Browsing by Author "De Girolamo, G."

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A multinational study of mental disorders, marriage, and divorce
(WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA, 2011) Breslau, J.; Miller, E.; Jin, R.; Sampson, N.A.; Alonso, J.; Andrade, L.H.; Bromet, E.J.; De Girolamo, G.; Demyttenaere, K.; Fayyad, J.; Fukao, A.; Galaon, M.; Gureje, O.; He, Y.; Hinkov, H.R.; Hu, C.; Kovess-Masfety, V.; Matschinger, H.; Medina-Mora, M.E.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Kessler, R.C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; ncs@hcp.med.harvard.edu
Objective: Estimate predictive associations of mental disorders with marriage and divorce in a cross-national sample. Method: Population surveys of mental disorders included assessment of age at first marriage in 19 countries (n = 46 128) and age at first divorce in a subset of 12 countries (n = 30 729). Associations between mental disorders and subsequent marriage and divorce were estimated in discrete time survival models. Results: Fourteen of 18 premarital mental disorders are associated with lower likelihood of ever marrying (odds ratios ranging from 0.6 to 0.9), but these associations vary across ages of marriage. Associations between premarital mental disorders and marriage are generally null for early marriage (age 17 or younger), but negative associations come to predominate at later ages. All 18 mental disorders are positively associated with divorce (odds ratios ranging from 1.2 to 1.8). Three disorders, specific phobia, major depression, and alcohol abuse, are associated with the largest population attributable risk proportions for both marriage and divorce. Conclusion: This evidence adds to research demonstrating adverse effects of mental disorders on life course altering events across a diverse range of socioeconomic and cultural settings. These effects should be included in considerations of public health investments in preventing and treating mental disorders.
Age patterns in the prevalence of DSM-IV depressive/anxiety disorders with and without physical co-morbidity
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2008) Scott, K.M.; Von Korff, M.; Alonso, J.; Angermeyer, M.; Bromet, E.J.; Bruffaerts, R.; De Girolamo, G.; De Graaf, R.; Fernández, A.; Gureje, O.; He, Y.; Kessler, R.C.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Mneimneh, Z.; Browne, M.A. Oakley; Posada-Villa, J.; Tachimori, H.; Williams, D.; Univ Otago, Dept Psychol Med, Wellington, New Zealand; kate.scott@otago.ac.nz
Background. Physical morbidity is a potent risk factor for depression onset and clearly increases with age, yet prior research has often found depressive disorders to decrease with age. This study tests the possibility that the relationship between age and mental disorders differs as a function of physical co-morbidity. Method. Eighteen general population surveys were carried out among household-residing adults as part of the World Mental Health (WMH) surveys initiative (n = 42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). The effect of age was estimated for 12-month depressive and/or anxiety disorders with and without physical or pain co-morbidity, and for physical and/or pain conditions without mental co-morbidity. Results. Depressive and anxiety disorders decreased with age, a result that cannot be explained by organic exclusion criteria. No significant difference was found in the relationship between mental disorders and age as a function of physical/pain co-morbidity. The majority of older persons have chronic physical or pain conditions without co-morbid mental disorders; by contrast, the majority of those with mental disorders have physical/pain co-morbidity, particularly among the older age groups. Conclusions. CIDI-diagnosed depressive and anxiety disorders in the general population decrease with age, despite greatly increasing physical morbidity with age. Physical morbidity among persons with mental disorder is the norm, particularly in older populations. Health professionals, including mental health professionals, need to address barriers to the management of physical co-morbidity among those with mental disorders.
Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys
(WILEY-BLACKWELL, COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA, 2008) Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J.P.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Tachimori, H.; Mneimneh, Z.N.; Medina-Mora, M.E.; Ormel, J.; Scott, K.M.; Gureje, O.; Haro, J.M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R.C.; Von Korff, M.; Hosp Mar, Inst Municipal Invest Med, Hlth Serv Res Unit, PRBB, Barcelona 08003, Spain; jalonso@imim.es
Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Mental disorders were assessed with Composite International Diagnostic Interview (CIDI) 3.0. Chronic conditions were ascertained by self-report. Household-residing adults (80 737) participated in 17 population surveys in 16 countries. Results: Perceived stigma was present in 13.5% (22.1% in developing and 11.7% in developed countries). Suffering from a depressive or an anxiety disorder (vs. no mental disorder) was associated with about a twofold increase in the likelihood of stigma, while comorbid depression and anxiety was even more strongly associated (OR 3.4, 95%CI 2.7-4.2). Chronic physical conditions showed a much lower association. Conclusion: Perceived stigma is frequent and strongly associated with mental disorders worldwide. Efforts to alleviate stigma among individuals with comorbid depression and anxiety are needed.
Associations between mental disorders and subsequent onset of hypertension
(2014) Stein, D. J.; Aguilar-Gaxiola, S.; Alonso, J.; Bruffaerts, R.; de Jonge, P.; Liu, Z.R.; Caldas-de-Almeida, J.M.; O'Neill, S.; Viana, M.C.; Al-Hamzawi, A. O.; Angermeyer, M.C.; Benjet, C.; de Graaf, R.; Ferry, F.; Kovess-Masfety, V.; Levinson, D.; De Girolamo, G.; Florescu, S.; Hu, C.Y.; Kawakami, N.; Haro, J.M.; Piazza, M.; Posada-Villa, J.; Wojtyniak, B.J.; Xavier, M.; Lim, C.C.W.; Kessler, R.C.; Scott, K.M.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; dan.stein@uct.ac.za
Barriers to Mental Health Treatment: Results from the WHO World Mental Health (WMH) Surveys
(2014) Andrade, L. H.; Alonso, J.; Mneimneh, Z.; Wells, J. E.; Al-Hamzawi, A.; Borges, G.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; De Graaf, R.; Florescu, S.; Gureje, O.; Hinkov, H. R.; Hu, C.; Huang, Y.; Hwang, I.; Jin, R.; Karam, E. G.; Kovess-Masfety, V.; Levinson, D.; Matschinger, H.; O’Neill, S.; Posada-Villa, J.; Sagar, R.; Sampson, N. A.; Section of Psychiatric Epidemiology-LIM 23, Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; kessler@hcp.med.harvard.edu
Cross-national differences in the prevalence and correlates of burden among older family caregivers in the WHO World Mental Health (WMH) Surveys
(2013) Shahly, V.; Chatterji, S.; Gruber, M. J.; Al-Hamzawi, A.; Alonso, J.; Andrade, L. H.; Angermeyer, M. C.; Bruffaerts, R.; Bunting, B.; Caldas-de-Almeida, J. M.; De Girolamo, G.; De Jonge, P.; Florescu, S.; Gureje, O.; Haro, J. M.; Hinkov, H. R.; Hu, C.; Karam, E. G.; Lépine, J.-P.; Levinson, D.; Medina-Mora, M.E.; Posada-Villa, J.; Sampson, N. A.; Trivedi, J. K.; Viana, M. C.; Kessler, R. C.; Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA; kessler@hcp.med.harvard.edu
Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder
(2007) Fayyad, J.; De Graaf, R.; Kessler, R.; Alonso, J.; Angermeyer, M.; Demyttenaere, K.; De Girolamo, G.; Haro, J. M.; Karam, E. G.; Lara, C.; Lepine, J. P.; Ormel, J.; Posada-Villa, J.; Zaslavsky, A. M.; Jin, R.; permissions@rcpsych.ac.uk
Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys
(NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, 2011) Alonso, J.; Petukhova, M.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Uestuen, T.B.; Alhamzawi, A.O.; Viana, M.C.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C-y; Karam, E.G.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Nakamura, Y.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Tsang, A.; Williams, D.R.; Kessler, R.C.; IMIM Inst Recerca Hosp del Mar, Hlth Serv Res Unit, Barcelona 08003, Spain; jalonso@imim.es
Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental Health (WMH) surveys. Face-to-face interviews were carried out with 62 971 respondents (72.0% pooled response rate). Presence of ten chronic physical disorders and nine mental disorders was assessed for each respondent along with information about the number of days in the past month each respondent reported being totally unable to work or carry out their other normal daily activities because of problems with either physical or mental health. Multiple regression analysis was used to estimate associations of specific conditions and comorbidities with days out of role, controlling by basic socio-demographics (age, gender, employment status and country). Overall, 12.8% of respondents had some day totally out of role, with a median of 51.1 a year. The strongest individual-level effects (days out of role per year) were associated with neurological disorders (17.4), bipolar disorder (17.3) and post-traumatic stress disorder (15.2). The strongest population-level effect was associated with pain conditions, which accounted for 21.5% of all days out of role (population attributable risk proportion). The 19 conditions accounted for 62.2% of all days out of role. Common health conditions, including mental disorders, make up a large proportion of the number of days out of role across a wide range of countries and should be addressed to substantially increase overall productivity. Molecular Psychiatry (2011) 16, 1234-1246; doi:10.1038/mp.2010.101; published online 12 October 2010
Days out of role due to common physical and mental conditions: results from the WHO World Mental Health surveys
(2011) Alonso, J.; Petukhova, M.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Ustun, TB; Alhamzawi, A.O.; Viana, M.C.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C-y; Karam, E.G.; Kovess, V.; Levinson, D.; Medina-Mora, M.E.; Nakamura, Y.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K.M.; Tsang, A.; Williams, D.R.; Kessler, R.C.; Health Services Research Unit, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain; jalonso@imim.es
Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys
(2007) Scott, K.M.; Bruffaerts, R.; Tsang, A.; Ormel, J.; Alonso, J.; Angermeyer, M.C.; Benjet, C.; Bromet, E.; De Girolamo, G.; De Graaf, R.; Gasquet, I.; Gureje, O.; Haro, J.M.; He, Y.; Kessler, R.C.; Levinson, D.; Mneimneh, Z.N.; Oakley-Browne, M.A.; Posada-Villa, J.; Stein, D.J.; Takeshima, T.; Von-Korff, M.; Department of Psychological Medicine, Wellington School of Medicine and Health Sciences, PO Box 7343 Wellington South, New Zealand; kate.scott@otago.ac.nz
Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2013) Ahmedani, B.K.; Kubiak, S.P.; Kessler, R.C.; De Graaf, R.; Alonso, J.; Bruffaerts, R.; Zarkov, Z.; Viana, M.C.; Huang, Y.Q.; Hu, C.; Posada-Villa, J.A.; Lepine, J.P.; Angermeyer, M.C.; De Girolamo, G.; Karam, A.N.; Medina-Mora, M.E.; Gureje, O.; Ferry, F.; Sagar, R.; Anthony, J.C.; Henry Ford Hlth Syst, Ctr Hlth Policy & Hlth Serv Res, 1 Ford Pl,Suite 3A, Detroit, MI 48202 USA.; bahmeda1@hfhs.org
Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys
(2013) Viana, M.C.; Gruber, M.J.; Shahly, V.; Alhamzawi, A.; Alonso, J.; Andrade, L.H.; Angermeyer, M.C.; Benjet, C.; Bruffaerts, R.; Caldas-de-Almeida, J.M.; De Girolamo, G.; De Jonge, P.; Ferry, F.; Florescu, S.; Gureje, O.; Haro, J.M.; Hinkov, H.; Hu, C.; Karam, E.G.; Lépine, J.P.; Levinson, D.; Posada-Villa, J.; Sampson, N.A.; Kessler, R.C.; Department of Social Medicine, Universidade Federal do Espirito Santo (UFES); mcviana@uol.com.br
Gender and the relationship between marital status and first onset of mood, anxiety and substance use disorders
(London : Cambridge University Press, 2010) Scott, K.M.; Wells, J.E.; Angermeyer, M.; Brugha, T.S.; Bromet, E.; Demyttenaere, K.; De Girolamo, G.; Gureje, O.; Haro, J.M.; Jin, R.; Nasser Karam, A.; Kovess, V.; Lara, C.; Levinson, D.; Ormel, J.; Posada-Villa, J.; Sampson, N.; Takeshima, T.; Zhang, M.; Kessler, R.C.; Department of Psychological Medicine, University of Otago, Wellington, New Zealand; kate.scott@otago.ac.nz
Implications of modifying the duration requirement of generalized anxiety disorder in developed and developing countries
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2009) Lee, S.; Tsang, A.; Ruscio, A.M.; Haro, J.M.; Stein, D.J.; Alonso, J.; Angermeyer, M.C.; Bromet, E.J.; Demyttenaere, K.; De Girolamo, G.; De Graaf, R.; Gureje, O.; Iwata, N.; Karam, E.G.; Lepine, J.P.; Levinson, D.; Medina-Mora, M.E.; Oakley Browne, M.A.; Posada-Villa, J.; Kessler, R.C.; Chinese Univ Hong Kong, Dept Psychiat, Hong Kong Mood Disorders Ctr, Hong Kong, Hong Kong, Peoples R China; singlee@cuhk.edu.hk
Background. A number of western studies have suggested that the 6-month duration requirement of generalized anxiety disorder (GAD) does not represent a critical threshold in terms of onset, course, or risk factors of the disorder. No study has examined the consequences of modifying the duration requirement across a wide range of correlates in both developed and developing countries. Method. Population surveys were carried out in seven developing and 10 developed countries using the WHO Composite International Diagnostic Interview (total sample=85052). prevalence and correlates of GAD were compared across mutually exclusive GAD subgroups defined by different minimum duration criteria. Results. Lifetime prevalence estimates for GAD lasting I month, 3 months, 6 months and 12 months were 7.5%, 5.2%, 4.1% and 3.0% for developed countries and 2.7%, 1.8%, 1.5% and 1.2% for developing countries, respectively. There was little difference between GAD of 6 months' duration and GAD of shorter durations (1-2 months, 3-5 months) in age of onset, symptom severity or persistence, co-morbidity or impairment. GAD lasting >= 12 months was the most severe, persistently symptomatic and impaired subgroup. Conclusions. In both developed and developing countries, the clinical profile of GAD is similar regardless of duration. The DSM-IV 6-month duration criterion excludes a large number of individuals who present with shorter generalized anxiety episodes which may be recurrent, impairing and contributory to treatment-seeking. Future iterations of the DSM and ICD should consider modifying the 6-month duration criterion so as to better capture the diversity of clinically salient anxiety presentations.
Including information about co-morbidity in estimates of disease burden: results from the World Health Organization World Mental Health Surveys
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2011) Alonso, J.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Schoenbaum, M.; Uestuen, T. Bedirhan; Rojas-Farreras, S.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Gureje, O.; Haro, J.M.; Karam, A.N.; Kovess, V.; Levinson, D.; Liu, Z.; Medina-Mora, M.E.; Ormel, J.; Posada-Villa, J.; Uda, H.; Kessler, R.C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; Kessler@hcp.med.harvard.edu
Background. The methodology commonly used to estimate disease burden, featuring ratings of severity of individual conditions, has been criticized for ignoring co-morbidity. A methodology that addresses this problem is proposed and illustrated here with data from the World Health Organization World Mental Health Surveys. Although the analysis is based on self-reports about one's own conditions in a community survey, the logic applies equally well to analysis of hypothetical vignettes describing co-morbid condition profiles. Method. Face-to-face interviews in 13 countries (six developing, nine developed; n = 31 067; response rate = 69.6%) assessed 10 classes of chronic physical and nine of mental conditions. A visual analog scale (VAS) was used to assess overall perceived health. Multiple regression analysis with interactions for co-morbidity was used to estimate associations of conditions with VAS. Simulation was used to estimate condition-specific effects. Results. The best-fitting model included condition main effects and interactions of types by numbers of conditions. Neurological conditions, insomnia and major depression were rated most severe. Adjustment for co-morbidity reduced condition-specific estimates with substantial between-condition variation (0.24-0.70 ratios of condition-specific estimates with and without adjustment for co-morbidity). The societal-level burden rankings were quite different from the individual-level rankings, with the highest societal-level rankings associated with conditions having high prevalence rather than high individual-level severity. Conclusions. Plausible estimates of disorder-specific effects on VAS can be obtained using methods that adjust for co-morbidity. These adjustments substantially influence condition-specific ratings.
Mental disorders among college students in the World Health Organization World Mental Health Surveys
(London : Cambridge University Press, 2016) Auerbach, R. P.; Alonso, J.; Axinn, W. G.; Cuijpers, P.; Ebert, D. D.; Green, J. G.; Hwang, I.; Kessler, R. C.; Liu, H.; Mortier, P.; Nock, M. K.; Pinder-Amaker, S.; Sampson, N. A.; Aguilar-Gaxiola, A.; Al-Hamzawi, A.; Andrade, L. H.; Benjet, C.; Caldas-de-Almeida, J. M.; Demyttenaere, K.; Florescu, S.; De Girolamo, G.; Gureje, O.; Haro, J. M.; Karam, E. G.; Kiejna, A.; Kovess-Masfety, V.; Lee, S.; McGrath, J. J.; O’Neill, S.; Pennell, B.-E.; Scott, K.; Ten Have, M.; Torres, Y.; Zaslavsky, A. M.; Zarkov, Z.; Bruffaerts, R.; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; kessler@hcp.med.harvard.edu
Mental disorders among persons with arthritis: results from the World Mental Health Surveys
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2008) He, Y.; Zhang, M.; Lin, E.H.B.; Bruffaerts, R.; Posada-Villa, J.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Uda, H.; Mneimneh, Z.; Benjet, C.; De Graaf, R.; Scott, K.M.; Gureje, O.; Seedat, S.; Haro, J.M.; Bromet, E.J.; Alonso, J.; Kovess, V.; Von Korff, M.; Kessler, R.; Shanghai Mental Hlth Ctr, Shanghai 200030, Peoples R China; heyl2001@yahoo.com.cn
Mental disorders and termination of education in high-income and low- and middle-income countries: epidemiological study
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2009) Lee, S.; Tsang, A.; Breslau, J.; Aguilar-Gaxiola, S.; Angermeyer, M.; Borges, G.; Bromet, E.; Bruffaerts, R.; De Girolamo, G.; Fayyad, J.; Gureje, O.; Haro, J.M.; Kawakami, N.; Levinson, D.; Browne, M.A. Oakley; Ormel, J.; Posada-Villa, J.; Williams, D.R.; Kessler, R.C.; Prince Wales Hosp, Hong Kong Mood Disorders Ctr, 7A,Block E,Staff Quarters, Shatin, Hong Kong, Peoples R China.; singlee@cuhk.edu.hk
Mental-physical co-morbidity and its relationship with disability: results from the World Mental Health Surveys
(CAMBRIDGE UNIV PRESS, 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA, 2009) Scott, K.M.; Von Korff, M.; Alonso, J.; Angermeyer, M.C.; Bromet, E.; Fayyad, J.; De Girolamo, G.; Demyttenaere, K.; Gasquet, I.; Gureje, O.; Haro, J.M.; He, Y.; Kessler, R.C.; Levinson, D.; Medina Mora, M.E.; Oakley Browne, M.; Ormel, J.; Posada-Villa, J.; Watanabe, M.; Williams, D.; Univ Otago, Dept Psychol Med, Wellington, New Zealand; kate.scott@otago.ac.nz
Background. The relationship between mental and physical disorders is well established, but there is less consensus as to the nature of their joint association with disability, in part because additive and interactive models of co-morbidity have not always been clearly differentiated in prior research. Method. Eighteen general population surveys were carried out among adults as part of the World Mental Health (WMH) Survey Initiative (n = 42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions (arthritis, heart disease, respiratory disease, chronic back/neck pain, chronic headache, and diabetes) were ascertained using a standard checklist. Severe disability was defined as on or above the 90th percentile of the WMH version of the World Health Organization Disability Assessment Schedule (WHODAS-II). Results. The odds of severe disability among those with both mental disorder and each of the physical conditions (with the exception of heart disease) were significantly greater than the sum of the odds of the single conditions. The evidence for synergy was model dependent: it was observed in the additive interaction models but not in models assessing multiplicative interactions. Mental disorders were more likely to be associated with severe disability than were the chronic physical conditions. Conclusions. This first cross-national study of the joint effect of mental and physical conditions on the probability of severe disability finds that co-morbidity exerts modest synergistic effects. Clinicians need to accord both mental and physical conditions equal priority, in order for co-morbidity to be adequately managed and disability reduced.
Obesity and mental disorders in the general population: results from the world mental health surveys
(NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND, 2008) Scott, K.M.; Bruffaerts, R.; Simon, G.E.; Alonso, J.; Angermeyer, M.; De Girolamo, G.; Demyttenaere, K.; Gasquet, I.; Haro, J.M.; Karam, E.; Kessler, R.C.; Levinson, D.; Medina Mora, M.E.; Browne, M.A. Oakley; Ormel, J.; Villa, J.P.; Uda, H.; Von Korff, M.; Univ Otago, Wellington Sch Med & Hlth Sci, Wellington, New Zealand; kate.scott@otago.ac.nz
Objectives: (1) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (2) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design: Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects: Household residing adults, 18 years and over (n = 62 277). Measurements: DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m(2) or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results: Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.5) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. Conclusions: The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population.