Prevalence, Comorbidity, and Sociodemographic Correlates of Psychiatric Disorders in the All Of Us Biobank

ABSTRACTImportanceAll of Us is a landmark initiative for population-scale research into the etiology of psychiatric disorders and disparities across various sociodemographic categories.ObjectiveTo estimate the prevalence, comorbidity, and demographic covariates of psychiatric and substance use disorders in the All of Us biobank.Design, Setting, and ParticipantsWe estimated prevalence, overlap, and demographic correlates for psychiatric disorders derived from electronic health records in the All of Us biobank (release 5; N = 331,380)ExposuresSocial and demographic covariates.Main Outcome and MeasuresPsychiatric disorders derived from ICD10CM codes and grouped into phecodes across six broad domains: mood disorders, anxiety disorders, substance use disorders, stress-related disorders, schizophrenia, and personality disorders.ResultsThe prevalence of various disorders ranges from approximately 15% to less than 1%, with mood and anxiety disorders being the most common, followed by substance use disorders, stress-related disorders, schizophrenia, and personality disorders. There is substantial overlap among disorders, with a large portion of those with a disorder (~57%) having two or more registered diagnoses and tetrachoric correlations ranging from 0.43 – 0.74. The prevalence of disorders across demographic categories demonstrates that non-Hispanic whites, those of low socioeconomic status, women and those assigned female at birth, and sexual minorities are at greatest risk for most disorders.Conclusions and RelevanceAlthough the rates of disorders in All of Us are lower than rates for disorders in the general population, there is considerable variation, comorbidity, and differences across social groups. Large-scale resources like All of Us will prove to be invaluable for understanding the causes and consequences of psychiatric conditions. As we move towards an era of precision medicine, we must work to ensure it is delivered in an equitable manner.

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A prospective examination of Axis I psychiatric disorders in the first 5 years following moderate to severe traumatic brain injury

Psychological Medicine ◽

10.1017/s0033291715002986 ◽

2016 ◽

Vol 46 (6) ◽

pp. 1331-1341 ◽

Cited By ~ 41

Author(s):

Y. Alway ◽

K. R. Gould ◽

L. Johnston ◽

D. McKenzie ◽

J. Ponsford

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Substance Use ◽

Brain Injury ◽

Anxiety Disorders ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

First Year ◽

Post Injury ◽

Over Time

BackgroundPsychiatric disorders commonly emerge during the first year following traumatic brain injury (TBI). However, it is not clear whether these disorders soon remit or persist for long periods post-injury. This study aimed to examine, prospectively: (1) the frequency, (2) patterns of co-morbidity, (3) trajectory, and (4) risk factors for psychiatric disorders during the first 5 years following TBI.MethodParticipants were 161 individuals (78.3% male) with moderate (31.2%) or severe (68.8%) TBI. Psychiatric disorders were diagnosed using the Structured Clinical Interview for DSM-IV, administered soon after injury and 3, 6 and 12 months, and 2, 3, 4 and 5 years post-injury. Disorder frequencies and generalized estimating equations were used to identify temporal relationships and risk factors.ResultsIn the first 5 years post-injury, 75.2% received a psychiatric diagnosis, commonly emerging within the first year (77.7%). Anxiety, mood and substance-use disorders were the most common diagnostic classes, often presenting co-morbidly. Many (56.5%) experienced a novel diagnostic class not present prior to injury. Disorder frequency ranged between 61.8 and 35.6% over time, decreasing by 27% [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.65–0.83] with each year post-injury. Anxiety disorders declined significantly over time (OR 0.73, 95% CI 0.63–0.84), whilst mood and substance-use disorder rates remained stable. The strongest predictors of post-injury disorder were pre-injury disorder (OR 2.44, 95% CI 1.41–4.25) and accident-related limb injury (OR 1.78, 95% CI 1.03–3.07).ConclusionsFindings suggest the first year post-injury is a critical period for the emergence of psychiatric disorders. Disorder frequency declines thereafter, with anxiety disorders showing greater resolution than mood and substance-use disorders.

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Cognitive Therapy for Comorbid Depression

10.1093/oxfordhb/9780199797004.013.009 ◽

2014 ◽

Author(s):

Mark A. Whisman ◽

Daniel BE

Keyword(s):

Substance Use ◽

Anxiety Disorders ◽

Personality Disorders ◽

Cognitive Therapy ◽

Substance Use Disorders ◽

Clinical Guidelines ◽

Clinical Samples ◽

Comorbid Depression ◽

Axis Ii ◽

Axis I

Depression often co-occurs with other Axis I and Axis II psychiatric disorders. This chapter presents a model for how cognitive therapy (CT) of depression can be adapted in conceptualizing and treating the complex set of issues and problems that often accompany comorbid depression. It begins with a discussion of the prevalence of comorbidity in community and clinical samples, then review the research on comorbidity and outcome to CT for depression, followed by a model for adapting or modifying CT for patients who present with depression and a comorbid Axis I or Axis II disorder. The chapter concludes with specific clinical guidelines for treating depression that co-occurs with anxiety disorders, substance use disorders, and personality disorders.

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Lifetime prevalence of psychiatric disorders in South Africa

The British Journal of Psychiatry ◽

10.1192/bjp.bp.106.029280 ◽

2008 ◽

Vol 192 (2) ◽

pp. 112-117 ◽

Cited By ~ 119

Author(s):

Dan J. Stein ◽

Soraya Seedat ◽

Allen Herman ◽

Hashim Moomal ◽

Steven G. Heeringa ◽

...

Keyword(s):

Mental Health ◽

South Africa ◽

Substance Use ◽

Anxiety Disorders ◽

Psychiatric Disorders ◽

Mood Disorders ◽

Ethnic Groups ◽

Substance Use Disorders ◽

Age At Onset ◽

Lifetime Prevalence

BackgroundData on the lifetime prevalence of psychiatric disorders in South Africa are of interest, not only for the purposes of developing evidence-based mental health policy, but also in view of South Africa's particular historical and demographic circumstances.MethodA nationally representative household survey was conducted between 2002 and 2004 using the World Health Organization Composite International Diagnostic Interview (CIDI) to generate diagnoses. The data-set analysed included 4351 adult South Africans of all ethnic groups.ResultsLifetime prevalence of DSM–IV/CIDI disorders was determined for anxiety disorders (15.8%), mood disorders (9.8%), substance use disorders (13.4%) and any disorder (30.3%). Lifetime prevalence of substance use disorders differed significantly across ethnic groups. Median age at onset was earlier for substance use disorders (21 years) than for anxiety disorders (32 years) or mood disorders (37 years).ConclusionsIn comparison with data from other countries, South Africa has a particularly high lifetime prevalence of substance use disorders. These disorders have an early age at onset, providing an important target for the planning of local mental health services.

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Overdiagnosis of major psychiatric disorders in individuals with substance use disorders and personality disorders: the downside of the Woodruff principle.

Journal of Studies on Alcohol ◽

10.15288/jsa.1998.59.477 ◽

1998 ◽

Vol 59 (4) ◽

pp. 477-478 ◽

Cited By ~ 2

Author(s):

J A Brim

Keyword(s):

Substance Use ◽

Personality Disorders ◽

Psychiatric Disorders ◽

Substance Use Disorders

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Prevalence, sociodemographic correlates and DSM-5 substance use disorders and other psychiatric disorders among sexual minorities in the United States

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2016.10.038 ◽

2017 ◽

Vol 170 ◽

pp. 82-92 ◽

Cited By ~ 83

Author(s):

Bradley T. Kerridge ◽

Roger P. Pickering ◽

Tulshi D. Saha ◽

W. June Ruan ◽

S. Patricia Chou ◽

...

Keyword(s):

United States ◽

Substance Use ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Sexual Minorities ◽

The United States ◽

Dsm 5 ◽

Sociodemographic Correlates

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Onset and recurrence of psychiatric disorders associated with anti-hypertensive drug classes

Translational Psychiatry ◽

10.1038/s41398-021-01444-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lucy Colbourne ◽

Sierra Luciano ◽

Paul J. Harrison

Keyword(s):

Substance Use ◽

Anxiety Disorders ◽

Sleep Disorders ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Enzyme Inhibitor ◽

First Episode ◽

Drug Classes ◽

Β Blockers ◽

Risk Ratios

AbstractThe major anti-hypertensive (AHT) drug classes have been associated with differential risks of psychiatric disorders. However, existing data are limited largely to depression, and confounding variables have not always been controlled for. We sought to fill the evidence gap, using TriNetX Analytics, an electronic health records network. Amongst 58.6 million patients aged 18–90 years, patients prescribed a calcium channel blocker (CCB) were compared with those taking a diuretic, angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or β-blocker. Cohorts were propensity score-matched for age, sex, race, and blood pressure. Over a 2-year exposure period, we measured the incidence and risk ratio of a first diagnosis (ICD-10 codes), or a recurrence, of psychotic, affective, and anxiety disorders, as well as substance use disorders and sleep disorders. Cohort sizes ranged from 33,734 to 322,814. CCBs were associated with a lower incidence of psychotic, affective, and anxiety disorders than β-blockers (risk ratios 0.69–0.99) and a higher incidence than ARBs (risk ratios 1.04–2.23) for both first and recurrent diagnoses. Comparisons of CCBs with ACEIs or diuretics showed smaller risk ratios that varied between disorders, and between first episode and recurrence. AHT classes were also associated with the incidence of substance use and sleep disorders. Results remained largely unchanged after more extensive cohort matching for additional potential confounders. In a secondary analysis, a comparison between ARBs and ACEIs showed lower rates of psychotic, affective, and substance use disorders with ARBs, but higher risks of anxiety and sleep disorders. In conclusion, AHT classes are differentially associated with the incidence of psychiatric disorders. ARBs show the most advantageous profile and β-blockers the least. The apparent beneficial effects of ARBs merit further study.

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Greater decision uncertainty characterizes a transdiagnostic patient sample during approach-avoidance conflict: a computational modelling approach

Journal of Psychiatry and Neuroscience ◽

10.1503/jpn.200032 ◽

2020 ◽

Vol 46 (1) ◽

pp. E74-E87

Author(s):

Ryan Smith ◽

Namik Kirlic ◽

Jennifer L. Stewart ◽

James Touthang ◽

Rayus Kuplicki ◽

...

Keyword(s):

Substance Use ◽

Anxiety Disorders ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Computational Modelling ◽

Healthy Controls ◽

Full Sample ◽

Decision Uncertainty ◽

Emotional Conflict ◽

Approach Avoidance

Background: Imbalances in approach-avoidance conflict (AAC) decision-making (e.g., sacrificing rewards to avoid negative outcomes) are considered central to multiple psychiatric disorders. We used computational modelling to examine 2 factors that are often not distinguished in descriptive analyses of AAC: decision uncertainty and sensitivity to negative outcomes versus rewards (emotional conflict). Methods: A previously validated AAC task was completed by 478 participants, including healthy controls (n = 59), people with substance use disorders (n = 159) and people with depression and/or anxiety disorders who did not have substance use disorders (n = 260). Using an active inference model, we estimated individual-level values for a model parameter that reflected decision uncertainty and another that reflected emotional conflict. We also repeated analyses in a subsample (59 healthy controls, 161 people with depression and/or anxiety disorders, 56 people with substance use disorders) that was propensity-matched for age and general intelligence. Results: The model showed high accuracy (72%). As further validation, parameters correlated with reaction times and self-reported task motivations in expected directions. The emotional conflict parameter further correlated with self-reported anxiety during the task (r = 0.32, p < 0.001), and the decision uncertainty parameter correlated with self-reported difficulty making decisions (r = 0.45, p < 0.001). Compared to healthy controls, people with depression and/or anxiety disorders and people with substance use disorders showed higher decision uncertainty in the propensity-matched sample (t = 2.16, p = 0.03, and t = 2.88, p = 0.005, respectively), with analogous results in the full sample; people with substance use disorders also showed lower emotional conflict in the full sample (t = 3.17, p = 0.002). Limitations: This study was limited by heterogeneity of the clinical sample and an inability to examine learning. Conclusion: These results suggest that reduced confidence in how to act, rather than increased emotional conflict, may explain maladaptive approach-avoidance behaviours in people with psychiatric disorders.

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