scholarly journals O7.1. ASSOCIATION BETWEEN PATTERNS OF COMORBID MENTAL DISORDERS AND MORTALITY-RELATED ESTIMATES. A NATIONWIDE, REGISTER-BASED COHORT STUDY BASED ON 7.5 MILLION INDIVIDUALS LIVING IN DENMARK

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Oleguer Plana-Ripoll ◽  
Natalie Momen ◽  
Nanna Weye ◽  
John McGrath
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Neurotic Disorders ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common – individuals with one type of mental disorder are at increased risk of subsequently developing other types of disorders. Previous studies are usually restricted to temporally-ordered pairs of disorders. While more complex patterns of comorbidity have been described (e.g. internalizing and externalizing disorders), there is a lack of detailed information on the nature of the different sets of comorbid mental disorders. Additionally, mental disorders are associated with premature mortality, and people with two or more types of mental disorders have a shorter life expectancy compared to those with exactly one type of mental disorder. The aims of this study were to: (a) describe the prevalence and demographic correlates of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995–2016. Information on mental disorders and mortality was obtained from national registers. First, we described the most common combinations of mental disorders defined by the ICD-10 F-subchapters (substance use disorders, schizophrenia spectrum disorder, mood disorders, neurotic disorders, etc.). Then, we investigated excess mortality using mortality rate ratios (MRRs) and differences in life expectancy after disease diagnosis compared to the general population of same sex and age. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one type of disorder, 2.7% with exactly two, 1.1% with exactly three, and 0.5% with four or more types. The most prevalent mental disorders were neurotic disorders (4.6%) and mood disorders (3.8%), even when looking particularly at persons with a specific number of disorders (exactly one type, exactly two types, etc.). We observed 616 out of 1,024 possible sets of disorders, but the 52 most common sets (with at least 1,000 individuals each) represented 92.8% of all persons with diagnosed mental disorders. Mood and/or neurotic disorders, alone or in combination with other disorders, were present in 64.8% of individuals diagnosed with mental disorders. People with all combinations of mental disorders had higher mortality rates than those without any mental disorder diagnosis, with MRRs ranging from 1.10 (95% CI 0.67 – 1.84) for the two-disorder set of developmental-behavioral disorders to 5.97 (95% CI 5.52 – 6.45) for the three-disorder set of schizophrenia-neurotic-substance use disorders. Additionally, any combination of mental disorders was associated with shorter life expectancies compared to the general population, with estimates ranging from 5.06 years [95% CI 5.01 – 5.11] for the one-disorder set of organic disorders to 17.46 years [95% CI 16.86 – 18.03] for the three-disorder set of schizophrenia-personality-substance use disorders. Discussion Within those with mental disorders, approximately 2 out of 5 had two more types of mental disorders. Our study provides prevalence estimates of the most common sets of mental disorders – mood disorders (e.g. depression) and neurotic disorders (e.g. anxiety) commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality-related estimates revealed the prominent role of substance use disorders with respect to both elevated mortality rates and reduced life expectancies. Substance use disorders are relatively common, and these disorders often feature in sets of mental disorders. In light of the substantial contribution to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

scholarly journals 307Association between patterns of comorbid mental disorders and mortality-related estimates. A Danish register-based cohort study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Oleguer Plana-Ripoll ◽  
John J McGrath
Keyword(s):  
Substance Use ◽  
Cohort Study ◽  
Mental Disorders ◽  
Life Expectancy ◽  
Substance Use Disorders ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Population Based ◽  
Substantial Contribution ◽  
Comorbid Mental Disorders

Abstract Background Comorbidity within mental disorders is common, and people with two or more types of mental disorders have shorter life expectancy compared to those with exactly one type. The aims of this study were to: (a) describe the prevalence of combinations of mental disorders; and (b) estimate the excess mortality for each of these combinations. Methods We conducted a population-based cohort study including all 7,505,576 persons living in Denmark in 1995-2016. Using national registers, we described the most common combinations of mental disorders and investigated excess mortality by means of mortality rate ratios (MRRs) and differences in life expectancy. Results At the end of the 22-year observation, 6.2% individuals were diagnosed with exactly one disorder, and 5.3% with two or more types. People with any combination of disorders had higher mortality rates than those without any diagnosis (MRRs ranging from 1.10 [95% CI 0.67 – 1.84] to 5.97 [95% CI 5.52 – 6.45]) and shorter life expectancies compared to the general population (estimates ranging from 5.06 years [95% CI 5.01 – 5.11] to 17.46 years [95% CI 16.86 – 18.03]). Conclusions Mood disorders and neurotic disorders commonly co-occur, and contribute to many different sets of comorbid mental disorders. The association between mental disorders comorbidity and mortality revealed the prominent role of substance use disorders. Key messages Our study provides prevalence estimates of the most common sets of mental disorders. In light of the substantial contribution of substance use disorders to premature mortality, efforts related to the ‘primary prevention of secondary comorbidity’ warrant added scrutiny.

The prevalence, age-of-onset and the correlates of DSM-IV psychiatric disorders in the Tianjin Mental Health Survey (TJMHS)

2017 ◽  
Vol 48 (3) ◽  
pp. 473-487 ◽  
Author(s):  
H. Yin ◽  
G. Xu ◽  
H. Tian ◽  
G. Yang ◽  
K. J. Wardenaar ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mood Disorders ◽  
Age Of Onset ◽  
Male Gender ◽  
Immigrant Status ◽  
Sociodemographic Correlates ◽  
Mental Health Survey

BackgroundTo effectively shape mental healthcare policy in modern-day China, up-to-date epidemiological data on mental disorders is needed. The objective was to estimate the prevalence, age-of-onset (AOO) and sociodemographic correlates of mental disorders in a representative household sample of the general population (age ⩾ 18) in the Tianjin Municipality in China.MethodsData came from the Tianjin Mental health Survey (TJMHS), which was conducted between July 2011 and March 2012 using a two-phase design. 11 748 individuals were screened with an expanded version of the General Health Questionnaire and 4438 subjects were selected for a diagnostic interview by a psychiatrist, using the Structured Clinical Interview for the Diagnostic and Statistical Manual – fourth edition (SCID).ResultsThe lifetime and 1-month prevalence of any mental disorder were 23.6% and 12.8%, respectively. Mood disorders (lifetime: 9.3%; 1-month: 3.9%), anxiety disorders (lifetime: 4.5% 1-month: 3.1%) and substance-use disorders (lifetime: 8.8%; 1-month: 3.5%) were most prevalent. The median AOO ranged from 25 years [interquartile range (IQR): 23–32] for substance-use disorders to 36 years (IQR: 24–50) for mood disorders. Not being married, non-immigrant status (i.e. local ‘Hukou’), being a farmer, having <6 years of education and male gender were associated with a higher lifetime prevalence of any mental disorder.ConclusionResults from the current survey indicate that mental disorders are steadily reported more commonly in rapidly-developing urban China. Several interesting sociodemographic correlates were observed (e.g. male gender and non-immigrant status) that warrant further investigation and could be used to profile persons in need of preventive intervention.

Neuropsychological Profile of Various Neurological and Psychiatric Conditions

2020 ◽  
pp. 149-197
Author(s):  
Ramprasad Santhanakrishnan K.
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Mood Disorders ◽  
Substance Use Disorders ◽  
Psychotic Disorders ◽  
Sexual Disorders ◽  
Childhood Disorders ◽  
Neuropsychological Profile ◽  
Psychiatric Conditions

In the current chapter, the neuropsychological profile of various neurological and psychiatric conditions is focused on, including two major divisions (i.e., dementia—cortical and sub-cortical—and major mental disorders—substance use disorders, mood disorders, anxiety disorders, psychotic disorders, sleep disorders, childhood disorders, personality disorders, and sexual disorders). Both divisions have sub-classifications that include introduction, etiopathogenesis, epidemiology, clinical features, evaluation, treatment, and psychosocial aspects.

What is Comorbidity – Fact or Artefact?

1996 ◽  
Vol 168 (S30) ◽  
pp. 7-8 ◽  
Author(s):  
Hans-Ulrich Wittchen
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Mood Disorders ◽  
Diagnostic Criteria ◽  
Substance Use Disorders ◽  
Statistical Manual ◽  
Axis Ii ◽  
Diagnostic And Statistical Manual ◽  
Icd 10

Comorbidity can be described broadly as the presence of more than one disorder in a person in a defined period of time (Wittchen & Essau, 1993). Stimulated by the introduction of explicit diagnostic criteria and operationalised diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (DSM–III; APA, 1980) and the Diagnostic Criteria for Research in ICD–10 (WHO, 1991), numerous studies in the 1980s and early 1990s, have assessed the extent, the nature, and more recently, the implications of comorbidity for a better understanding of mental disorders. Most studies investigated the association of anxiety and mood disorders, but increasingly there are also studies looking into the association of mood disorders with other disorders (such as somatoform and substance use disorders (Wittchen et al, 1993, 1996)) as well as with somatic conditions (axis II) and personality disorders (axis III).

scholarly journals Discussion questions about the therapy of nonchemical addictions

2021 ◽  
Vol LIII (1) ◽  
pp. 52-56
Author(s):  
Alexey Y. Egorov
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Pharmacological Therapy ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Addictive Disorders ◽  
Dsm V ◽  
Comorbid Mental Disorders ◽  
High Comorbidity

Today there are no international standards for the treatment of non-chemical (behavioral) addiction (NA). This is largely due to the vagueness of their existence as nosological units and, as a consequence, their place in international classifications. This article discusses the forms of NA that are or will be included in DSM-V and ICD-11. It has been shown that NA research has sparked discussions about the spectrum of addictive disorders, expands the multidisciplinary understanding of the etiology and pathogenesis of addictive disorders, and promotes the study of new forms and expansion of therapeutic approaches. The criticism of the addictive spectrum concept is analyzed. The modern approaches of non-drug and pharmacological therapy of different forms of NA are presented. The following conclusions are drawn. The existence of NA is confirmed by the inclusion of a part of them in the International Classifications of Diseases. NA have high comorbidity with other mental disorders, in respect of which pharmacotherapy and psychotherapy are not in doubt. Taking into account the general neurobiological mechanisms of the formation of addictive disorders, the possible pharmacotherapy of non-chemical addictions, officially recognized in the ICD and DSM, should proceed from the currently available approaches to the therapy of substance use disorders. Treatment of non-chemical addictions that are not included in the International Classifications can only be carried out within the framework of therapy for confirmed comorbid mental disorders. In its absence, psychological correction seems to be possible. There is an obvious need to continue researching the problem of non-chemical addictions to expand new approaches to their therapy and psychological correction.

Even More Complex…. When Mental Disorder Meets Addiction in Youth: Dual Pathology

2019 ◽  
Vol 11 (1) ◽  
pp. 40-43
Author(s):  
Julio Torales ◽  
João M. Castaldelli-Maia ◽  
Antonio Geraldo da Silva ◽  
Marcela W. Campos ◽  
Israel González-Urbieta ◽  
...  
Keyword(s):  
Public Health ◽  
Substance Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Substance Use Disorders ◽  
Temporal Association ◽  
Negative Consequences ◽  
Longitudinal Assessment ◽  
Coordinated Care ◽  
Dual Pathology

Background: The management of mental disorders in child and adolescent is challenging. In addition, when substance use disorders are associated with mental disorders, important complications are noted. Dual pathology and Substance-induced disorders should be distinguished in cases like this. Objective: To summarize the latest information on the epidemiology, etiology and management aspects of dual pathology in adolescents. Methods: PubMed, Web of Science, PsycINFO and SciELO databases were searched to perform a narrative review. Results: Dual pathology is the term used to designate the co-occurrence of an addictive disorder and at least one other mental health disorder, independently. To distinguish dual pathology from substance- induced disorders, the temporal association between the disorders in a longitudinal assessment should be emphasized. If the symptoms of the mental disorder appear prior to the substance use or after a long period of abstinence, a diagnosis of dual pathology should be considered. Patients with dual pathology present greater psychosocial issues, more medical problems, and worse prognosis than those with substance-induced disorders. The proposed etiological models agree that biological, psychological and social factors are shared in the development of these conditions. Conclusion: Healthcare systems should focus on creating policies that will allow early detection, preventive public health measures, and an integrated and coordinated care for these patients. Public health policies should create means to promote awareness and prevention of these pathologies since early initiation of treatment (pharmacological, psychotherapeutic, family therapy, education in schools, behavioral interventions and treatment of comorbidities) reduces the risks associated to substance use disorders and other negative consequences.

scholarly journals Prevalence of Mental Disorders and Suicidality in Canadian Provinces

2019 ◽  
Vol 64 (11) ◽  
pp. 761-769
Author(s):  
Joshua Palay ◽  
Tamara L. Taillieu ◽  
Tracie O. Afifi ◽  
Sarah Turner ◽  
James M. Bolton ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Substance Use Disorders ◽  
Alcohol Use Disorder ◽  
Service Providers ◽  
The Past ◽  
Canadian Provinces

Objective: There is limited information to guide health-care service providers and policy makers on the burden of mental disorders and addictions across the Canadian provinces. This study compares interprovincial prevalence of major depressive disorder (MDD), bipolar disorder, generalized anxiety disorder (GAD), alcohol use disorder, substance use disorders, and suicidality. Method: Data were extracted from the 2012 Canadian Community Health Survey—Mental Health ( n = 25,113), a representative sample of Canadians over the age of 15 years across all provinces. Cross tabulations and logistic regression were used to determine the prevalence and odds of the above disorders for each province. Adjustments for provincial sociodemographic factors were performed. Results: The past-year prevalence of all measured mental disorders and suicidality, excluding GAD, demonstrated significant interprovincial differences. Manitoba exhibited the highest prevalence of any mental disorder (13.6%), reflecting high prevalence of MDD and alcohol use disorder compared to the other provinces (7.0% and 3.8%, respectively). Nova Scotia exhibited the highest prevalence of substance use disorders (2.9%). Quebec and Prince Edward Island exhibited the lowest prevalence of any mental disorder (8.5% and 7.7%, respectively). Manitoba also exhibited the highest prevalence of suicidal ideation (5.1%); however, British Columbia and Ontario exhibited the highest prevalence of suicidal planning (1.4% and 1.3%, respectively), and Ontario alone exhibited the highest prevalence of suicide attempts (0.7%). Conclusions: Significant interprovincial differences were found in the past-year prevalence of mental disorders and suicidality in Canada. More research is necessary to explore these differences and how they impact the need for mental health services.

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