期刊
DEPRESSION AND ANXIETY
卷 28, 期 1, 页码 29-39出版社
WILEY-LISS
DOI: 10.1002/da.20760
关键词
anxiety disorders; comorbidity; epidemiology; epidemiologic methods
资金
- National Institute of Mental Health (NIMH) [R01MH46376, R01-MH070884, R13-MH066849, R01-MH069864, R01-MH077883, U01-MH60220, R01-MH66627, U01MH060220-0951]
- National Institute on Drug Abuse (NIDA) [R01DA012058, R01-DA016558]
- Robert Wood Johnson Foundation (RWJF) [044780]
- National Institutes of Health [FIRCA R03-TW006481]
- Substance Abuse and Mental Health Services Administration (SAMHSA)
- John W. Alden Trust
- Shire Pharmaceuticals
- Canadian Research Chair
- Canadian Institutes of Health Research
- John D. and Catherine T. MacArthur Foundation
- Pfizer Foundation
- Pan American Health Organization
- Astra Zeneca
- BristolMyersSquibb
- Eli Lilly and Company
- GlaxoSmithKline
- Ortho-McNeil
- Pfizer
- Sanofi-Aventis
- Shire, and Wyeth
- FOGARTY INTERNATIONAL CENTER [R03TW006481] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF MENTAL HEALTH [R13MH066849, R01MH069864, R01MH070884, U01MH060220, ZIAMH002781, R01MH046376, U13MH066849, R01MH077883, R01MH066627, ZIAMH002808] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [R01DA016558, R01DA012058, K05DA015799] Funding Source: NIH RePORTER
Background: Although numerous studies have examined the role of latent predispositions to internalizing and externalizing disorders in the structure of comorbidity among common mental disorders, none examined latent predispositions in predicting development of comorbidity. Methods: A novel method was used to study the role of latent variables in the development of comorbidity among lifetime DSM-IV disorders in the National Comorbidity Surveys. Broad preliminary findings are briefly presented to describe the method. The method used survival analysis to estimate time-lagged associations among 18 lifetime DSM-IV anxiety, mood, behavior, and substance disorders. A novel estimation approach examined the extent to which these predictive associations could be explained by latent canonical variables representing internalizing and externalizing disorders. Results: Consistently significant positive associations were found between temporally primary and secondary disorders. Within-domain time-lagged associations were generally stronger than between-domain associations. The vast majority of associations were explained by a model that assumed mediating effects of latent internalizing and externalizing variables, although the complexity of this model differed across samples. A number intriguing residual associations emerged that warrant further investigation. Conclusions: The good fit of the canonical model suggests that common causal pathways account for most comorbidity among the disorders considered. These common pathways should be the focus of future research on the development of comorbidity. However, the existence of several important residual associations shows that more is involved than simple mediation. The method developed to carry out these analyses provides a unique way to pinpoint these significant residual associations for subsequent focused study. Depression and Anxiety 28:29-39, 2011. 2011 (C) Wiley-Liss, Inc.
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