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. 2019 Jun;28(2):e1750.
doi: 10.1002/mpr.1750. Epub 2018 Nov 6.

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

Jordi Alonso  1   2   3 , Gemma Vilagut  1   2   3 , Philippe Mortier  4 , Randy P Auerbach  5 , Ronny Bruffaerts  4 , Pim Cuijpers  6 , Koen Demyttenaere  4 , David D Ebert  7 , Edel Ennis  8 , Raul A Gutiérrez-García  9 , Jennifer Greif Green  10 , Penelope Hasking  11 , Sue Lee  12 , Jason Bantjes  13 , Matthew K Nock  14 , Stephanie Pinder-Amaker  15 , Nancy A Sampson  12 , Alan M Zaslavsky  12 , Ronald C Kessler  12 ; WHO WMH-ICS Collaborators
Affiliations

The role impairment associated with mental disorder risk profiles in the WHO World Mental Health International College Student Initiative

Jordi Alonso et al. Int J Methods Psychiatr Res. 2019 Jun.

Abstract

Objective: The objective of this study is to assess the contribution of mental comorbidity to role impairment among college students.

Methods: Web-based self-report surveys from 14,348 first-year college students (Response Rate [RR] = 45.5%): 19 universities, eight countries of the World Mental Health International College Student Initiative. We assessed impairment (Sheehan Disability Scales and number of days out of role [DOR] in the past 30 days) and seven 12-month DSM-IV disorders. We defined six multivariate mental disorder classes using latent class analysis (LCA). We simulated population attributable risk proportions (PARPs) of impairment.

Results: Highest prevalence of role impairment was highest among the 1.9% of students in the LCA class with very high comorbidity and bipolar disorder (C1): 78.3% of them had severe role impairment (vs. 20.8%, total sample). Impairment was lower in two other comorbid classes (C2 and C3) and successively lower in the rest. A similar monotonic pattern was found for DOR. Both LCA classes and some mental disorders (major depression and panic, in particular) were significant predictors of role impairment. PARP analyses suggest that eliminating all mental disorders might reduce severe role impairment by 64.6% and DOR by 44.3%.

Conclusions: Comorbid mental disorders account for a substantial part of role impairment in college students.

Keywords: college students; disability; role impairment.

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Conflict of interest statement

In the past 3 years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis; was a consultant for Johnson & Johnson Wellness and Prevention, Sage Pharmaceuticals, Shire, Takeda; and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. Kessler is a co‐owner of DataStat, Inc., a market research firm that carries out healthcare research.

Dr. Ebert reports to have received consultancy fees/served in the scientific advisory board from several companies such as Minddistrict, Lantern, Schoen Kliniken, and German health insurance companies (BARMER, Techniker Krankenkasse). He is also stakeholder of the Institute for Health Training Online (GET.ON), which aims to implement scientific findings related to digital health interventions into routine care.

References

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