Mental disorder comorbidity and suicidal thoughts and behaviors in the World Health Organization World Mental Health Surveys International College Student initiative
Objectives Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond thi...
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| Published in | International journal of methods in psychiatric research Vol. 28; no. 2; pp. e1752 - n/a |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
John Wiley & Sons, Inc
01.06.2019
John Wiley and Sons Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Objectives
Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college‐related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)‐IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative.
Method
A web‐based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM‐IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention‐deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12‐month disorder.
Results
Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12‐month cases had profiles of internalizing–externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3–2.6% of students with disorders in C2–4, 0.2% of students with lifetime disorders but no 12‐month disorders (C5), and 0.1% of students with no lifetime disorders (C6).
Conclusions
In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students. |
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| AbstractList | Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college-related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative.OBJECTIVESComorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college-related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative.A web-based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12-month disorder.METHODA web-based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12-month disorder.Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12-month cases had profiles of internalizing-externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3-2.6% of students with disorders in C2-4, 0.2% of students with lifetime disorders but no 12-month disorders (C5), and 0.1% of students with no lifetime disorders (C6).RESULTSMultivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12-month cases had profiles of internalizing-externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3-2.6% of students with disorders in C2-4, 0.2% of students with lifetime disorders but no 12-month disorders (C5), and 0.1% of students with no lifetime disorders (C6).In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students.CONCLUSIONSIn line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students. Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college-related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative. A web-based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12-month disorder. Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12-month cases had profiles of internalizing-externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3-2.6% of students with disorders in C2-4, 0.2% of students with lifetime disorders but no 12-month disorders (C5), and 0.1% of students with no lifetime disorders (C6). In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students. ObjectivesComorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college‐related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)‐IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative.MethodA web‐based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM‐IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention‐deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12‐month disorder.ResultsMultivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12‐month cases had profiles of internalizing–externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3–2.6% of students with disorders in C2–4, 0.2% of students with lifetime disorders but no 12‐month disorders (C5), and 0.1% of students with no lifetime disorders (C6).ConclusionsIn line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students. Objectives Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college‐related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)‐IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative. Method A web‐based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM‐IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention‐deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12‐month disorder. Results Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12‐month cases had profiles of internalizing–externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3–2.6% of students with disorders in C2–4, 0.2% of students with lifetime disorders but no 12‐month disorders (C5), and 0.1% of students with no lifetime disorders (C6). Conclusions In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students. |
| Author | Nock, Matthew K. Petukhova, Maria V. McLafferty, Margaret Kessler, Ronald C. Lochner, Christine Mortier, Philippe Bruffaerts, Ronny Lee, Sue Sampson, Nancy A. Vilagut, Gemma Pinder‐Amaker, Stephanie Auerbach, Randy P. Cuijpers, Pim Ebert, David D. Zaslavsky, Alan M. Green, Jennifer Greif Demyttenaere, Koen Hasking, Penelope Alonso, Jordi Benjet, Corina Rosellini, Anthony J. |
| AuthorAffiliation | 5 Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam The Netherlands 6 Department for Psychology, Clinical Psychology and Psychotherapy Friedrich‐Alexander University Erlangen Nuremberg Erlangen Germany 13 Department of Psychiatry Harvard Medical School, McLean Hospital Belmont Massachusetts 2 Universitair Psychiatrisch Centrum, Campus Gasthuisberg Katholieke Universiteit Leuven (UPC‐KUL) Leuven Belgium 4 Department of Epidemiologic and Psychosocial Research National Institute of Psychiatry Ramón de la Fuente Muñiz Mexico City Mexico 10 MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry Stellenbosch University Cape Town South Africa 11 Psychology Research Institute Ulster University Coleraine UK 3 Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP) Pompeu Fabra University (UPF) Barcelona Spain 8 School of Ps |
| AuthorAffiliation_xml | – name: 13 Department of Psychiatry Harvard Medical School, McLean Hospital Belmont Massachusetts – name: 14 Psychological and Brain Sciences Boston University Boston Massachusetts – name: 7 Wheelock College of Education and Human Development Boston University Boston Massachusetts – name: 2 Universitair Psychiatrisch Centrum, Campus Gasthuisberg Katholieke Universiteit Leuven (UPC‐KUL) Leuven Belgium – name: 11 Psychology Research Institute Ulster University Coleraine UK – name: 6 Department for Psychology, Clinical Psychology and Psychotherapy Friedrich‐Alexander University Erlangen Nuremberg Erlangen Germany – name: 10 MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry Stellenbosch University Cape Town South Africa – name: 12 Department of Psychology Harvard University Cambridge Massachusetts – name: 1 Department of Psychiatry Columbia University New York New York – name: 4 Department of Epidemiologic and Psychosocial Research National Institute of Psychiatry Ramón de la Fuente Muñiz Mexico City Mexico – name: 5 Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam The Netherlands – name: 8 School of Psychology Curtin University Perth Western Australia Australia – name: 3 Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), CIBER en Epidemiología y Salud Pública (CIBERESP) Pompeu Fabra University (UPF) Barcelona Spain – name: 9 Department of Health Care Policy Harvard Medical School Boston Massachusetts |
| Author_xml | – sequence: 1 givenname: Randy P. orcidid: 0000-0003-2319-4744 surname: Auerbach fullname: Auerbach, Randy P. email: rpa2009@columbia.edu organization: Columbia University – sequence: 2 givenname: Philippe surname: Mortier fullname: Mortier, Philippe organization: Katholieke Universiteit Leuven (UPC‐KUL) – sequence: 3 givenname: Ronny surname: Bruffaerts fullname: Bruffaerts, Ronny organization: Katholieke Universiteit Leuven (UPC‐KUL) – sequence: 4 givenname: Jordi orcidid: 0000-0001-8627-9636 surname: Alonso fullname: Alonso, Jordi organization: Pompeu Fabra University (UPF) – sequence: 5 givenname: Corina surname: Benjet fullname: Benjet, Corina organization: National Institute of Psychiatry Ramón de la Fuente Muñiz – sequence: 6 givenname: Pim orcidid: 0000-0001-5497-2743 surname: Cuijpers fullname: Cuijpers, Pim organization: Vrije Universiteit Amsterdam – sequence: 7 givenname: Koen surname: Demyttenaere fullname: Demyttenaere, Koen organization: Katholieke Universiteit Leuven (UPC‐KUL) – sequence: 8 givenname: David D. surname: Ebert fullname: Ebert, David D. organization: Friedrich‐Alexander University Erlangen Nuremberg – sequence: 9 givenname: Jennifer Greif orcidid: 0000-0002-3541-4989 surname: Green fullname: Green, Jennifer Greif organization: Boston University – sequence: 10 givenname: Penelope surname: Hasking fullname: Hasking, Penelope organization: Curtin University – sequence: 11 givenname: Sue surname: Lee fullname: Lee, Sue organization: Harvard Medical School – sequence: 12 givenname: Christine surname: Lochner fullname: Lochner, Christine organization: Stellenbosch University – sequence: 13 givenname: Margaret surname: McLafferty fullname: McLafferty, Margaret organization: Ulster University – sequence: 14 givenname: Matthew K. surname: Nock fullname: Nock, Matthew K. organization: Harvard University – sequence: 15 givenname: Maria V. surname: Petukhova fullname: Petukhova, Maria V. organization: Harvard Medical School – sequence: 16 givenname: Stephanie surname: Pinder‐Amaker fullname: Pinder‐Amaker, Stephanie organization: Harvard Medical School, McLean Hospital – sequence: 17 givenname: Anthony J. surname: Rosellini fullname: Rosellini, Anthony J. organization: Boston University – sequence: 18 givenname: Nancy A. surname: Sampson fullname: Sampson, Nancy A. organization: Harvard Medical School – sequence: 19 givenname: Gemma surname: Vilagut fullname: Vilagut, Gemma organization: Pompeu Fabra University (UPF) – sequence: 20 givenname: Alan M. surname: Zaslavsky fullname: Zaslavsky, Alan M. organization: Harvard Medical School – sequence: 21 givenname: Ronald C. orcidid: 0000-0003-4831-2305 surname: Kessler fullname: Kessler, Ronald C. organization: Harvard Medical School |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30450753$$D View this record in MEDLINE/PubMed |
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| Copyright | 2018 John Wiley & Sons, Ltd. 2019 John Wiley & Sons, Ltd. |
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| Keywords | college student mental health comorbidity suicide thoughts and behaviors mental disorders |
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| References | 2008; 192 2006; 74 2010; 15 2010; 14 2013; 22 2018; 127 2000; 4 2006; 32 2010; 17 2005; 62 2013; 201 2005; 2005 2018; 48 2017; 207 2018; 9 2011; 168 2001 2015; 41 2017; 78 1999; 56 2013; 60 2008; 65 2008; 22 2016; 80 2016; 46 2005; 35 2018; 35 2015; 6 2013; 47 2012 2013; 43 2010 2015; 50 1993; 88 2018; 225 1998 2008 1994 2004 2003 2018; 20 2012; 33 2007; 16 2002; 26 2010; 46 2013; 34 2005; 8 2004; 13 2018 2017 2015 2007; 45 1994; 51 2018; 57 e_1_2_9_31_1 e_1_2_9_52_1 e_1_2_9_50_1 Hughes T. (e_1_2_9_22_1) 2015 e_1_2_9_10_1 e_1_2_9_35_1 e_1_2_9_12_1 e_1_2_9_33_1 e_1_2_9_54_1 Thomas N. (e_1_2_9_56_1) 2006; 32 Babor T. F. (e_1_2_9_5_1) 2001 e_1_2_9_14_1 e_1_2_9_39_1 e_1_2_9_16_1 e_1_2_9_58_1 e_1_2_9_18_1 Harkness J. (e_1_2_9_19_1) 2008 e_1_2_9_41_1 e_1_2_9_20_1 e_1_2_9_45_1 e_1_2_9_24_1 e_1_2_9_8_1 e_1_2_9_4_1 e_1_2_9_2_1 e_1_2_9_26_1 e_1_2_9_28_1 First M. (e_1_2_9_17_1) 1994 e_1_2_9_30_1 e_1_2_9_53_1 e_1_2_9_51_1 e_1_2_9_11_1 e_1_2_9_34_1 e_1_2_9_57_1 e_1_2_9_13_1 e_1_2_9_32_1 e_1_2_9_55_1 Rankin S. (e_1_2_9_47_1) 2003 SAS Institute Inc (e_1_2_9_49_1) 2010 e_1_2_9_15_1 e_1_2_9_38_1 e_1_2_9_36_1 e_1_2_9_42_1 e_1_2_9_40_1 e_1_2_9_21_1 e_1_2_9_46_1 e_1_2_9_23_1 e_1_2_9_44_1 e_1_2_9_7_1 Barlow D. H. (e_1_2_9_6_1) 2017 e_1_2_9_3_1 Muthén L. K. (e_1_2_9_43_1) 2012 e_1_2_9_9_1 e_1_2_9_25_1 Merkouris T. (e_1_2_9_37_1) 2015; 41 e_1_2_9_27_1 e_1_2_9_48_1 e_1_2_9_29_1 |
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Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on... Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even... ObjectivesComorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on... |
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| SubjectTerms | Adolescent Affective disorders Anxiety Attention deficit hyperactivity disorder college student mental health College students Comorbidity Diagnostic and Statistical Manual of Mental Disorders Female Humans Hyperactivity Latent Class Analysis Male Mental depression Mental disorders Mental Disorders - epidemiology Mental Disorders - psychology Mental health Sociodemographics Special Issue Special Issues Students - psychology Students - statistics & numerical data Suicidal Ideation Suicide suicide thoughts and behaviors Suicide, Attempted - psychology Suicide, Attempted - statistics & numerical data Suicides & suicide attempts Surveys and Questionnaires Young Adult |
| Title | Mental disorder comorbidity and suicidal thoughts and behaviors in the World Health Organization World Mental Health Surveys International College Student initiative |
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