Browsing by Author "Hwang, Irving"

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Age differences in the prevalence and comorbidity of DSM-IV major depressive episodes: Results from the WHO World Mental Health Survey Initiative
(2010) Kessler, Ronald C.; Birnbaum, Howard; Shahly, Victoria; Bromet, Evelyn; Hwang, Irving; McLaughlin, Katie A.; Sampson, Nancy; Andrade, Laura Helena; De Girolamo, Giovanni; Demyttenaere, Koen; Haro, Josep Maria; Karam, Aimee N.; Kostyuchenko, Stanislav; Kovess, Viviane; Lara, Carmen; Levinson, Daphna; Matschinger, Herbert; Nakane, Yoshibumi; Oakley Browne, Mark; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Stein, Dan J.; Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts; kessler@hcp.med.harvard.edu
Antidepressant use in low- middle- and high-income countries: a World Mental Health Surveys report
(Cambridge University Press, 2023) Kazdin, Alan E.; Wu, Chi Shin; Hwang, Irving; Puac-Polanco, Victor; Sampson, Nancy A.; Al-Hamzawi, Ali; Alonso, Jordi; Andrade, Laura Helena; Benjet, Corina; Caldas-de-Almeida, José-Miguel; Girolamo, Giovanni de; Jonge, Peter de; Florescu, Silvia; Gureje, Oye; Haro, Josep M.; Harris, Meredith G.; Karam, Elie G.; Karam, Georges; Kovess-Masfety, Viviane; Lee, Sing; McGrath, John J.; Navarro-Mateu, Fernando; Nishi, Daisuke; Oladeji, Bibilola D.; Posada-Villa, José; Stein, Dan J.; Üstün, T. Bedirhan; Vigo, Daniel V.; Zarkov, Zahari; Zaslavsky, Alan M.; Kessler, Ronald C.; the WHO World Mental Health Survey collaborators; Borges, Guilherme; Medina-Mora, María Elena; Department of Psychology, Yale University, New Haven, CT, USA; kessler@hcp.med.harvard.edu (Ronald C. Kessler)
Barriers to treatment for mental disorders in six countries of the Americas: a regional report from the World Mental Health Surveys
(Elsevier, 2022) Orozco, Ricardo; Vigo, Daniel; Benjet, Corina; Borges, Guilherme; Aguilar-Gaxiola, Sergio; Andrade, Laura H.; Cia, Alfredo; Hwang, Irving; Kessler, Ronald C.; Piazza, Marina; Posada-Villa, José; Rafful, Claudia; Sampson, Nancy; Stagnaro, Juan Carlos; Torres, Yolanda; Viana, María Carmen; Medina-Mora, María-Elena; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico; ric_oz@imp.edu.mx (R. Orozco)
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.uk
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.be
Background: 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.
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.nz
Objective: 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.
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.edu
Background: 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.
Cross-National Analysis of the Associations between Traumatic Events and Suicidal Behavior: Findings from the WHO World Mental Health Surveys
(PUBLIC LIBRARY SCIENCE, 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA, 2010) Stein, Dan J.; Chiu, Wai Tat; Hwang, Irving; Kessler, Ronald C.; Sampson, Nancy; Alonso, Jordi; Borges, Guilherme; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; He, Yanling; Kovess-Masfety, Viviane; Levinson, Daphna; Matschinger, Herbert; Mneimneh, Zeina; Nakamura, Yosikazu; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Scott, Kate M.; Tomov, Toma; Viana, María Carmen; Williams, David R.; Nock, Matthew K.; Groote Schuur Hosp, Dept Psychiat, ZA-7925 Cape Town, South Africa; Kessler@hcp.med.harvard.edu
Background: Community and clinical data have suggested there is an association between trauma exposure and suicidal behavior (i.e., suicide ideation, plans and attempts). However, few studies have assessed which traumas are uniquely predictive of: the first onset of suicidal behavior, the progression from suicide ideation to plans and attempts, or the persistence of each form of suicidal behavior over time. Moreover, few data are available on such associations in developing countries. The current study addresses each of these issues. Methodology/Principal Findings: Data on trauma exposure and subsequent first onset of suicidal behavior were collected via structured interviews conducted in the households of 102,245 (age 18+) respondents from 21 countries participating in the WHO World Mental Health Surveys. Bivariate and multivariate survival models tested the relationship between the type and number of traumatic events and subsequent suicidal behavior. A range of traumatic events are associated with suicidal behavior, with sexual and interpersonal violence consistently showing the strongest effects. There is a dose-response relationship between the number of traumatic events and suicide ideation/attempt; however, there is decay in the strength of the association with more events. Although a range of traumatic events are associated with the onset of suicide ideation, fewer events predict which people with suicide ideation progress to suicide plan and attempt, or the persistence of suicidal behavior over time. Associations generally are consistent across high-, middle-, and low-income countries. Conclusions/Significance: This study provides more detailed information than previously available on the relationship between traumatic events and suicidal behavior and indicates that this association is fairly consistent across developed and developing countries. These data reinforce the importance of psychological trauma as a major public health problem, and highlight the significance of screening for the presence and accumulation of traumatic exposures as a risk factor for suicide ideation and attempt.
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.edu
Background: 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.
Determinants of effective treatment coverage for major depressive disorder in the WHO World Mental Health Surveys
(BioMed Central, 2022) Vigo, Daniel V.; Kazdin, Alan E.; Sampson, Nancy A.; Hwang, Irving; Alonso, Jordi; Andrade, Laura Helena; Ayinde, Olatunde; Borges, Guilherme; Brufaerts, Ronny; Bunting, Brendan; Girolamo, Giovanni de; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Harris, Meredith G.; Karam, Elie G.; Karam, Georges; Koves-Masfety, Viviane; Lee, Sing; Navar-Mateu, Fernando; Posada-Villa, José; Scott, Kate; Stagnaro, Juan Carlos; Have, Margreet ten; Wu, Chi-Shin; Xavier, Miguel; Kessler, Ronald C.; Department of Psychiatry, University of British Columbia, UBC Hospital - Detwiller Pavilion, Room 2813, 2255 Wesbrook Mall, UBC Vancouver Campus, Vancouver, BC, V6T 2A1, Canada; daniel.vigo@ubc.ca
Determinants of effective treatment coverage for posttraumatic stress disorder: findings from the World Mental Health Surveys
(BioMed Central, 2023) Stein, Dan J.; Kazdin, Alan E.; Munthali, Richard J.; Hwang, Irving; Harris, Meredith G.; Alonso, Jordi; Andrade, Laura Helena; Brufaerts, Ronny; Cardoso, Graça; Chardoul, Stephanie; Girolamo, Giovanni de; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Karam, Aimee N.; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Medina-Mora, Maria Elena; Navarro-Mateu, Fernando; Posada-Villa, José; Stagnaro, Juan Carlos; Have, Margreet ten; Sampson, Nancy A.; Kessler, Ronald C.; Vigo, Daniel V.; WHO World Mental Health Survey Collaborators; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali; Alonso, Jordi; Altwaijri, Yasmin A.; Andrade, Laura Helena; Atwoli, Lukoye; Benjet, Corina; Borges, Guilherme; Bromet, Evelyn J.; Bruffaerts, Ronny; Bunting, Brendan; Caldas-de-Almeida, Jose Miguel; Cardoso, Graça; Chardoul, Stephanie; Chatterji, Somnath; Cia, Alfredo H.; Degenhardt, Louisa; Demyttenaere, Koen; Florescu, Silvia; Girolamo, Giovanni; Gureje, Oye; Haro, Josep Maria; Harris, Meredith G.; Hinkov, Hristo; Hu, Chi-Yi; Jonge, Peter de; Karam, Aimee Nasser; Karam, Elie G.; Karam, Georges; Kawakami, Norito; Kessler, Ronald C.; Kiejna, Andrzej; Kovess-Masfety, Viviane; Lee, Sing; Lepine, Jean-Pierre; McGrath, John J.; Moskalewicz, Jacek; Navarro-Mateu, Fernando; Piazza, Marina; Posada-Villa, Jose; Scott, Kate M.; Slade, Tim; Stagnaro, Juan Carlos; Stein, Dan J.; Have, Margreet ten; Torres, Yolanda; Viana, Maria Carmen; Vigo, Daniel V.; Whiteford, Harvey; Williams, David R.; Wojtyniak, Bogdan; Department of Psychiatry & Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa; dan.stein@uct.ac.za (Dan J. Stein)
Disability and treatment of specific mental and physical disorders across the world
(ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2008) Ormel, Johan; Petukhova, María; Chatterji, Somnath; Aguilar-Gaxiola, Sergio; Alonso, Jordi; Angermeyer, Matthias C.; Bromet, Evelyn J.; Burger, Huibert; Demyttenaere, Koen; De Girolamo, Giovanni; Maria Haro, Josep; Hwang, Irving; Karam, Elie; Kawakami, Norito; Lepine, Jean Pierre; Medina-Mora, María Elena; Posada-Villa, José; Sampson, Nancy; Scott, Kate; Uestuen, T. Bedirhan; Von Korff, Michael; Williams, David R.; Zhang, Mingyuan; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; kessler@hcp.med.harvard.edu
Background: Advocates of expanded mental health treatment assert that mental disorders are as disabling as physical disorders, but little evidence supports this assertion. Aims: To establish the disability and treatment of specific mental and physical disorders in high-income and low- and middle-income countries. Method: Community epidemiological surveys were administered in 15 countries through the World Health organization World Mental Health (WMH) Survey Initiative. Results: Respondents in both high-income and low- and middle-income countries attributed higher disability to mental disorders than to the commonly occurring physical disorders included in the surveys. This pattern held for all disorders and also for treated disorders. Disaggregation showed that the higher disability of mental than physical disorders was limited to disability in social and personal role functioning, whereas disability in productive role functioning was generally comparable for mental and physical disorders. Conclusions: Despite often higher disability, mental disorders are under-treated compared with physical disorders in both high-income and in low- and middle-income countries.
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.nz
Dropout from treatment for mental disorders in six countries of the Americas: a regional report from the World Mental Health Surveys
(Elsevier, 2022) Benjet, Corina; Borges, Guilherme; Orozco, Ricardo; Aguilar-Gaxiola, Sergio; Andrade, Laura H.; Cia, Alfredo; Hwang, Irving; Kessler, Ronald C.; Piazza, Marina; Posada-Villa, José; Sampson, Nancy; Stagnaro, Juan Carlos; Torres, Yolanda; Viana, María Carmen; Vigo, Daniel; Medina-Mora, María-Elena; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico; cbenjet@imp.edu.mx (C. Benjet)
Patterns of care and dropout rates from outpatient mental healthcare in low-, middle- and high-income countries from the World Health Organization's World Mental Health Survey Initiative
(Cambridge University Press, 2021) Fernández, Daniel; Vigo, Daniel; Sampson, Nancy A.; Hwang, Irving; Aguilar-Gaxiola, Sergio; Al-Hamzawi, Ali O.; Alonso, Jordi; Andrade, Laura Helena; Bromet, Evelyn J.; Girolamo, Giovanni de; Jonge, Peter de; Florescu, Silvia; Gureje, Oye; Hinkov, Hristo; Hu, Chiyi; Karam, Elie G.; Karam, Georges; Kawakami, Norito; Kiejna, Andrzrej; Kovess-Masfety, Viviane; Medina-Mora, Maria E.; Navarro-Mateu, Fernando; Ojagbemi, Akin; O'Neill, Siobhan; Piazza, Marina; Posada-Villa, Jose; Rapsey, Charlene; Williams, David R.; Xavier, Miguel; Ziv, Yuval; Kessler, Ronald C.; Haro, Josep M.; World Health Organization World Mental Health Survey collaborators; Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain.; Kessler@hcp.med.harvard.edu (Ronald C. Kessler)
Perceived helpfulness of service sectors used for mental and substance use disorders: findings from the WHO World Mental Health Surveys
(BioMed Central, 2022) Harris, Meredith G.; Kazdin, Alan E.; Munthali, Richard J.; Vigo, Daniel V.; Hwang, Irving; Sampson, Nancy A.; Al-Hamzawi, Ali; Alonso, Jordi; Andrade, Laura Helena; Borges, Guilherme; Bunting, Brendan; Florescu, Silvia; Gureje, Oye; Karam, Elie G.; Lee, Sing; Navarro-Mateu, Fernando; Nishi, Daisuke; Rapsey, Charlene; Scott, Kate M.; Stagnaro, Juan Carlos; Viana, Maria Carmen; Wojtyniak, Bogdan; Xavier, Miguel; Kessler, Ronald C.; School of Public Health, The University of Queensland, Level 2, Public Health Building (887), 288 Herston Road, Herston, QLD, 4006, Australia; meredith.harris@uq.edu.au
Psychiatric disorders, comorbidity, and suicidality in Mexico
(Elsevier Science BV, PO Box 211, 1000 AE Amsterdam, Netherlands, 2010) Borges, Guilherme; Nock, Matthew K.; Medina-Mora, María Elena; Hwang, Irving; Kessler, Ronald C.; Inst Nacl Psiquiatria Ramon de la Fuente, Direcc Invest Epidemiol & Psicosociales, Mexico City 14370, DF, Mexico; guibor@imp.edu.mx
Background: Prior studies have reported that psychiatric disorders are among the strongest predictors of suicidal behavior (i.e., suicide ideation, plans, and attempts). However, surprisingly little is known about the independent associations between each disorder and each suicidal behavior due to a failure to account for comorbidity. Methods: This study used data from a representative sample of 5782 respondents participating in the Mexican National Comorbidity Survey (2001-2002) to examine the unique associations between psychiatric disorders and suicidality. Results: A prior psychiatric disorder was present in 48.8% of those with a suicide ideation and in 65.2% of those with an attempt. Discrete-time survival models adjusting for comorbidity revealed that conduct disorder and alcohol abuse/dependence were the strongest predictors of a subsequent suicide attempt. Most disorders predicted suicidal ideation but few predicted the transition from ideation to a suicide plan or attempt. Limitations: M-NCS is a household survey that excluded homeless and institutionalized people, and the diagnostic instrument used did not include an assessment of all DSM-IV disorders which would increase the comorbidity discussed here. Conclusions: These results reveal a complex pattern of associations in which diverse psychiatric disorders impact different parts of the pathway to suicide attempts. These findings will help inform clinical and public health efforts aimed at suicide prevention in Mexico and other developing countries. (C) 2009 Elsevier B.V. All rights reserved.
Towards measuring efective coverage: critical bottlenecks in quality- and user-adjusted coverage for major depressive disorder in São Paulo metropolitan area, Brazil
(BioMed Central, 2023) Henriques Franca, Mariane; Bharat, Chrianna; Novello, Ercole; Hwang, Irving; Medina‑Mora, María Elena; Benjet, Corina; Andrade, Laura Helena; Vigo, Daniel V.; Viana, Maria Carmen; Post-Graduate Program in Public Health, Federal University of Espirito Santo, Vitória, ES, Brazil; marianehf@yahoo.com.br (Mariane Henriques Franca)
Twelve-Month Prevalence of and Risk Factors for Suicide Attempts in the World Health Organization World Mental Health Surveys
(PHYSICIANS POSTGRADUATE PRESS, P O BOX 752870, MEMPHIS, TN 38175-2870 USA, 2010) Borges, Guilherme; Nock, Matthew K.; Haro Abad, Josep M.; Hwang, Irving; Sampson, Nancy A.; Alonso, Jordi; Andrade, Laura Helena; Angermeyer, Matthias C.; Beautrais, Annette; Bromet, Evelyn; Bruffaerts, Ronny; De Girolamo, Giovanni; Florescu, Silvia; Gureje, Oye; Hu, Chiyi; Karam, Elie G.; Kovess-Masfety, Viviane; Lee, Sing; Levinson, Daphna; Medina-Mora, María Elena; Ormel, Johan; Posada-Villa, José; Sagar, Rajesh; Tomov, Toma; Uda, Hidenori; Williams, David R.; Kessler, Ronald C.; Harvard Univ, Sch Med, Dept Hlth Care Policy, Boston, MA 02115 USA; Kessler@hcp.med.harvard.edu
Objective: Although suicide is a leading cause of death worldwide, clinicians and researchers lack a data-driven method to assess the risk of suicide attempts. This study reports the results of an analysis of a large cross-national epidemiologic survey database that estimates the 12-month prevalence of suicidal behaviors, identifies risk factors for suicide attempts, and combines these factors to create a risk index for 12-month suicide attempts separately for developed and developing countries. Method: Data come from the World Health Organization (WHO) World Mental Health (WMH) Surveys (conducted 2001-2007), in which 108,705 adults from 21 countries were interviewed using the WHO Composite International Diagnostic Interview. The survey assessed suicidal behaviors and potential risk factors across multiple domains, including socio-demographic characteristics, parent psychopathology, childhood adversities, DSM-IV disorders, and history of suicidal behavior. Results: Twelve-month prevalence estimates of suicide ideation, plans, and attempts are 2.0%, 0.6%, and 0.3%, respectively, for developed countries and 2.1%, 0.7%, and 0.4%, respectively, for developing countries. Risk factors for suicidal behaviors in both developed and developing countries include female sex, younger age, lower education and income, unmarried status, unemployment, parent psychopathology, childhood adversities, and presence of diverse 12-month DSM-IV mental disorders. Combining risk factors from multiple domains produced risk indices that accurately predicted 12-month suicide attempts in both developed and developing countries (area under the receiver operating characteristic curve = 0.74-0.80). Conclusions: Suicidal behaviors occur at similar rates in both developed and developing countries. Risk indices assessing multiple domains can predict suicide attempts with fairly good accuracy and may be useful in aiding clinicians in the prediction of these behaviors. J Clin Psychiatry 2010;71(12):1617-1628 (C) Copyright 2010 Physicians Postgraduate Press, Inc.