Artículos de revista

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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.
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    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.
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    Psychiatric disorders in Mexico: lifetime prevalence in a nationally representative sample
    (ROYAL COLLEGE OF PSYCHIATRISTS, BRITISH JOURNAL OF PSYCHIATRY 17 BELGRAVE SQUARE, LONDON SW1X 8PG, ENGLAND, 2007) Medina-Mora, María Elena; Borges, Guilherme; Benjet, Corina; Lara, Carmen; Berglund, Patricia; Inst Nacl Psiquiatria, Dept Invest Epidemiol, Direcc Invest Epidemiol & Psicosociales, Calzada Mexico Xochimilco 101, Mexico City 14370, DF, Mexico.; medinam@imp.edu.mx
    Background No national data on lifetime prevalence and risk factors for DSM-IV psychiatric disorders are available in Mexico. Aims To present data on lifetime prevalence and projected lifetime risk, age at onset and demographic correlates of DSM-IV psychiatric disorders assessed in the Mexican National Comorbidity Survey. Method The survey was based on a multistage area probability sample of non-institutionalised people aged 18-65 years in urban Mexico. The World Mental Health Survey version of the Composite international Diagnostic Interview was administered by lay interviewers. Results Of those surveyed, 26.1% had experienced at least one psychiatric disorder in their life and 36.4% of Mexicans will eventually experience one of these disorders, Half of the population who present with a psychiatric disorder do so by the age of 21 and younger cohorts are at greater risk for most disorders. Conclusions Our results suggest an urgent need to re-evaluate the resources allocated for the detection and treatment of psychiatric illnesses in Mexico. Declaration of interest None. Funding detailed in Acknowledgements.