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. 2021 Apr:136:334-342.
doi: 10.1016/j.jpsychires.2021.02.013. Epub 2021 Feb 13.

Latent classes of posttraumatic psychiatric comorbidity in the general population

Anthony J Rosellini  1 , Péter Szentkúti  2 , Erzsébet Horváth-Puhó  2 , Meghan L Smith  3 , Isaac Galatzer-Levy  4 , Timothy L Lash  5 , Sandro Galea  3 , Paula P Schnurr  6 , Henrik T Sørensen  7 , Jaimie L Gradus  8
Affiliations

Latent classes of posttraumatic psychiatric comorbidity in the general population

Anthony J Rosellini et al. J Psychiatr Res. 2021 Apr.

Abstract

Some narrow patterns of posttraumatic psychiatric comorbidity are well-established (e.g., posttraumatic stress disorder and substance use). However, broad multi-diagnosis profiles of posttraumatic comorbidity are poorly characterized. The goal of the current study was to use latent class analysis (LCA) to identify profiles of posttraumatic psychopathology from 11 International Classification of Diseases (ICD-10) diagnostic categories (e.g., stress, substance, depressive, psychosis, personality). Danish national registries were used to identify 166,539 individuals (median age = 41 years, range = <1 to >100) who experienced a traumatic event between 1994 and 2016 and were diagnosed with one or more mental disorders within 5 years. Two through 14-class LCA solutions were evaluated. A 13-class solution (a) provided the best fit, with the Bayes and Akaike Information Criteria reaching a minimum, (b) was broadly consistent with prior LCA studies, and (c) included several novel classes reflecting differential patterns of posttraumatic psychopathology. Three classes were characterized by high comorbidity: broad high comorbidity (M # diagnoses = 4.3), depression with stress/substance use/personality/neurotic disorders (M# diagnoses = 3.8), and substance use with personality/stress/psychotic disorders (M # diagnoses = 3.1). The other 10 classes were characterized by distinct patterns of mild comorbidity or negligible comorbidity. Compared to the mild and negligible comorbidity classes, individuals in high comorbidity classes were younger, had lower income, and had more pre-event psychiatric disorders. Results suggest that several different comorbidity patterns should be assessed when studying and treating posttraumatic psychopathology.

Keywords: Comorbidity; Diagnosis; Latent class analysis; Psychopathology; Trauma.

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Conflict of interest statement

Conflicts of Interest. None.

Figures

Figure 1.
Figure 1.
Conditional probabilities of diagnostic categories for the three high comorbidity classes
Figure 2.
Figure 2.
Conditional probabilities of diagnostic categories for the three mild comorbidity classes
Figure 3.
Figure 3.
Conditional probabilities of diagnostic categories for the seven negligible comorbidity classes
See this image and copyright information in PMC

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