Journal article
Exploring Comorbidity Within Mental Disorders Among a Danish National Population
JAMA psychiatry (Chicago, Ill.), v 76(3)
01 Mar 2019
PMID: 30649197
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Individuals with mental disorders often develop comorbidity over time. Past studies of comorbidity have often restricted analyses to a subset of disorders and few studies have provided absolute risks of later comorbidity.
To undertake a comprehensive study of comorbidity within mental disorders, by providing temporally ordered age- and sex-specific pairwise estimates between the major groups of mental disorders, and to develop an interactive website to visualize all results and guide future research and clinical practice.
This population-based cohort study included all individuals born in Denmark between January 1, 1900, and December 31, 2015, and living in the country between January 1, 2000, and December 31, 2016. The analyses were conducted between June 2017 and May 2018.
Danish health registers were used to identify mental disorders, which were examined within the broad 10-level International Statistical Classification of Diseases and Related Health Problems, 10th Revision, subchapter groups (eg, codes F00-F09 and F10-F19). For each temporally ordered pair of disorders, overall and lagged hazard ratios and 95% CIs were calculated using Cox proportional hazards regression models. Absolute risks were estimated using competing risks survival analyses. Estimates for each sex were generated.
A total of 5 940 778 persons were included in this study (2 958 293 men and 2 982 485 women; mean [SD] age at beginning of follow-up, 32.1 [25.4] years). They were followed up for 83.9 million person-years. All mental disorders were associated with an increased risk of all other mental disorders when adjusting for sex, age, and calendar time (hazard ratios ranging from 2.0 [95% CI, 1.7-2.4] for prior intellectual disabilities and later eating disorders to 48.6 [95% CI, 46.6-50.7] for prior developmental disorders and later intellectual disabilities). The hazard ratios were temporally patterned, with higher estimates during the first year after the onset of the first disorder, but with persistently elevated rates during the entire observation period. Some disorders were associated with substantial absolute risks of developing specific later disorders (eg, 30.6% [95% CI, 29.3%-32.0%] of men and 38.4% [95% CI, 37.5%-39.4%] of women with a diagnosis of mood disorders before age 20 years developed neurotic disorders within the following 5 years).
Comorbidity within mental disorders is pervasive, and the risk persists over time. This study provides disorder-, sex-, and age-specific relative and absolute risks of the comorbidity of mental disorders. Web-based interactive data visualization tools are provided for clinical utility.
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Details
- Title
- Exploring Comorbidity Within Mental Disorders Among a Danish National Population
- Creators
- Oleguer Plana-Ripoll - Aarhus UniversityCarsten Bøcker Pedersen - Aarhus UniversityYan Holtz - University of QueenslandMichael E Benros - University of Copenhagen Faculty of Health SciencesSøren Dalsgaard - Aarhus UniversityPeter de Jonge - University of GroningenChun Chieh Fan - University of California, San DiegoLouisa Degenhardt - National Drug and Alcohol Research CentreAndrea Ganna - Massachusetts General HospitalAja Neergaard Greve - Aarhus University HospitalJane Gunn - University of MelbourneKim Moesgaard Iburg - Department of Public Health, Aarhus University, Aarhus, DENMARKLars Vedel Kessing - Copenhagen University HospitalBrian K Lee - Drexel UniversityCarmen C W Lim - University of QueenslandOle Mors - Aarhus University HospitalMerete Nordentoft - University of Copenhagen Faculty of Health SciencesAnders Prior - Aarhus UniversityAnnelieke M Roest - University of GroningenSukanta Saha - University of QueenslandAndrew Schork - Mental Health ServicesJames G Scott - University of QueenslandKate M Scott - University of OtagoTerry Stedman - West Moreton Division of Mental Health and Specialised Services, Archerfield, Queensland, Australia.Holger J Sørensen - Copenhagen University HospitalThomas Werge - University of CopenhagenHarvey A Whiteford - Park Centre for Mental HealthThomas Munk Laursen - Aarhus UniversityEsben Agerbo - Aarhus UniversityRonald C Kessler - Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts,Preben Bo Mortensen - Aarhus UniversityJohn J McGrath - Aarhus University
- Publication Details
- JAMA psychiatry (Chicago, Ill.), v 76(3)
- Publisher
- American Medical Association
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000460506700009
- Scopus ID
- 2-s2.0-85060214766
- Other Identifier
- 991019169619904721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Psychiatry