – revisited. British Journal of Psychiatry, 168 (suppl. 30), 6875.
Kessler, R. C. (1995) Epidemiology of psychiatric comorbidity. In Textbook in Psychiatric Epidemiology (eds Tsuang, M., Tohen, M. & Zahner, G.), pp. 179198. New York: Wiley–Liss.
Kessler, R. C. & Frank, R. G. (1997) The impact of psychiatric disorders on work loss days. Psychological Medicine, 27, 861873.
Kessler, R. C., Nelson, C. B., McGonagle, K. A., et al (1996) Comorbidity of DSM–III–R major depressive disorder in the general population: results from the US National Comorbidity Survey. British Journal of Psychiatry, 168 (suppl. 30), 1730.
Kessler, R. C., Stang, P., Wittchen, H. U., et al (1999) Lifetime comorbidities between social phobia and mood disorders in the US National Comorbidity Survey. Psychological Medicine, 29, 555567.
Kessler, R. C., Andrews, G., Colpe, L. J., et al (2002) Short screening scales to monitor population prevalences and trends in non–specific psychological distress. Psychological Medicine, in press.
Kish, L. & Frankel, M. R. (1974) Inference from complex samples. Journal of the Royal Statistical Society, Series B, 36, 137.
McLeod, J. D., Kessler, R. C. & Landis, K. R. (1992) Speed of recovery from major depressive episodes in a community sample of married men and women. Journal of Abnormal Psychology, 101, 277286.
Robins, L. N. & Regier, D. A. (1991) Psychiatric Disorders in America. New York: Free Press.
Sanderson, K. & Andrews, G. (2002) Prevalence and severity of mental health-related disability and relationship to diagnosis. Psychiatric Services, 53, 8086.
Shah, B. V., Barnwell, B.G. & Biegler, G. S. (1997) SUDAAN User's Manual. Research Triangle Park. NC: Research Triangle Institute.
Siegel, S. (1956) Nonparametric Statistics for the Behavioral Sciences. New York: McGraw–Hilll.
Sturt, E. (1981) Hierarchical patterns in the distribution of psychiatric symptoms. Psychological Medicine, ii, 783794.
Tabachnick, B.G. & Fidell, L. S. (1996) Using Multivariate Statistics. New York: Harper Collins.
Vollebergh, W. A. M., Iedema, J., Bijl, R. V., et al (2001) The structure and stability of common mental disorders. Archives of General Psychiatry, 58, 597603.
Ware, J. E., Kosinski, M. & Keller, S. D. (1996) A 12–item short form health survey: construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220233.
Wells, B. & Sherbourne, C.D. (1999) Functioning and utility for current health of patients with depression or chronic medical conditions in managed, primary care practices. Archives of General Psychiatry, 56, 897904.
Wittchen, H.-U. (1996) Critical issues in the evaluation of comorbidity of psychiatric disorders. British Journal of Psychiatry, 168 (suppl. 30), 916.
World Health Organization (1992) Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.
World Health Organization (1997) Composite International Diagnostic Interview – Version 2.1. Geneva: WHO.

Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being

  • Gavin Andrews (a1), Tim Slade (a1) and Cathy Issakidis (a1)

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Deconstructing current comorbidity: data from the Australian National Survey of Mental Health and Well-Being

  • Gavin Andrews (a1), Tim Slade (a1) and Cathy Issakidis (a1)
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