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Nematocide activity of 6,7-diarylpteridines in three experimental models
- C. Ochoa, M. Rodríguez, L. Domínguez, J. Saldaña, R. Di Maio, P. Alonso-Villalobos, M.M. Martínez Grueiro
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- Journal:
- Journal of Helminthology / Volume 73 / Issue 4 / April 1999
- Published online by Cambridge University Press:
- 11 April 2024, pp. 333-336
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The in vitro nematocide activity of seventeen 6,7-diarylpteridines has been tested using three different experimental models, Caenorhabditis elegans, Nippostrongylus brasiliensis and Heligmosomoides polygyrus. The method of evaluation of inhibition in the secretion of acetylcholinesterase by H. polygyrus seems to be the most indicated to avoid false positives. The in vivo activities, against Trichinella spiralis, of the most in vitro active pteridines have been assayed. All pteridine derivatives bearing 6,7-di-p-bromophenyl substituents have shown in vitronematocide activites in the three experimental models used. Amongst all the pteridines tested in vivo, only 2,4-pteridinedithione derivatives exhibited moderate activity.
Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys
- Alan E. Kazdin, Meredith G. Harris, Irving Hwang, Nancy A. Sampson, Dan J. Stein, Maria Carmen Viana, Daniel V. Vigo, Chi-Shin Wu, Sergio Aguilar-Gaxiola, Jordi Alonso, Corina Benjet, Ronny Bruffaerts, José Miguel Caldas-Almeida, Graça Cardoso, Elisa Caselani, Stephanie Chardoul, Alfredo Cía, Peter de Jonge, Oye Gureje, Josep Maria Haro, Elie G. Karam, Viviane Kovess-Masfety, Fernando Navarro-Mateu, Marina Piazza, José Posada-Villa, Kate M. Scott, Juan Carlos Stagnaro, Margreet ten Have, Yolanda Torres, Cristian Vladescu, Ronald C. Kessler
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- Psychological Medicine / Volume 54 / Issue 1 / January 2024
- Published online by Cambridge University Press:
- 14 September 2023, pp. 67-78
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Background
Despite their documented efficacy, substantial proportions of patients discontinue antidepressant medication (ADM) without a doctor's recommendation. The current report integrates data on patient-reported reasons into an investigation of patterns and predictors of ADM discontinuation.
MethodsFace-to-face interviews with community samples from 13 countries (n = 30 697) in the World Mental Health (WMH) Surveys included n = 1890 respondents who used ADMs within the past 12 months.
Results10.9% of 12-month ADM users reported discontinuation-based on recommendation of the prescriber while 15.7% discontinued in the absence of prescriber recommendation. The main patient-reported reason for discontinuation was feeling better (46.6%), which was reported by a higher proportion of patients who discontinued within the first 2 weeks of treatment than later. Perceived ineffectiveness (18.5%), predisposing factors (e.g. fear of dependence) (20.0%), and enabling factors (e.g. inability to afford treatment cost) (5.0%) were much less commonly reported reasons. Discontinuation in the absence of prescriber recommendation was associated with low country income level, being employed, and having above average personal income. Age, prior history of psychotropic medication use, and being prescribed treatment from a psychiatrist rather than from a general medical practitioner, in comparison, were associated with a lower probability of this type of discontinuation. However, these predictors varied substantially depending on patient-reported reasons for discontinuation.
ConclusionDropping out early is not necessarily negative with almost half of individuals noting they felt better. The study underscores the diverse reasons given for dropping out and the need to evaluate how and whether dropping out influences short- or long-term functioning.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
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- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
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Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Biomarkers and clinical predictors of long-term course in obsessivecompulsive disorder: A prospective cohort study
- S. López-Rodriguez, P. Alonso Ortega, C. Segalàs Cosi, E. Real Barrero, S. Bertolín Triquell, C. Soriano Mas, Á. Carracedo Alvarez, J. M. Menchón Magriña
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S231
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Introduction
The purpose of the research project is to analyze the long-term evolution of obsessive-compulsive disorder (OCD) from of a study of a cohort of patients prospectively followed over a period ranging from 5 to 20 years, treated for according to therapeutic guidelines mediating serotonin reuptake inhibitors (IRS) and drug enhancers (antipsychotics) and cognitive behavioral therapy and evaluated in a standardized manner.
ObjectivesTo assess the long-term course of Obsessive-Compulsive Disorder (OCD) in a cohort of patients treated according to current clinical guidelines; to analyse possible prognostic factors associated with the long-term course of the disorder including clinical and sociodemographic variables, as well as genetic and neuroimaging biomarkers, and their interaction, and finally to study neuroanatomical and functional cerebral connectivity changes after 15 years of treatment in a subsample of patients.
MethodsProspective, descriptive, and observational study of a cohort of OCD patients, receiving treatment at the Department of Psychiatry of Hospital de Bellvitge since 1998, according to a standardized protocol. Follow-up period ranges from 5 (n=423), to 10 (n= 247) and 15 years (123). Baseline clinical and sociodemographic assessment, long-term evolution and information on treatments provided are available for the whole sample. Data on whole exome sequencing is available for 300 of the patients included in the cohort and baseline structural neuroimaging and cerebral functional connectivity has been analysed in 168 subjects. To expand the analysis of genetic biomarkers, we propose the study of de novo variants through exome analysis of 50 trios (patient and both parents) selected among those subjects that have reached 15 years of follow-up (25 trios with patients within the “long-term remission” group and 25 trios with patients with chronic OCD). De novo variants detected in the trio analysis will be replicated in the rest of the sample. A structural and resting state MRI will be obtained in a subsample of 100 patients recruited among those who have completed a minimum follow-up period of 15 years, to assess cerebral changes associated with the long-term course of the disorder.
Resultsin the current moment the recruitment period of the study has ended and all the data is being statistically analysed in order to provide solid results in a short period of time.
ConclusionsThe identification of those factors associated with an increased risk of chronic disease is an element essential to offer personalized treatment to our patients and improve their prognosis, emphasizing the intensive use of those therapeutic strategies for which we can predict a better response and modifying to the extent of, if possible, environmental factors or factors of access to treatment that contribute to perpetuate obsessive symptoms.
Disclosure of InterestNone Declared
Smoking treatments for patients with mental illness: case presentation and a brief literature review
- F. Garcia Sanchez, M. Gutierrez Rodriguez, C. Moreno Menguiano, M. A. Corral Alonso, J. J. Vazquez Vazquez, S. M. Bañon Gonzalez, V. Voces Domingo, J. A. Casado de la Hera
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S756
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Introduction
Smoking prevalence in patients with mental illness ranges between two to 4 times higher than general population. This higher prevalence has a multifactorial origin, and some of the possible causes are still unknown.
They have a higher prevalence of tobacco-associated diseases and higher mortality.
Additionally, these patients have greater difficulty in treating and quitting smoking.
A relationship has been found between severity of mental illness and smoking. Risk of suicide seems to be higher in patients with higher tobacco consumption. Schizophrenia is the mental illness that has been most closely related to smoking, with a prevalence close to 90%.
ObjectivesThe aim of this work is reviewing the current bibliography referring to smoking treatments for patients with mental illness
MethodsA literature search using electronic manuscripts available in PubMed database published during the last ten years and further description and discussion of a single-patient clinical case
ResultsThe treatment of tobacco dependence in patients with mental illnesses is sometimes waited until there is psychiatric stability, which can take a long time in those cases with more severe mental disorders, which can have negative physical and psychiatric consequences.
The combined treatment of cognitive behavioral therapy and pharmacological treatment is the most effective approach. Nicotine replacement therapy can be useful, while combined use of antidepressants or anxiolytics is also recommended.
Bupropion has shown efficacy. In patients with schizophrenia it does not seem to worsen positive symptomatology, but improving the negative one. It should not be used in patients with bipolar disorder or bulimia.
Varenicline has shown efficacy in the general population, but limitations were established in patients with mental illness, although it is the drug that has shown greater efficacy. However, is not currently available in our country.
Cytisine is a drug with limited number of studies in the psychiatric population but it may be a reasonable treatment alternative.
ConclusionsThe prevalence of tobacco use in patients with mental illness is higher than the general population, especially in paranoid schizophrenia. The consequences on physical health and the evolution of psychiatric illness are very relevant. Based on above, a multidisciplinary and coordinated management involving psychiatrists and other specialists in the treatment of these patients should be desirable.
Disclosure of InterestNone Declared
Acute mutism in a young female. A case report of a 20-year-old female who presents a 3-month mutism
- A. Gonzalez-Mota, A. Gonzalez-Gil, C. Martin-Gomez, J. A. Benito-Sanchez, I. M. Peso-Navarro, L. Fernandez-Alonso
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S177-S178
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Introduction
A 20-year-old female presents with a progressive 3-month mutism, hyporexia (20kg weight loss), abulia, anhedonia, apathy, social isolation,seeking company of her parents even at night, bradypsychia, sialorrhea, psychomotor slowdown and hypomimia. She is hospitalized in the Psychiatric Brief Hospitalization Unit (PBHU).Her parents relate the beginning of this symptomatology to a breakup and gender violence,which the patient confirms during the interview by eye/cephalic movements and single words jotted down.
ObjectivesThe objective of this study is to describe the evolution of the patient during her hospitalization in the PBHU of Salamanca and to look into the available bibliography about mutism related to stress and sialorrhea.
MethodsWe carried out a follow-up of the hospitalization of the patient and a structured search in PubMed with the keywords “mutism”,“sialorrhea” and “stress” in the last 10 years in English,Spanish and French.
ResultsFew or no articles where found.Therefore, the articles about mutism and stress were analyzed, which focused mostly in selective mutism. Regarding fear,the response to cope with the threat(fight, flight, freeze) is mediated by the autonomic system. The “Polyvagal Theory” speaks about the vagus nerve participating in emotion regulation (social communication and mobilization). Dissociation, in this context,has adaptive and defensive purposes and its threshold can be reduced by repeated stress situations.Long-term alteration of the autonomic nervous system has been described in selective mutism.This malfunction can be related to an elevated production of saliva due to the activation of the parasympathetic in the salivary glands, causing sialorrhea in our patient.
The patient began treatment with sertraline 100mg and risperidone 2mg with the aim of its antidepressive and major tranquilizer effects, she also began individual and family psychotherapy, we assured her sleep and intakes and she began to progressively recover her speech and mobility,identifying a possible trigger for the symptomatology: a physical beating of gender violence after her breakup.
ConclusionsDissociation and “freeze” response can be a maladaptative mechanism to fear.The malfunction of the autonomic nervous system can explain the disconnection,poor gaze,low facial and body expression and inability to speak.
Disclosure of InterestNone Declared
Visual hallucinations and age-related macular degeneration: case presentation and a brief literature review
- M. M. Gutiérrez Rodríguez, F. García Sánchez, M. Á. Corral Alonso, J. J. Vázquez Vázquez, C. Moreno Menguiano
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S936-S937
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Introduction
age-related macular degeneration (AMD) is an ocular disease involving central vision. It is one of the mainreasons of vision loss in people over 50. Seeing non-existing faces or shapes are described in AMD. Symtoms of visualhallucinations that occur as a result of vision loss is known as Charles Bonnet syndrome (CBS). These patients haveintact cognition, do not have hallucinations in any other sensory modalities, and retain insight into the unreal nature oftheir hallucinations.
Objectivesthe aim of this work is analizing ethiology, demographic characteristics, clinica features and treatment inpatients with AMD and visual hallucinations
Methodsa literature search using electronic manuscripts available in PubMed database published during the last ten years with further description and discussion of a single-patient clinical case.
Resultsin different studies in patients diagnosed with AMD, the reported prevalence ranges between 15 up to 39percent. Patients with more significant vision loss may be more likely to experience visual hallucinations. In large caseseries, mean age is 70 to 85 years. Hallucinations can last few minutes or several hours. On average, people experiencethese hallucinations on and off for about 3 years. Those who experience hallucinations tend to see multiple types ofimages, particularly people and faces.The diagnosis of CBS is made when visual hallucinations occur in patients withvision loss in the absence of psychosis, delirium, or other causes.
There is no specific treatment for CBS: optimal ocular care, education and differents techniques to manage hallucinations(changing your lighting conditions and environment, blinking frequently or moving your eyes side-to-side rapidly whilekeeping your head still…). Antidepressants, anticonvulsants, anxiolytics and low-dose of antipsychotics have been used for CBS with positiveeffects in previous reports, but the efficacy of these drugs in the treatment is somewhat questionable and should bereserved for those who exhibit high levels of distress and have not responded to conventional intervention.
Case report: 80-years old woman who presented with a 4 month history of hallucinations and legally blind from AMD. Aworkup for other pathological causes of visual hallucinations was negative.
ConclusionsCBS is an under-recognized and under-reported disorder that involves visual hallucinations in visuallyimpaired individuals. It requires a multidisciplinary approach from neurologists, psychiatrists, general practitioners andophthalmologists. New studies are needed in order to understand its clinical presentation and to improve its management.
Disclosure of InterestNone Declared
GnRh agonists as precipitating components of psychiatric pathology. A case report.
- A. Guerrero Medina, J. S. García Eslava, A. C. Martín Rodriguez, L. Martinez Salvador, M. J. Alvarez Alonso, M. Aubareda Magriña
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- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S1042-S1043
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Introduction
GnRh agonists are drugs used in various gynecological pathologies, among which is endometriosis. They act by stimulating GnRh receptors in the pituitary gland. This sustained and continuous stimulation of GnRh, will initially generate an increase in the release of luteinizing hormones and follicle-stimulating hormones, subsequently losing sensitivity to the receptors, internalizing them, and thus suppressing the release of these hormones, which would entail an ovarian suppression, thereby inhibiting the release of estrogens and progesterone. Psychiatric adverse effects have been described. Gonzalez-Rodriguez et al (Front Psychiatry 2020; 11:479), described this association with changes in mood, and the presence of a series of cases where the link between GnRh agonist and the possibility of presenting psychotic symptoms is observed. Wieck (Curr Top Behav Neurosci 2011;8:173-87), Frokjaer (J Neurosci Res 2020;98(7):1283-1292), Brzezinski-Sinai et al (Front Psychiatry 2020;11:693) reported that this association could be related with the relationship of the hypothalamic-pituitary-gonadal axis, hormonal fluctuation and its relationship with the dopaminergic regulation, a genetic component that would increase the predisposition to trigger psychiatric pathology in patients with greater sensitivity to hormonal fluctuations, and the loss of neuroprotection generated by the decrease of estrogens in the central nervous system. All of this in the context of multiple environmental and genetic factors that participate together in the appearance of the disease.
ObjectivesTo describe the importance of detecting the risk factors that can precipitate a psychotic episode, including the use of certain drugs, such as GnRh agonists.
MethodsWe describe a case of a 45 year old patient with endometriosis with multiple organ involvement who went to the emergency room due to behavioral changes in the context of a brief psychotic disorder with “ad-integrum” recovery.
ResultsA retrospective analysis of the case is conducted, observing an association between the introduction of GnRh agonists and the presentation of a first psychotic episode.
ConclusionsThe importance of this case lies in the limited evidence of this association in the literature, and the implication of these drugs in the triggering of psychiatric pathology, being an aspect to be considered by psychiatrists in their patient’s follow-up.
Disclosure of InterestNone Declared
Neuropsychiatric phenotypes of anti-NMDAR encephalitis: a prospective study
- M. Espinola-Nadurille, M. Restrepo-Martínez, L. Bayliss, E. Flores-Montes, V. Rivas-Alonso, S. Vargas-Cañas, L. Hernández, I. Martínez-Juarez, A. Gonzalez-Aguilar, R. Solis-Vivanco, G. L. Fricchione, J. Flores-Rivera, J. Ramirez-Bermudez
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- Psychological Medicine / Volume 53 / Issue 9 / July 2023
- Published online by Cambridge University Press:
- 10 May 2022, pp. 4266-4274
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Background
Patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis (ANMDARE) show a wide range of behavioral abnormalities and are often mistaken for primary psychiatric presentations. We aimed to determine the behavioral hallmarks of ANMDARE with the use of systematic neuropsychiatric and cognitive assessments.
MethodsA prospective study was conducted, with 160 patients admitted to the National Institute of Neurology and Neurosurgery of Mexico, who fulfilled criteria for possible autoimmune encephalitis and/or red flags along a time window of seven years. Cerebrospinal fluid (CSF) antibodies against the NR1 subunit of the NMDAR were processed with rat brain immunohistochemistry and cell-based assays with NMDA expressing cells. Systematic cognitive, neuropsychiatric, and functional assessments were conducted before knowing NMDAR antibodies results. A multivariate analysis was used to compare patients with and without definite ANMDARE according to antibodies in CSF.
ResultsAfter obtaining the CSF antibodies results in 160 consecutive cases, 100 patients were positive and classified as having definite ANMDARE. The most frequent neuropsychiatric patterns were psychosis (81%), delirium (75%), catatonia (69%), anxiety-depression (65%), and mania (27%). Cognition was significantly impaired. A total of 34% of the patients had a predominantly neuropsychiatric presentation without seizures. After multivariate analysis, the clinical hallmarks of ANMDARE consisted of a catatonia–delirium comorbidity, tonic-clonic seizures, and orolingual dyskinesia.
ConclusionsOur study supports the notion of a neurobehavioral phenotype of ANMDARE characterized by a fluctuating course with psychotic and affective symptoms, catatonic signs, and global cognitive dysfunction, often accompanied by seizures and dyskinesia. The catatonia–delirium comorbidity could be a distinctive neurobehavioral phenotype of ANMDARE.
Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey
- J. Alonso, G. Vilagut, I. Alayo, M. Ferrer, F. Amigo, A. Aragón-Peña, E. Aragonès, M. Campos, I. del Cura-González, I. Urreta, M. Espuga, A. González Pinto, J. M. Haro, N. López Fresneña, A. Martínez de Salázar, J. D. Molina, R. M. Ortí Lucas, M. Parellada, J. M. Pelayo-Terán, A. Pérez Zapata, J. I. Pijoan, N. Plana, M. T. Puig, C. Rius, C. Rodriguez-Blazquez, F. Sanz, C. Serra, R. C. Kessler, R. Bruffaerts, E. Vieta, V. Pérez-Solá, P. Mortier, MINDCOVID Working group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 31 / 2022
- Published online by Cambridge University Press:
- 29 April 2022, e28
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Aims
Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors.
Methods8996 healthcare workers evaluated on 5 May–7 September 2020 (baseline) were invited to a second web-based survey (October–December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview.
Results4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar.
ConclusionsOur study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565
Childhood adversities and mental disorders in first-year college students: results from the World Mental Health International College Student Initiative
- Mathilde M. Husky, Ekaterina Sadikova, Sue Lee, Jordi Alonso, Randy P. Auerbach, Jason Bantjes, Ronny Bruffaerts, Pim Cuijpers, David D. Ebert, Raùl Gutiérrez Garcia, Penelope Hasking, Arthur Mak, Margaret McLafferty, Nancy A. Sampson, Dan J. Stein, Ronald C. Kessler, WHO WMH-ICS collaborators
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- Psychological Medicine / Volume 53 / Issue 7 / May 2023
- Published online by Cambridge University Press:
- 11 January 2022, pp. 2963-2973
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Background
This study investigates associations of several dimensions of childhood adversities (CAs) with lifetime mental disorders, 12-month disorder persistence, and impairment among incoming college students.
MethodsData come from the World Mental Health International College Student Initiative (WMH-ICS). Web-based surveys conducted in nine countries (n = 20 427) assessed lifetime and 12-month mental disorders, 12-month role impairment, and seven types of CAs occurring before the age of 18: parental psychopathology, emotional, physical, and sexual abuse, neglect, bullying victimization, and dating violence. Poisson regressions estimated associations using three dimensions of CA exposure: type, number, and frequency.
ResultsOverall, 75.8% of students reported exposure to at least one CA. In multivariate regression models, lifetime onset and 12-month mood, anxiety, and substance use disorders were all associated with either the type, number, or frequency of CAs. In contrast, none of these associations was significant when predicting disorder persistence. Of the three CA dimensions examined, only frequency was associated with severe role impairment among students with 12-month disorders. Population-attributable risk simulations suggest that 18.7–57.5% of 12-month disorders and 16.3% of severe role impairment among those with disorders were associated with these CAs.
ConclusionCAs are associated with an elevated risk of onset and impairment among 12-month cases of diverse mental disorders but are not involved in disorder persistence. Future research on the associations of CAs with psychopathology should include fine-grained assessments of CA exposure and attempt to trace out modifiable intervention targets linked to mechanisms of associations with lifetime psychopathology and burden of 12-month mental disorders.
Previous disorders and depression outcomes in individuals with 12-month major depressive disorder in the World Mental Health surveys
- Annelieke M. Roest, Ymkje Anna de Vries, Ali Al-Hamzawi, Jordi Alonso, Olatunde O. Ayinde, Ronny Bruffaerts, Brendan Bunting, José Miguel Caldas de Almeida, Giovanni de Girolamo, Louisa Degenhardt, Silvia Florescu, Oye Gureje, Josep Maria Haro, Chiyi Hu, Elie G. Karam, Andrzej Kiejna, Viviane Kovess-Masfety, Sing Lee, John J. McGrath, Maria Elena Medina-Mora, Fernando Navarro-Mateu, Daisuke Nishi, Marina Piazza, José Posada-Villa, Kate M. Scott, Juan Carlos Stagnaro, Dan J. Stein, Yolanda Torres, Maria Carmen Viana, Zahari Zarkov, Ronald C. Kessler, Peter de Jonge
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- Epidemiology and Psychiatric Sciences / Volume 30 / 2021
- Published online by Cambridge University Press:
- 11 November 2021, e70
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Aims
Major depressive disorder (MDD) is characterised by a recurrent course and high comorbidity rates. A lifespan perspective may therefore provide important information regarding health outcomes. The aim of the present study is to examine mental disorders that preceded 12-month MDD diagnosis and the impact of these disorders on depression outcomes.
MethodsData came from 29 cross-sectional community epidemiological surveys of adults in 27 countries (n = 80 190). The Composite International Diagnostic Interview (CIDI) was used to assess 12-month MDD and lifetime DSM-IV disorders with onset prior to the respondent's age at interview. Disorders were grouped into depressive distress disorders, non-depressive distress disorders, fear disorders and externalising disorders. Depression outcomes included 12-month suicidality, days out of role and impairment in role functioning.
ResultsAmong respondents with 12-month MDD, 94.9% (s.e. = 0.4) had at least one prior disorder (including previous MDD), and 64.6% (s.e. = 0.9) had at least one prior, non-MDD disorder. Previous non-depressive distress, fear and externalising disorders, but not depressive distress disorders, predicted higher impairment (OR = 1.4–1.6) and suicidality (OR = 1.5–2.5), after adjustment for sociodemographic variables. Further adjustment for MDD characteristics weakened, but did not eliminate, these associations. Associations were largely driven by current comorbidities, but both remitted and current externalising disorders predicted suicidality among respondents with 12-month MDD.
ConclusionsThese results illustrate the importance of careful psychiatric history taking regarding current anxiety disorders and lifetime externalising disorders in individuals with MDD.
Association between the Prime Diet Quality Score and depressive symptoms in a Mediterranean population with metabolic syndrome. Cross-sectional and 2-year follow-up assessment from PREDIMED-PLUS study
- Naomi Cano-Ibáñez, Lluis Serra-Majem, Sandra Martín-Peláez, Miguel Ángel Martínez-González, Jordi Salas-Salvadó, Maria Dolores Corella Piquer, Camille Lassale, José Alfredo Martínez Hernandez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque Lopez, Dora Romaguera, José López-Miranda, Ramon Estruch, Ana María Gómez-Pérez, José Manuel Santos-Lozano, Fernando Fernández-Aranda, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín, Xavier Pintó Sala, Miguel Delgado-Rodríguez, Pilar Matía Martín, Josep Vidal, Jersy J. Cárdenas, Lidia Daimiel Ruiz, Emilio Ros, Pilar Buil-Cosiales, Nerea Becerra-Tomás, Carmen Saiz, Miguel-Ángel Muñoz-Perez, Itziar Abete, Lucas Tojal-Sierra, Olga Fernández-Barceló, Andrea Bernabé-Casanova, Jadwiga Konieczna, Antonio García-Ríos, Rosa Casas, Maria Rosa Bernal-López, José Lapetra, Estefanía Toledo, Carlos Gómez-Martínez, Oscar Coltell, Mireia Malcampo-Manrúbia, María Angeles Zulet, Carolina Sorto-Sánchez, Alfredo Gea, José Luis Hernández-Fleta, Olga Castañer Niño, Almudena Sánchez-Villegas
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- Journal:
- British Journal of Nutrition / Volume 128 / Issue 6 / 28 September 2022
- Published online by Cambridge University Press:
- 29 October 2021, pp. 1170-1179
- Print publication:
- 28 September 2022
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The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = −0·67 z-score (–1·17, −0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.
Antidepressant use in low- middle- and high-income countries: a World Mental Health Surveys report
- Alan E. Kazdin, Chi-Shin Wu, Irving Hwang, Victor Puac-Polanco, Nancy A. Sampson, Ali Al-Hamzawi, Jordi Alonso, Laura Helena Andrade, Corina Benjet, José-Miguel Caldas-de-Almeida, Giovanni de Girolamo, Peter de Jonge, Silvia Florescu, Oye Gureje, Josep M. Haro, Meredith G. Harris, Elie G. Karam, Georges Karam, Viviane Kovess-Masfety, Sing Lee, John J. McGrath, Fernando Navarro-Mateu, Daisuke Nishi, Bibilola D. Oladeji, José Posada-Villa, Dan J. Stein, T. Bedirhan Üstün, Daniel V. Vigo, Zahari Zarkov, Alan M. Zaslavsky, Ronald C. Kessler, the WHO World Mental Health Survey collaborators
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- Journal:
- Psychological Medicine / Volume 53 / Issue 4 / March 2023
- Published online by Cambridge University Press:
- 23 September 2021, pp. 1583-1591
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Background
The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries.
MethodsFace-to-face interviews with community samples totaling n = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents.
Results3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2–4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as very effective by 58.8% of users and somewhat effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness.
ConclusionADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.
How is COVID-19 affecting patients with obsessive–compulsive disorder? A longitudinal study on the initial phase of the pandemic in a Spanish cohort
- P. Alonso, S. Bertolín, J. Segalàs, M. Tubío-Fungueiriño, E. Real, L. Mar-Barrutia, M. Fernández-Prieto, S. Carvalho, A. Carracedo, JM. Menchón
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- Journal:
- European Psychiatry / Volume 64 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 08 June 2021, e45
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Background
Although the consequences of the COVID-19 pandemic on emotional health are evident, little is known about its impact on patients with obsessive-compulsive disorder (OCD).
MethodsOne hundred and twenty-seven patients with OCD who attended a specialist OCD Clinic in Barcelona, Spain, were assessed by phone from April 27 to May 25, 2020, during the early phase of the pandemic, using the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) and a structured interview that collected clinical and sociodemographic information. Results were compared with those for 237 healthy controls from the same geographic area who completed an online survey.
ResultsAlthough 65.3% of the patients with OCD described a worsening of their symptoms, only 31.4% had Y-BOCS scores that increased >25%. The risk of getting infected by SARS-CoV2 was reported as a new obsession by 44.8%, but this only became the main obsessive concern in approximately 10% of the patients. Suicide-related thoughts were more frequent among the OCD cohort than among healthy controls. The presence of prepandemic depression, higher Y-BOCS scores, contamination/washing symptoms, and lower perceived social support all predicted a significantly increased risk of OCD worsening.
ConclusionsMost patients with OCD appear to be capable of coping with the emotional stress of the COVID-19 outbreak and its consequences during the initial phase of the pandemic. Nevertheless, the current crisis constitutes a risk factor for a significant worsening of symptoms and suicidal ideation. Action is needed to ensure effective and individualized follow-up care for patients with OCD in the COVID-19 era.
Obesity is a strong risk factor for short-term mortality and adverse outcomes in Mexican patients with COVID-19: a national observational study
- J. M. Vera-Zertuche, J. Mancilla-Galindo, M. Tlalpa-Prisco, P. Aguilar-Alonso, M. M. Aguirre-García, O. Segura-Badilla, M. Lazcano-Hernández, H. I. Rocha-González, A. R. Navarro-Cruz, A. Kammar-García, J. de J. Vidal-Mayo
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- Journal:
- Epidemiology & Infection / Volume 149 / 2021
- Published online by Cambridge University Press:
- 29 April 2021, e109
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Conflicting results have been obtained through meta-analyses for the role of obesity as a risk factor for adverse outcomes in patients with coronavirus disease-2019 (COVID-19), possibly due to the inclusion of predominantly multimorbid patients with severe COVID-19. Here, we aimed to study obesity alone or in combination with other comorbidities as a risk factor for short-term all-cause mortality and other adverse outcomes in Mexican patients evaluated for suspected COVID-19 in ambulatory units and hospitals in Mexico. We performed a retrospective observational analysis in a national cohort of 71 103 patients from all 32 states of Mexico from the National COVID-19 Epidemiological Surveillance Study. Two statistical models were applied through Cox regression to create survival models and logistic regression models to determine risk of death, hospitalisation, invasive mechanical ventilation, pneumonia and admission to an intensive care unit, conferred by obesity and other comorbidities (diabetes mellitus (DM), chronic obstructive pulmonary disease, asthma, immunosuppression, hypertension, cardiovascular disease and chronic kidney disease). Models were adjusted for other risk factors. From 24 February to 26 April 2020, 71 103 patients were evaluated for suspected COVID-19; 15 529 (21.8%) had a positive test for SARS-CoV-2; 46 960 (66.1%), negative and 8614 (12.1%), pending results. Obesity alone increased adjusted mortality risk in positive patients (hazard ratio (HR) = 2.7, 95% confidence interval (CI) 2.04–2.98), but not in negative and pending-result patients. Obesity combined with other comorbidities further increased risk of death (DM: HR = 2.79, 95% CI 2.04–3.80; immunosuppression: HR = 5.06, 95% CI 2.26–11.41; hypertension: HR = 2.30, 95% CI 1.77–3.01) and other adverse outcomes. In conclusion, obesity is a strong risk factor for short-term mortality and critical illness in Mexican patients with COVID-19; risk increases when obesity is present with other comorbidities.
Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic
- P. Mortier, G. Vilagut, M. Ferrer, I. Alayo, R. Bruffaerts, P. Cristóbal-Narváez, I. del Cura-González, J. Domènech-Abella, M. Felez-Nobrega, B. Olaya, J. I. Pijoan, E. Vieta, V. Pérez-Solà, R. C. Kessler, J. M. Haro, J. Alonso, MINDCOVID Working group
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 30 / 2021
- Published online by Cambridge University Press:
- 17 February 2021, e19
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Aims
To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March−July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains.
MethodsCross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1–30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights.
ResultsEstimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7–42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events−experiences related to the pandemic.
ConclusionsSTB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events−experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload.
Study registration numberNCT04556565
Development and validation of the patient history COVID-19 (PH-Covid19) scoring system: a multivariable prediction model of death in Mexican patients with COVID-19
- J. Mancilla-Galindo, J. M. Vera-Zertuche, A. R. Navarro-Cruz, O. Segura-Badilla, G. Reyes-Velázquez, F. J. Tepepa-López, P. Aguilar-Alonso, J. de J. Vidal-Mayo, A. Kammar-García
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- Journal:
- Epidemiology & Infection / Volume 148 / 2020
- Published online by Cambridge University Press:
- 26 November 2020, e286
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Most of the existing prediction models for COVID-19 lack validation, are inadequately reported or are at high risk of bias, a reason which has led to discourage their use. Few existing models have the potential to be extensively used by healthcare providers in low-resource settings since many require laboratory and imaging predictors. Therefore, we sought to develop and validate a multivariable prediction model of death in Mexican patients with COVID-19, by using demographic and patient history predictors. We conducted a national retrospective cohort study in two different sets of patients from the Mexican COVID-19 Epidemiologic Surveillance Study. Patients with a positive reverse transcription-polymerase chain reaction for SARS-CoV-2 and complete unduplicated data were eligible. In total, 83 779 patients were included to develop the scoring system through a multivariable Cox regression model; 100 000, to validate the model. Eight predictors (age, sex, diabetes, chronic obstructive pulmonary disease, immunosuppression, hypertension, obesity and chronic kidney disease) were included in the scoring system called PH-Covid19 (range of values: −2 to 25 points). The predictive model has a discrimination of death of 0.8 (95% confidence interval (CI) 0.796–0.804). The PH-Covid19 scoring system was developed and validated in Mexican patients to aid clinicians to stratify patients with COVID-19 at risk of fatal outcomes, allowing for better and efficient use of resources.
First experiments on ICRF discharge generation by a W7-X-like antenna in the Uragan-2M stellarator
- Part of
- V. E. Moiseenko, Yu. V. Kovtun, T. Wauters, A. Goriaev, A. I. Lyssoivan, A. V. Lozin, R. O. Pavlichenko, A. N. Shapoval, S. M. Maznichenko, V. B. Korovin, E. D. Kramskoy, M. M. Kozulya, N. V. Zamanov, Y. V. Siusko, A. Yu. Krasiuk, V. S. Romanov, A. Alonso, R. Brakel, A. Dinklage, D. Hartmann, Ye. Kazakov, H. Laqua, J. Ongena, T. Stange, the Uragan-2M Team
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- Journal:
- Journal of Plasma Physics / Volume 86 / Issue 5 / October 2020
- Published online by Cambridge University Press:
- 28 October 2020, 905860517
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In support of the ICRF experiments planned on the Wendelstein 7-X (W7-X) stellarator, i.e. fast ion generation, wall conditioning, target plasma production and heating, a first experimental study on plasma production has been made in the Uragan-2M (U-2M) stellarator using W7-X-like two-strap antenna. In all the experiments, antenna monopole phasing was used. The W7-X-like antenna operation with launched radiofrequency power of ~100 kW have been performed in helium (p = (4–14) × 10−2 Pa) with the vacuum vessel walls pre-loaded with hydrogen. Production of plasma with a density higher than 1012 cm−3 was observed near the first harmonic of the hydrogen cyclotron frequency. Operation at first hydrogen harmonic is feasible in W7-X future ICRF experiments.
Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries
- J. J. McGrath, C. C. W. Lim, O. Plana-Ripoll, Y. Holtz, E. Agerbo, N. C. Momen, P. B. Mortensen, C. B. Pedersen, J. Abdulmalik, S. Aguilar-Gaxiola, A. Al-Hamzawi, J. Alonso, E. J. Bromet, R. Bruffaerts, B. Bunting, J. M. C. de Almeida, G. de Girolamo, Y. A. De Vries, S. Florescu, O. Gureje, J. M. Haro, M. G. Harris, C. Hu, E. G. Karam, N. Kawakami, A. Kiejna, V. Kovess-Masfety, S. Lee, Z. Mneimneh, F. Navarro-Mateu, R. Orozco, J. Posada-Villa, A. M. Roest, S. Saha, K. M. Scott, J. C. Stagnaro, D. J. Stein, Y. Torres, M. C. Viana, Y. Ziv, R. C. Kessler, P. de Jonge
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- Journal:
- Epidemiology and Psychiatric Sciences / Volume 29 / 2020
- Published online by Cambridge University Press:
- 12 August 2020, e153
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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.
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.