Development of lifetime comorbidity in the World Health Organization world mental health surveys.
Development of lifetime comorbidity in the World Health Organization world mental health surveys.
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DOI：
10.1001/archgenpsychiatry.2010.180
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发表时间：
2011-01
影响因子：
--
通讯作者：
Uestuen, T. Bedirhan
中科院分区：
文献类型：
--
作者：
Kessler, Ronald C.;Ormel, Johan;Petukhova, Maria;McLaughlin, Katie A.;Green, Jennifer Greif;Russo, Leo J.;Stein, Dan J.;Zaslavsky, Alan M.;Aguilar-Gaxiola, Sergio;Alonso, Jordi;Andrade, Laura;Benjet, Corina;de Girolamo, Giovanni;de Graaf, Ron;Demyttenaere, Koen;Fayyad, John;Haro, Josep Maria;Hu, Chi Yi;Karam, Aimee;Lee, Sing;Lepine, Jean-Pierre;Matchsinger, Herbert;Mihaescu-Pintia, Constanta;Posada-Villa, Jose;Sagar, Rajesh;Uestuen, T. Bedirhan
虽然许多研究已经研究了潜变量在精神障碍共病结构中的作用，但没有一项研究检查它们在共病发展中的作用。研究潜变量在WHO世界精神卫生(WMH)调查中18种终生DSM-IV疾病共病发生中的作用。在14个国家进行了具有国家或区域代表性的社区调查，共有21,229名受访者。在世界卫生组织综合国际诊断访谈(CIDI)中，对首次发病的18个终身DSM-IV焦虑、情绪、行为和物质障碍进行了回顾性评估。在终生障碍的探索性因素分析中，发现内化因素(焦虑和情绪障碍)和外化因素(行为和物质障碍)是分开的。在几乎所有暂时性原发终生疾病的生存分析中发现了持续显着的正时滞关联，预测了其他疾病的后续发病。域内(即内部化或外部化)关联通常比域间关联更强。绝大多数时滞关联可以用一个模型来解释，该模型假设存在中介、潜在的内化和外化变量。特异性恐惧症和强迫症(内在化)、多动障碍和对抗-违抗障碍(外在化)是最重要的预测因子。在控制了潜在变量后，少数残留关联仍然显著。潜变量模型的良好适合性表明，共同的因果路径解释了这里所考虑的疾病中的大部分共病。这些共同的途径应该是未来关于共病发展的研究的重点，尽管也存在一些不能被潜在变量解释的重要的成对关联，需要进一步的重点研究。
Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the WHO World Mental Health (WMH) surveys. Nationally or regionally representative community surveys in 14 countries with a total of 21,229 respondents. First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the WHO Composite International Diagnostic Interview (CIDI). Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (i.e., internalizing or externalizing) associations were generally stronger than between-domain associations. The vast majority of time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity disorder and oppositional-defiant disorder (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered here. These common pathways should be the focus of future research on the development of comorbidity, although several important pair-wise associations that cannot be accounted for by latent variables also exist that warrant further focused study.
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影响因子：
17.7
作者：
Herpertz, SC;Mueller, B;Herpertz-Dahlmann, B
通讯作者：
Herpertz-Dahlmann, B
影响因子：
7.4
作者：
Cox, BJ;Swinson, RP
通讯作者：
Swinson, RP
影响因子：
6.9
作者：
Hegerl, Ulrich;Himmerich, Hubertus;Hensch, Tilman
通讯作者：
Hensch, Tilman
影响因子：
3.7
作者：
EFRON, B
通讯作者：
EFRON, B
DOI：
10.1111/j.1469-7610.2005.00422.x
发表时间：
2005-11-01
影响因子：
7.6
作者：
Burke, JD;Loeber, R;Rathouz, PJ
通讯作者：
Rathouz, PJ