Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative.
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Roest Annelieke M, de Vries Ymkje Anna, Pozuelo Julia R, Petukhova Maria V, Lee Sue, Sampson Nancy A, Albor Yesica, Alhadi Ahmad N, Alonso Jordi, Al-Saud Nouf, Altwaijri Yasmin, Andersson Claes, Atwoli Lukoye, Auerbach Randy P, Muaka Caroline Ayuya, Báez-Mansur Patricia M, Ballester Laura, Bantjes Jason, Baumeister Harald, Bendtsen Marcus, Benjet Corina, Berman Anne H, Bruffaerts Ronny, Carrasco Paula, Chan Silver C N, Cohut Irina, Couder María Anabell Covarrubias Díaz, Crockett Marcelo A, Cuijpers Pim, David Oana A, Dong Dong, Ebert David D, Gaete Jorge, Forero Carlos García, Gili Margalida, Gutiérrez-García Raúl, Haro Josep Maria, Hasking Penelope, Hunt Xanthe, Husky Mathilde M, Jaguga Florence, Langer Álvaro I, Léniz Irene, Liu Yan, Mac-Ginty Scarlett, Martínez Vania, McLafferty Margaret, Miranda Andrea, Monroy-Velasco Iris Ruby, Murray Elaine K, Musyoka Catherine M, Nedelcea Catalin, Núñez Daniel, O'Neill Siobhan M, Piqueras José A, Popescu Codruta A, Prescivalli Ana Paula, Rapsey Charlene, Robinson Kealagh, Rodriguez-Jimenez Tiscar, Saal Wylene, Siu Oi-Ling, Stein Dan J, Struijs Sascha Y, Tomoiaga Cristina T, Valdés-García Karla Patricia, Vargas-Contreras Eunice, Vigo Daniel V, Wang Angel Y, Wong Samuel Y S, Kessler Ronald C, World Mental Health International College Student collaborators
Аннотация
METHODS: The study included 72,288 students from 18 countries as part of the World Mental Health International College Student (WMH-ICS) Initiative, with cross-sectional data collected between 2017 and 2023. Screening for common DSM-5 disorders was conducted using validated screening measures. Latent variables were examined using exploratory principal axis factor analysis on a correlation matrix among the lifetime mental disorders. Based on age-of-onset information, multivariable poisson regression models were used to examine associations of prior disorders with the first onset of other disorders.
RESULTS: 27.0 % of students screened positive for only one lifetime disorder, 17.1 % for two, 10.9 % for three, and 10.6 % for 4+ disorders. In the factor analysis, three latent variables were found, comprising: internalizing disorders (generalized anxiety disorder, major depressive episode, post-traumatic stress disorder, and panic disorder), substance use disorders (drug use disorder and alcohol use disorder), and externalizing disorders (attention deficit/hyperactivity disorder and mania/hypomania). Prior internalizing and externalizing disorders were associated with the subsequent first onset of all other disorders with risk ratios ranging from 1.5-7.5. Substance use disorders were less consistently associated with the subsequent first onset of other disorders, but alcohol use disorder was associated with the first onset of drug use disorder and vice versa.
CONCLUSIONS: Mental disorder comorbidity is common among students, and students with disorders across the internalizing and externalizing spectrum have an increased risk of future mental disorder comorbidities.