Browsing by Author "Merikangas, Kathleen R."

Now showing 1 - 5 of 5

Comorbidity of substance use disorders with mood and anxiety disorders: Results of the international consortium in psychiatric epidemiology
(1998) Merikangas, Kathleen R.; Mehta, Rajni L.; Molnar, Beth E.; Walters, Ellen E.; Swendsen, Joel D.; Aguilar-Gaxiola, Sergio; Bijl, Rob; Borges, Guilherme; Caraveo-Anduaga, Jorge J.; DeWit, David J.; Kolody, Bohdan; Vega, William A.; Wittchen, Hans-Ulrich; Kessler, Ronald C.; Yale University School of Medicine
Mental-substance comorbidities in the ICPE surveys
(Helsinki : Helsinki University Central Hospital. Psychiatric Clinic, 2001) Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Andrade, Laura; Bijl, Rob; Borges, Guilherme; Caraveo-Anduaga, Jorge J.; DeWit, David J.; Kolody, Bo; Merikangas, Kathleen R.; Molnar, Beth E.; Vega, William A.; Walters, Ellen E.; Hans-Ulrich, Wittchen; Bedirhan, Ustun; Harvard Medical School, Department of Health Care Policy, 180 Longwood Avenue Boston, MA, 02115 U.S.A.; kessler@hcp.med.harvard.edu
Data are presented from seven community epidemiology surveys carried out in six countries in North America (Canada and the United States), Latin America (Brazil and Mexico), and Europe (Germany and the Netherlands) exploring patterns of comorbidity between mental disorders and substance use disorders. The surveys have a combined sample size of 28,658 respondents. Results are consistent across the surveys in showing that strong comorbidities exist between mental disorders and substance use disorders, that mental disorders are typically temporally primary (i.e., have earlier ages of onset than substance use disorders) in these comorbid pairs, and that primary mental disorders are significant predictors of the subsequent first onset of substance use disorders. Only active mental disorders, not remitted disorders, predict subsequent substance use, problems, and dependence, arguing indirectly that there is something about the mental disorders themselves rather than about determinants of these disorders, that promotes substance disorders. Decomposition shows that mental disorders are less powerful predictors of first drug use than of progressing from use to problem use and from problem use to dependence. Simulations suggest that primary mental disorders are associated with 54.7% of all drug dependence among men and 47.8% among women in these surveys. Conduct disorder and adult antisocial behavior are responsible for these cases among men, while anxiety disorders and mood disorders are also important among women. These results suggest that early interventions to treat mental disorders might be affective in reducing the number of people who would otherwise become dependent on drugs.
Prevalence and age of onset for drug use in seven international sites: results from the international consortium of psychiatric epidemiology
(Lausanne, Elsevier Sequoia, 2002) Vega, William A.; Aguilar-Gaxiola, Sergio; Andrade, Laura; Bijl, Rob; Borges, Guilherme; Caraveo-Anduaga, Jorge J.; DeWit, David J.; Heeringa, Steven G.; Kessler, Ronald C.; Kolody, Bo; Merikangas, Kathleen R.; Molnar, Beth E.; Walters, Ellen E.; Warner, Lynn A.; Hans-Ulrich, Wittchen; Institute for Quality, Research, and Training, Robert Wood Johnson Medical School-UMDNJ, 335 George Street, 3rd Floor, Liberty Plaza, New Brunswick, NJ 08901, USA; vegawa@umdnj.edu
Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative
(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60654-0946 USA, 2011) Merikangas, Kathleen R.; Jin, Robert; He, Jian-Ping; Kessler, Ronald C.; Lee, Sing; Sampson, Nancy A.; Viana, María Carmen; Andrade, Laura Helena; Hu, Chiyi; Karam, Elie G.; Ladea, María; Medina-Mora, María Elena; Ono, Yutaka; Posada-Villa, José; Sagar, Rajesh; Wells, J. Elisabeth; Zarkov, Zahari; NIMH, Genet Epidemiol Res Branch, Bethesda, MD 20892 USA; kathleen.merikangas@nih.gov
Context: There is limited information on the prevalence and correlates of bipolar spectrum disorder in international population-based studies using common methods. Objectives: To describe the prevalence, impact, patterns of comorbidity, and patterns of service utilization for bipolar spectrum disorder (BPS) in the World Health Organization World Mental Health Survey Initiative. Design, Setting, and Participants: Crosssectional, face-to-face, household surveys of 61 392 community adults in 11 countries in the Americas, Europe, and Asia assessed with the World Mental Health version of the World Health Organization Composite International Diagnostic Interview, version 3.0, a fully structured, lay-administered psychiatric diagnostic interview. Main Outcome Measures: Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) disorders, severity, and treatment. Results: The aggregate lifetime prevalences were 0.6% for bipolar type I disorder (BP-I), 0.4% for BP-II, 1.4% for subthreshold BP, and 2.4% for BPS. Twelve-month prevalences were 0.4% for BP-I, 0.3% for BP-II, 0.8% for subthreshold BP, and 1.5% for BPS. Severity of both manic and depressive symptoms as well as suicidal behavior increased monotonically from subthreshold BP to BP-I. By contrast, role impairment was similar across BP subtypes. Symptom severity was greater for depressive episodes than manic episodes, with approximately 74.0% of respondents with depression and 50.9% of respondents with mania reporting severe role impairment. Three-quarters of those with BPS met criteria for at least 1 other disorder, with anxiety disorders (particularly panic attacks) being the most common comorbid condition. Less than half of those with lifetime BPS received mental health treatment, particularly in low-income countries, where only 25.2% reported contact with the mental health system. Conclusions: Despite cross-site variation in the prevalence rates of BPS, the severity, impact, and patterns of comorbidity were remarkably similar internationally. The uniform increases in clinical correlates, suicidal behavior, and comorbidity across each diagnostic category provide evidence for the validity of the concept of BPS. Treatment needs for BPS are often unmet, particularly in low-income countries.
Smoking and suicidal behaviors in the national comorbidity survey: Replication
(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2007) Kessler, Ronald C.; Berglund, Patricia A.; Borges, Guilherme; Castilla-Puentes, Ruby C.; Glantz, Meyer D.; Jaeger, Savina A.; Merikangas, Kathleen R.; Nock, Matthew K.; Russo, Leo J.; Stang, Paul E.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
Controversy exists about the role of mental disorders in the consistently documented association between smoking and suicidal behavior. This controversy is addressed here with data from the nationally representative National Comorbidity Survey-Replication (NCS-R). Assessments were made of 12-month smoking, suicidal behaviors (ideation, plans, attempts), and DSM-IV disorders (anxiety, mood, impulse-control, and substance use disorders). Statistically significant odds ratios (2.9 -3.1) were found between 12-month smoking and 12-month suicidal behaviors. However, the associations of smoking with the outcomes became insignificant with controls for DSM-IV mental disorders. Although clear adjudication among contending hypotheses about causal mechanisms cannot be made from the cross-sectional NCS-R data, the results make it clear that future research on smoking and suicidal behaviors should focus more centrally than previous research on mental disorders either as common causes, markers, or mediators.