Browsing by Author "De Graaf, Ron"
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Item A comparative analysis of role attainment and impairment in binge-eating disorder and bulimia nervosa: Results from the WHO World Mental Health Surveys(2014) Kessler, Ronald C.; Shahly, Victoria; Hudson, James I.; Supina, Dylan; Berglund, Patricia A.; Chiu, Wai Tat; Gruber, Michael; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura Helena; Benjet, Corina; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia E.; Haro, Josep Maria; Murphy, Samuel D.; Posada-Villa, Jose; Scott, Kate; Xavier, Miguel; Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA. Tel. (617) 432-3587, Fax (617) 432-3588; Kessler@hcp.med.harvard.eduItem Alcohol abuse in developed and developing countries in the World Mental Health Surveys: socially defined consequences or psychiatric disorder?(2014) Glantz, Meyer D.; Medina‐Mora, Maria Elena; Petukhova, Maria; Andrade, Laura Helena; Anthony, James C.; De Girolamo, Giovanni; De Graaf, Ron; Degenhardt, Louisa; Demyttenaere, Koen; Florescu, Silvia; Gureje, Oye; FRCPsych; Haro, Josep Maria; Horiguchi, Itsuko; Karam, Elie G.; Kostyuchenko, Stanislav; Lee, Sing; Lépine, Jean‐Pierre; Matschinger, Herbert; Neumark, Yehuda; Posada‐Villa, Jose; Sagar, Rajesh; Stein, Dan J.; Tomov, Toma; Wells, J. Elisabeth; Chatterji, Somnath; Kessler, Ronald C.; Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MarylandItem Association of headache with childhood adversity and mental disorder: cross-national study(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London Swix 8PG, England, 2009) Lee, Sing; Tsang, Adley; Von Korff, Michael; De Graaf, Ron; Benjet, Corina; Haro, Josep Maria; Angermeyer, Matthias; Demyttenaere, Koen; De Girolamo, Giovanni; Gasquet, Isabelle; Merikangas, Kathleen; Posada-Villa, José; Takeshima, Tadashi; Kessler, Ronald C.; Chinese Univ Hong Kong, Dept Psychiat, Hong Kong Mood Disorders Ctr, Hong Kong, Hong Kong, Peoples R China; singlee@cuhk.edu.hkBackground: Community studies about the association of headache with both childhood family adversities and depression/anxiety disorders are limited. Aims: To assess the independent and joint associations of childhood family adversities and early-onset depression and anxiety disorders with risks of adult-onset headache. Method: Data were pooled from cross-sectional community surveys conducted in ten Latin and North American, European and Asian countries (n-18303) by using standardised instruments. Headache and a range of childhood family adversities were assessed by self-report. Results: The number of childhood family adversities was associated with adult-onset headache after adjusting for gender, age, country and early-onset depression/anxiety disorder status (for one adversity, hazard ratio (HR)=1.22-1.6; for two adversities, HR=11.19-1.67; for three or more adversities, HR=1.37-1.95). Early and Current onset of depression/anxiety disorders were independently associated (HR=1.42-1.89) with adult onset headache after controlling for number of childhood family adversities. Conclusions: The findings call for a broad developmental perspective concerning risk factors for development of headache.Item Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Levinson, Daphna; Lakoma, Matthew D.; Petukhova, María; Schoenbaum, Michael; Zaslavsky, Alan M.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Maria Haro, Josep; Hu, Chiyi; Karam, Aimee N.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Browne, Mark Oakley; Okoliyski, Michail; Posada-Villa, José; Sagar, Rajesh; Viana, María Carmen; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduBackground: Burden-of-illness data, which are often used in setting healthcare policy-spending priorities, are unavailable for mental disorders in most countries. Aims: To examine one central aspect of illness burden, the association of serious mental illness with earnings, in the World Health Organization (WHO) World Mental Health (WMH) Surveys. Method: The WMH Surveys were carried out in 10 high-income and 9 low- and middle-income countries. The associations of personal earnings with serious mental illness were estimated. Results: Respondents with serious mental illness earned on average a third less than median earnings, with no significant between-country differences (chi(2)(9)=5.5-8.1, P=0.5-0.79). These losses are equivalent to 0.3-0.8% of total national earnings. Reduced earnings among those with earnings and the increased probability of not earning are both important components of these associations: Conclusions: These results add to a growing body of evidence that mental disorders have high societal costs. Decisions about healthcare resource allocation should take these costs into consideration.Item Associations of serious mental illness with earnings: results from the WHO World Mental Health surveys(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Levinson, Daphna; Lakoma, Matthew D.; Petukhova, María; Schoenbaum, Michael; Zaslavsky, Alan M.; Angermeyer, Matthias; Borges, Guilherme; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Maria Haro, Josep; Hu, Chiyi; Karam, Aimee N.; Kawakami, Norito; Lee, Sing; Lepine, Jean-Pierre; Browne, Mark Oakley; Okoliyski, Michail; Posada-Villa, José; Sagar, Rajesh; Viana, María Carmen; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, 180 Longwood Ave, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduItem Childhood adversities as risk factors for onset and persistence of suicidal behaviour(2010) Bruffaerts, Ronny; Demyttenaere, Koen; Borges, Guilherme; Haro, Josep Maria; Chiu, Wai Tat; Hwang, Irving; Karam, Elie G.; Kessler, Ronald C.; Sampson, Nancy; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Horiguchi, Itsuko; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, Jose; Sagar, Rajesh; Scott, Kate; Tsang, Adley; Vassilev, Svetlozar M.; Williams, David R.; Nock, Matthew K.; permissions@rcpsych.ac.ukItem Childhood adversities as risk factors for onset and persistence of suicidal behaviour(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2010) Bruffaerts, Ronny; Demyttenaere, Koen; Borges, Guilherme; Maria Haro, Josep; Chiu, Wai Tat; Hwang, Irving; Karam, Elie G.; Kessler, Ronald C.; Sampson, Nancy; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias; Benjet, Corina; Bromet, Evelyn; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Horiguchi, Itsuko; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Sagar, Rajesh; Scott, Kate; Tsang, Adley; Vassilev, Svetlozar M.; Williams, David R.; Nock, Matthew K.; Univ Hosp Gasthuisberg, Dept Psychiat, B-3000 Louvain, Belgium; ronny.bruffaerts@med.kuleuven.beBackground: Suicide is a leading cause of death worldwide, but the precise effect of childhood adversities as risk factors for the onset and persistence of suicidal behaviour (suicide ideation, plans and attempts) are not well understood. Aims: To examine the associations between childhood adversities as risk factors for the onset and persistence of suicidal behaviour across 21 countries worldwide. Method: Respondents from nationally representative samples (n = 55 299) were interviewed regarding childhood adversities that occurred before the age of 18 years and lifetime suicidal behaviour. Results: Childhood adversities were associated with an increased risk of suicide attempt and ideation in both bivariate and multivariate models (odds ratio range 1.2-5.7). The risk increased with the number of adversities experienced, but at a decreasing rate. Sexual and physical abuse were consistently the strongest risk factors for both the onset and persistence of suicidal behaviour, especially during adolescence. Associations remained similar after additional adjustment for respondents' lifetime mental disorder status. Conclusions: Childhood adversities (especially intrusive or aggressive adversities) are powerful predictors of the onset and persistence of suicidal behaviours.Item Childhood Predictors of Adult Attention-Deficit/Hyperactivity Disorder: Results from the World Health Organization World Mental Health Survey Initiative(Cambridge Univ. Press, 32 Avenue of the Americas, New York, NY 10013-2473 USA, 2009) Lara, Carmen; Fayyad, John; De Graaf, Ron; Kessler, Ronald C.; Aguilar-Gaxiola, Sergio; Angermeyer, Matthias; Demytteneare, Koen; De Girolamo, Giovanni; Haro, Josep Maria; Jin, Robert; Karam, Elie G.; Lepine, Jean-Pierre; Medina Mora, María Elena; Ormel, Johan; Posada-Villa, José; Sampson, Nancy; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; laracan@imp.edu.mxBackground: Although it is known that childhood attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, childhood predictors of this persistence have not been widely studied. Methods: Childhood history of ADHD and adult ADHD were assessed in 10 countries in the World Health Organization World Mental Health Surveys. Logistic regression analysis was used to study associations of retrospectively reported childhood risk factors with adult persistence among the 629 adult respondents with childhood ADHD. Risk factors included age; sex; childhood ADHD symptom profiles, severity, and treatment; comorbid child/adolescent DSM-IV disorders; childhood family adversities; and child/adolescent exposure to traumatic events. Results: An average of 50% of children with ADHD (range: 32.8%-84.1% across countries) continued to meet DSM-IV criteria for ADHD as adults. Persistence was strongly related to childhood ADHD symptom profile (highest persistence associated with the attentional plus impulsive-hyperactive type, odds ratio [OR] = 12.4, compared with the lowest associated with the impulsive-hyperactive type), symptom severity (OR = 2.0), comorbid major depressive disorder (MDD; OR = 2.2), high comorbidity (>= 3 child/adolescent disorders in addition to ADHD; OR = 1.7), paternal (but not maternal) anxiety mood disorder (OR = 2.4), and parental antisocial personality disorder (OR = 2.2). A multivariate risk profile of these variables significantly predicts persistence of ADHD into adulthood (area under the receiving operator characteristic curve = .76). Conclusions: A substantial proportion of children with ADHD continue to meet full criteria for ADHD as adults. A multivariate risk index comprising variables that can be assessed in adolescence predicts persistence with good accuracy.Item Chronic Physical Conditions and Their Association With First Onset of Suicidal Behavior in the World Mental Health Surveys(LIPPINCOTT WILLIAMS & WILKINS, 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA, 2010) Scott, Kate M.; Hwang, Irving; Chiu, Wai-Tat; Kessler, Ronald C.; Sampson, Nancy A.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bruffaerts, Ronny; De Graaf, Ron; Florescu, Silvia; Fukao, Akira; Haro, Josep Maria; Hu, Chiyi; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Scocco, Paolo; Nock, Matthew K.; Univ Otago, Dept Psychol Med, Sch Med & Hlth Sci, Wellington, New Zealand; kate.scott@otago.ac.nzObjective: To investigate the association of a range of temporally prior physical conditions with the subsequent first onset of suicidal ideation, plans, and attempts in large, general population, cross-national sample. The associations between physical conditions and suicidal behavior remain unclear due to sparse data and varied methodology. Methods: Predictive associations between 13 temporally prior physical conditions and first onset of suicidal ideation, plans, and attempts were examined in a 14-country sample (n = 37,915) after controlling for demographic, socioeconomic, and psychosocial covariates, with and without adjustment for mental disorders. Results: Most physical conditions were associated with suicidal ideation in the total sample; high blood pressure, heart attack/stroke, arthritis, chronic headache, other chronic pain, and respiratory conditions were associated with attempts in the total sample; epilepsy, cancer, and heart attack/stroke were associated with planned attempts. Epilepsy was the physical condition most strongly associated with the suicidal outcomes. Physical conditions were especially predictive of suicidality if they occurred early in life. As the number of physical conditions increased, the risk of suicidal outcomes also increased, however the added risk conferred was generally smaller with each additional condition. Adjustment for mental disorders made little substantive difference to these results. Physical conditions were equally predictive of suicidality in higher and lower income countries. Conclusions: The presence of physical conditions is a risk factor for suicidal behavior even in the absence of mental disorder.Item Common chronic pain conditions in developed and developing countries: Gender and age differences and comorbidity with depression-anxiety disorders.(CHURCHILL LIVINGSTONE, JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE, LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND, 2008) Tsang, Adley; Von Korff, Michael; Lee, Sing; Alonso, Jordi; Karam, Elie; Angermeyer, Matthias C.; Borges, Guilherme Luiz Guimaraes; Bromet, Evelyn J.; De Girolamo, Giovanni; De Graaf, Ron; Gureje, Oye; Lepine, Jean-Pierre; Haro, Josep Maria; Levinson, Daphna; Oakley Browne, Mark A.; Posada-Villa, José; Seedat, Soraya; Watanabe, Makoto; Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, HKSAR, Hong Kong, PRC.; guibor@imp.edu.mxAlthough there is a growing body of research concerning the prevalence and correlates of chronic pain conditions and their association with mental disorders, cross-national research on age and gender differences is limited. The present study reports the prevalence by age and gender of common chronic pain conditions (headache, back or neck pain, arthritis or joint pain, and other chronic pain) in 10 developed and 7 developing countries and their association with the spectrum of both depressive and anxiety disorders. It draws on data from 18 general adult population surveys using a common survey questionnaire (N _ 42,249). Results show that age-standardized prevalence of chronic pain conditions in the previous 12 months was 37.3% in developed countries and 41.1% in developing countries, with back pain and headache being somewhat more common in developing than developed countries. After controlling for comorbid chronic physical diseases, several findings were consistent across developing and developed countries. There was a higher prevalence of chronic pain conditions among females and older persons; and chronic pain was similarly associated with depression-anxiety spectrum disorders in developed and developing countries. However, the large majority of persons reporting chronic pain did not meet criteria for depression or anxiety disorder. We conclude that common pain conditions affect a large percentage of persons in both developed and developing countries.Item Cross-National Analysis of the Associations among Mental Disorders and Suicidal Behavior: Findings from the WHO World Mental Health Surveys(PUBLIC LIBRARY SCIENCE, 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA, 2009) Nock, Matthew K.; Hwang, Irving; Sampson, Nancy; Kessler, Ronald C.; Angermeyer, Matthias; Beautrais, Annette; Borges, Guilherme; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Huang, Yueqin; Karam, Elie G.; Kawakami, Norito; Kovess, Viviane; Levinson, Daphna; Posada-Villa, José; Sagar, Rajesh; Tomov, Toma; Viana, María Carmen; Williams, David R.; Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA; nock@wjh.harvard.eduBackground: Suicide is a leading cause of death worldwide. Mental disorders are among the strongest predictors of suicide; however, little is known about which disorders are uniquely predictive of suicidal behavior, the extent to which disorders predict suicide attempts beyond their association with suicidal thoughts, and whether these associations are similar across developed and developing countries. This study was designed to test each of these questions with a focus on nonfatal suicide attempts. Methods and Findings: Data on the lifetime presence and age-of-onset of Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) mental disorders and nonfatal suicidal behaviors were collected via structured face-to-face interviews with 108,664 respondents from 21 countries participating in the WHO World Mental Health Surveys. The results show that each lifetime disorder examined significantly predicts the subsequent first onset of suicide attempt (odds ratios [ORs] = 2.9-8.9). After controlling for comorbidity, these associations decreased substantially (ORs = 1.5-5.6) but remained significant in most cases. Overall, mental disorders were equally predictive in developed and developing countries, with a key difference being that the strongest predictors of suicide attempts in developed countries were mood disorders, whereas in developing countries impulse-control, substance use, and post-traumatic stress disorders were most predictive. Disaggregation of the associations between mental disorders and nonfatal suicide attempts showed that these associations are largely due to disorders predicting the onset of suicidal thoughts rather than predicting progression from thoughts to attempts. In the few instances where mental disorders predicted the transition from suicidal thoughts to attempts, the significant disorders are characterized by anxiety and poor impulse-control. The limitations of this study include the use of retrospective self-reports of lifetime occurrence and age-of-onset of mental disorders and suicidal behaviors, as well as the narrow focus on mental disorders as predictors of nonfatal suicidal behaviors, each of which must be addressed in future studies. Conclusions: This study found that a wide range of mental disorders increased the odds of experiencing suicide ideation. However, after controlling for psychiatric comorbidity, only disorders characterized by anxiety and poor impulse-control predict which people with suicide ideation act on such thoughts. These findings provide a more fine-grained understanding of the associations between mental disorders and subsequent suicidal behavior than previously available and indicate that mental disorders predict suicidal behaviors similarly in both developed and developing countries. Future research is needed to delineate the mechanisms through which people come to think about suicide and subsequently progress from ideation to attempts.Item Cross-National Comparisons of Sex Differences in Opportunities to Use Alcohol or Drugs, and the Transitions to Use(INFORMA HEALTHCARE, TELEPHONE HOUSE, 69-77 PAUL STREET, LONDON EC2A 4LQ, ENGLAND, 2011) Wells, J. Elisabeth; Maria Haro, Josep; Karam, Eli; Lee, Sing; Lepine, Jean-Pierre; Medina-Mora, Ma. Elena; Nakane, Hideyuki; Posada, José; Anthony, James C.; Cheng, Hui; Degenhardt, Louisa; Angermeyer, Matthias; Bruffaerts, Ronny; De Girolamo, Giovanni; De Graaf, Ron; Glantz, Meyer; Gureje, Oye; Univ Otago, Dept Publ Hlth & Gen Practice, Christchurch Mail Ctr, Christchurch 8140, New Zealand; elisabeth.wells@otago.ac.nzSex differences in opportunities to use alcohol or drugs, and transition to use, were investigated in 15 surveys, in 2001--2004 (Europe 6; Americas 3; Africa 2, Asia 3; Oceania 1). The paper focuses on 18--29 year olds (N == 9,873). The World Mental Health Survey Initiative oversaw the surveys; each country obtained its own funding. A complex picture emerged with different results for alcohol and for drugs and for opportunity to use and the transition to use. Sex differences in opportunity to use alcohol were small except in Lebanon and Nigeria, whereas for drugs, the largest differences were in Mexico and ColombiaItem Cross-national epidemiology of DSM-IV major depressive episode(BIOMED CENTRAL LTD, 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND, 2011) Bromet, Evelyn; Andrade, Laura Helena; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; De Girolamo, Giovanni; De Graaf, Ron; Demyttenaere, Koen; Hu, Chiyi; Iwata, Noboru; Karam, Aimee N.; Kaur, Jagdish; Kostyuchenko, Stanislav; Lepine, Jean-Pierre; Levinson, Daphna; Matschinger, Herbert; Medina Mora, María Elena; Browne, Mark Oakley; Posada-Villa, José; Viana, María Carmen; Williams, David R.; Kessler, Ronald C.; SUNY Stony Brook, Dept Psychiat, Stony Brook, NY 11794 USA; ebromet@notes.cc.sunysb.eduBackground: Major depression is one of the leading causes of disability worldwide, yet epidemiologic data are not available for many countries, particularly low- to middle-income countries. In this paper, we present data on the prevalence, impairment and demographic correlates of depression from 18 high and low-to middle-income countries in the World Mental Health Survey Initiative. Methods: Major depressive episodes (MDE) as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DMS-IV) were evaluated in face-to-face interviews using the World Health Organization Composite International Diagnostic Interview (CIDI). Data from 18 countries were analyzed in this report (n = 89,037). All countries surveyed representative, population-based samples of adults. Results: The average lifetime and 12-month prevalence estimates of DSM-IV MDE were 14.6% and 5.5% in the ten high-income and 11.1% and 5.9% in the eight low- to middle-income countries. The average age of onset ascertained retrospectively was 25.7 in the high-income and 24.0 in low- to middle-income countries. Functional impairment was associated with recency of MDE. The female: male ratio was about 2: 1. In high-income countries, younger age was associated with higher 12-month prevalence; by contrast, in several low-to middle-income countries, older age was associated with greater likelihood of MDE. The strongest demographic correlate in high-income countries was being separated from a partner, and in low- to middle-income countries, was being divorced or widowed. Conclusions: MDE is a significant public-health concern across all regions of the world and is strongly linked to social conditions. Future research is needed to investigate the combination of demographic risk factors that are most strongly associated with MDE in the specific countries included in the WMH.Item Cross-national prevalence and risk factors for suicidal ideation, plans and attempts(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2008) Nock, Matthew K.; Borges, Guilherme; Bromet, Evelyn J.; Alonso, Jordi; Angermeyer, Matthias; Beautrais, Annette; Bruffaerts, Ronny; Chiu, Wai Tat; De Girolamo, Giovanni; Gluzman, Semyon; De Graaf, Ron; Gureje, Oye; Haro, Josep Maria; Huang, Yueqin; Karam, Elie; Kessler, Ronald C.; Lepine, Jean Pierre; Levinson, Daphna; Medina-Mora, María Elena; Ono, Yutaka; Posada-Villa, José; Williams, David; Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA; nock@wjh.harvard.eduBackground: Suicide is a leading cause of death worldwide; however, the prevalence and risk factors for the immediate precursors to suicide - suicidal ideation, plans and attempts - are not well-known, especially in low- and middle-income countries. Aims: To report on the prevalence and risk factors for suicidal behaviours across 17 countries. Method: A total of 84850 adults were interviewed regarding suicidal behaviours and socio-demographic and psychiatric risk factors. Results: The cross-national lifetime prevalence of suicidal ideation, plans, and attempts is 9.2% (s.e.=0.1), 3.1% (s.e.=0.1), and 2.7% (s.e.=0.1). Across all countries, 60% of transitions from ideation to plan and attempt occur within the first year after ideation onset. Consistent cross-national risk factors included being female, younger, less educated, unmarried and having a mental disorder. interestingly, the strongest diagnostic risk factors were mood disorders in high-income countries but impulse control disorders in low- and middle-income countries. Conclusion: There is cross-national variability in the prevalence of suicidal behaviours, but strong consistency in the characteristics and risk factors for these behaviours. These findings have significant implications for the prediction and prevention of suicidal behaviours. Declaration of interests: None. Funding detailed in Acknowledgements.Item Cumulative traumas and risk thresholds: 12-month ptsd in the world mental health (WMH) surveys(2014) Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; De Girolamo, Giovanni; De Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne Oakley, Mark A.; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.; Department of Psychiatry and Clinical Psychology, Institute for Development, Research, Advocacy, and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon; kck5@mail.cumc.columbia.eduItem Development of lifetime comorbidity in the WHO World Mental Health (WMH) Surveys(2011) Kessler, Ronald C.; Ormel, Johan; Petukhova, Maria; McLaughlin, Katie A.; Greif Green, Jennifer; Russo, Leo J.; Stein, Dan J.; Zaslavsky, Alan M; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura; Benjet, Corina; De Girolamo, Giovanni; De Graaf, Ron; Demyttenaere, Koen; Fayyad, John; Haro, Josep Maria; Hu, Chi yi; Karam, Aimee; Lee, Sing; Lepine, Jean-Pierre; Matchsinger, Herbert; Mihaescu-Pintia, Constanta; Posada-Villa, Jose; Sagar, Rajesh; Üstün, Bedirhan; Department of Health Care Policy, Harvard Medical School, Boston, MA USA; kessler@hcp.med.harvard.eduItem Development of Lifetime Comorbidity in the World Health Organization World Mental Health Surveys(AMER MEDICAL ASSOC, 515 N STATE ST, CHICAGO, IL 60610-0946 USA, 2011) Kessler, Ronald C.; Ormel, Johan; Petukhova, María; McLaughlin, Katie A.; Green, Jennifer Greif; Russo, Leo J.; Stein, Dan J.; Zaslavsky, Alan M.; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Andrade, Laura; Benjet, Corina; De Girolamo, Giovanni; De Graaf, Ron; Demyttenaere, Koen; Fayyad, John; Haro, Josep Maria; Hu, Chi Yi; Karam, Aimee; Lee, Sing; Lepine, Jean-Pierre; Matchsinger, Herbert; Mihaescu-Pintia, Constanta; Posada-Villa, José; Sagar, Rajesh; Uestuen, T. Bedirhan; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduContext: Although numerous studies have examined the role of latent variables in the structure of comorbidity among mental disorders, none has examined their role in the development of comorbidity. Objective: To study the role of latent variables in the development of comorbidity among 18 lifetime DSM-IV disorders in the World Health Organization World Mental Health Surveys. Design: Nationally or regionally representative community surveys. Setting: Fourteen countries. Participants: A total of 21 229 survey respondents. Main Outcome Measures: First onset of 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders assessed retrospectively in the World Health Organization Composite International Diagnostic Interview. Results: Separate internalizing (anxiety and mood disorders) and externalizing (behavior and substance disorders) factors were found in exploratory factor analysis of lifetime disorders. Consistently significant positive time-lagged associations were found in survival analyses for virtually all temporally primary lifetime disorders predicting subsequent onset of other disorders. Within-domain (ie, internalizing or externalizing) associations were generally stronger than between-domain associations. Most time-lagged associations were explained by a model that assumed the existence of mediating latent internalizing and externalizing variables. Specific phobia and obsessive-compulsive disorder (internalizing) and hyperactivity and oppositional defiant disorders (externalizing) were the most important predictors. A small number of residual associations remained significant after controlling the latent variables. Conclusions: The good fit of the latent variable model suggests that common causal pathways account for most of the comorbidity among the disorders considered herein. These common pathways should be the focus of future research on the development of comorbidity, although several important pairwise associations that cannot be accounted for by latent variables also exist that warrant further focused study.Item Drop out from out-patient mental healthcare in the World Health Organization's World Mental Health Survey initiative(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London SW1X 8PG, England, 2013) Wells, J. Elisabeth; Browne, Mark Oakley; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Alonso, Jordi; Angermeyer, Matthias C.; Bouzan, Colleen; Bruffaerts, Ronny; Bunting, Brendan; Caldas-de-Almeida, Jose Miguel; De Girolamo, Giovanni; De Graaf, Ron; Florescu, Silvia; Fukao, Akira; Gureje, Oye; Hinkov, Hristo Ruskov; Hu, Chiyi; Hwang, Irving; Karam, Elie G.; Kostyuchenko, Stanislav; Kovess-Masfety, Viviane; Levinson, Daphna; Liu, Zhaorui; Medina-Mora, Maria Elena; Nizamie, S. Hague; Posada-Villa, Jose; Sampson, Nancy A.; Stein, Dan J.; Viana, Maria Carmen; Kessler, Ronald C.; Univ Otago, Dept Publ Hlth & Gen Practice, Christchurch 8140, New Zealand; elisabeth.wells@otago.ac.nzItem DSM-IV personality disorders in the WHO World Mental Health Surveys(Royal College of Psychiatrists, British Journal of Psychiatry 17 Belgrave Square, London SW1X 8PG, England, 2009) Huang, Yueqin; Kotov, Roman; De Girolamo, Giovanni; Preti, Antonio; Angermeyer, Matthias; Benjet, Corina; Demyttenaere, Koen; De Graaf, Ron; Gureje, Oye; Karam, Aimee Nasser; Lee, Sing; Lepine, Jean Pierre; Matschinger, Herbert; Posada-Villa, José; Suliman, Sharain; Vilagut, Gemma; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.eduBackground: Little is known about the cross-national population prevalence or correlates of personality disorders. Aims: To estimate prevalence and correlates of DSM-IV personality disorder clusters in the World Health organization World Mental Health (WMH) Surveys. Method: International Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses. Prevalence and correlates were estimated using multiple imputation. Results: Prevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and 3.6% (s.e.= 0.3), 1.5% (s.e.= 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B and C respectively. Personality disorders are significantly elevated among males, the previously married (Cluster C), unemployed (Cluster C), the young (Clusters A and B) and the poorly educated. Personality disorders are highly comorbid with Axis I disorders. Impairments associated with personality disorders are only partially explained by comorbidity. Conclusions: Personality disorders are relatively common disorders that often co-occur with Axis I disorders and are associated with significant role impairments beyond those due to comorbidity.Item Early Cannabis Use and Estimated Risk of Later Onset of Depression Spells: Epidemiologic Evidence From the Population-based World Health Organization World Mental Health Survey Initiative(Cary, NC : Oxford University Press, 2010) De Graaf, Ron; Radovanovic, Mirjana; van Laar, Margriet; Fairman, Brian; Degenhardt, Louisa; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; de Girolamo, Giovanni; Fayyad, John; Gureje, Oye; Maria Haro, María; Huang , Yueqin; Kostychenko, Stanislav; Lépine, Jean-Pierre; Matschinger, Herbert; Medina Mora, María Elena; Neumark , Yehuda; Ormel, Johan; Posada-Villa, Jose; Stein, Dan J.; Tachimori, Hisateru; Wells, J. Elisabeth; Anthony, James C.; Netherlands Institute of Mental Health and Addiction; rgraaf@trimbos.nl
