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. 2019 Jun;28(2):e1752.
doi: 10.1002/mpr.1752. Epub 2018 Nov 18.

Mental disorder comorbidity and suicidal thoughts and behaviors in the World Health Organization World Mental Health Surveys International College Student initiative

Randy P Auerbach  1 , Philippe Mortier  2 , Ronny Bruffaerts  2 , Jordi Alonso  3 , Corina Benjet  4 , Pim Cuijpers  5 , Koen Demyttenaere  2 , David D Ebert  6 , Jennifer Greif Green  7 , Penelope Hasking  8 , Sue Lee  9 , Christine Lochner  10 , Margaret McLafferty  11 , Matthew K Nock  12 , Maria V Petukhova  9 , Stephanie Pinder-Amaker  13 , Anthony J Rosellini  14 , Nancy A Sampson  9 , Gemma Vilagut  3 , Alan M Zaslavsky  9 , Ronald C Kessler  9 ; WHO WMH-ICS Collaborators
Affiliations

Mental disorder comorbidity and suicidal thoughts and behaviors in the World Health Organization World Mental Health Surveys International College Student initiative

Randy P Auerbach et al. Int J Methods Psychiatr Res. 2019 Jun.

Abstract

Objectives: Comorbidity is a common feature of mental disorders. However, needs assessment surveys focus largely on individual disorders rather than on comorbidity even though the latter is more important for predicting suicidal thoughts and behaviors. In the current report, we take a step beyond this conventional approach by presenting data on the prevalence and correlates (sociodemographic factors, college-related factors, and suicidal thoughts and behaviors) of the main multivariate profiles of common comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV disorders among students participating in the first phase of the World Health Organization World Mental Health International College Student initiative.

Method: A web-based mental health survey was administered to first year students in 19 colleges across eight countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States; 45.5% pooled response rate) to screen for seven common DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, attention-deficit/hyperactivity disorder, alcohol use disorder, and drug use disorder. We focus on the 14,348 respondents who provided complete data; 38.4% screened positive for at least one 12-month disorder.

Results: Multivariate disorder profiles were detected using latent class analysis (LCA). The least common class (C1; 1.9% of students) was made up of students with high comorbidity (four or more disorders, the majority including mania/hypomania). The remaining 12-month cases had profiles of internalizing-externalizing comorbidity (C2; 5.8%), internalizing comorbidity (C3; 14.6%), and pure disorders (C4; 16.1%). The 1.9% of students in C1 had much higher prevalence of suicidal thoughts and behaviors than other students. Specifically, 15.4% of students in C1 made a suicide attempt in the 12 months before the survey compared with 1.3-2.6% of students with disorders in C2-4, 0.2% of students with lifetime disorders but no 12-month disorders (C5), and 0.1% of students with no lifetime disorders (C6).

Conclusions: In line with prior research, comorbid mental disorders were common; however, sociodemographic correlates of LCA profiles were modest. The high level of comorbidity underscores the need to develop and test transdiagnostic approaches for treatment in college students.

Keywords: college student mental health; comorbidity; mental disorders; suicide thoughts and behaviors.

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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, Shire, Takeda, and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. Kessler is a coowner of DataStat, Inc., a market research firm that carries out healthcare research.

Dr. Ebert has received consultant fees and served on the scientific advisory board for several companies, including MindDistrict, Lantern, Schoen Kliniken, and German health insurance companies (BARMER, Techniker Krankenkasse). He also is a stakeholder in the institute for health training online (GET.ON), which aims to implement scientific findings related to digital health interventions into routine care.

Figures

Figure 1
Figure 1
Prevalence of disorders within each latent class. ADHD: attention‐deficit/hyperactive disorder
See this image and copyright information in PMC

References

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