TY - JOUR
T1 - Transdiagnostic development of internalizing psychopathology throughout the life course up to age 45: a World Mental Health Surveys report
AU - WHO World Mental Health Survey collaborators
AU - de Vries, Ymkje Anna
AU - Al-Hamzawi, Ali
AU - Alonso, Jordi
AU - Andrade, Laura Helena
AU - Benjet, Corina
AU - Bruffaerts, Ronny
AU - Bunting, Brendan
AU - de Girolamo, Giovanni
AU - Florescu, Silvia
AU - Gureje, Oye
AU - Haro, Josep Maria
AU - Karam, Aimee
AU - Karam, Elie G
AU - Kawakami, Norito
AU - Kovess-Masfety, Viviane
AU - Lee, Sing
AU - Mneimneh, Zeina
AU - Navarro-Mateu, Fernando
AU - Ojagbemi, Akin
AU - Posada-Villa, José
AU - Scott, Kate
AU - Stagnaro, Juan Carlos
AU - Torres, Yolanda
AU - Xavier, Miguel
AU - Zarkov, Zahari N
AU - Kessler, Ronald C
AU - de Jonge, Peter
N1 - Publisher Copyright:
Copyright © The Author(s) 2020. Published by Cambridge University Press.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/10
Y1 - 2020/11/10
N2 - Background Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45. Methods We used data from 24158 participants (aged 45+) in 23 population-based cross-sectional World Mental Health Surveys. Internalizing disorders were assessed with the Composite International Diagnostic Interview (CIDI). We applied latent class growth analysis (LCGA) and investigated the characteristics of identified classes using logistic or linear regression. Results The best-fitting LCGA solution identified eight classes: A healthy class (81.9%), three childhood-onset classes with mild (3.7%), moderate (2.0%), or severe (1.1%) internalizing comorbidity, two puberty-onset classes with mild (4.0%) or moderate (1.4%) comorbidity, and two adult-onset classes with mild comorbidity (2.7% and 3.2%). The childhood-onset severe class had particularly unfavorable sociodemographic outcomes compared to the healthy class, with increased risks of being never or previously married (OR = 2.2 and 2.0, p < 0.001), not being employed (OR = 3.5, p < 0.001), and having a low/low-Average income (OR = 2.2, p < 0.001). Moderate or severe (v. mild) comorbidity was associated with 12-month internalizing disorders (OR = 1.9 and 4.8, p < 0.001), disability (B = 1.1-2.3, p < 0.001), and suicidal ideation (OR = 4.2, p < 0.001 for severe comorbidity only). Adult (v. childhood) onset was associated with lower rates of 12-month internalizing disorders (OR = 0.2, p < 0.001). Conclusions We identified eight transdiagnostic trajectories of internalizing psychopathology. Unfavorable outcomes were concentrated in the 1% of participants with childhood onset and severe comorbidity. Early identification of this group may offer opportunities for preventive interventions.
AB - Background Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45. Methods We used data from 24158 participants (aged 45+) in 23 population-based cross-sectional World Mental Health Surveys. Internalizing disorders were assessed with the Composite International Diagnostic Interview (CIDI). We applied latent class growth analysis (LCGA) and investigated the characteristics of identified classes using logistic or linear regression. Results The best-fitting LCGA solution identified eight classes: A healthy class (81.9%), three childhood-onset classes with mild (3.7%), moderate (2.0%), or severe (1.1%) internalizing comorbidity, two puberty-onset classes with mild (4.0%) or moderate (1.4%) comorbidity, and two adult-onset classes with mild comorbidity (2.7% and 3.2%). The childhood-onset severe class had particularly unfavorable sociodemographic outcomes compared to the healthy class, with increased risks of being never or previously married (OR = 2.2 and 2.0, p < 0.001), not being employed (OR = 3.5, p < 0.001), and having a low/low-Average income (OR = 2.2, p < 0.001). Moderate or severe (v. mild) comorbidity was associated with 12-month internalizing disorders (OR = 1.9 and 4.8, p < 0.001), disability (B = 1.1-2.3, p < 0.001), and suicidal ideation (OR = 4.2, p < 0.001 for severe comorbidity only). Adult (v. childhood) onset was associated with lower rates of 12-month internalizing disorders (OR = 0.2, p < 0.001). Conclusions We identified eight transdiagnostic trajectories of internalizing psychopathology. Unfavorable outcomes were concentrated in the 1% of participants with childhood onset and severe comorbidity. Early identification of this group may offer opportunities for preventive interventions.
KW - Anxiety disorders
KW - depression
KW - internalizing disorders
KW - latent class growth analysis
UR - http://www.scopus.com/inward/record.url?scp=85095992614&partnerID=8YFLogxK
U2 - 10.1017/S0033291720004031
DO - 10.1017/S0033291720004031
M3 - Article
C2 - 33168122
SN - 0033-2917
SP - 1
EP - 10
JO - Psychological Medicine
JF - Psychological Medicine
ER -