Mental disorders, comorbidities, and suicidality at 30 years of age in a Brazilian birth cohort.
Comorbidity
Public mental health
Suicide
Journal
Comprehensive psychiatry
ISSN: 1532-8384
Titre abrégé: Compr Psychiatry
Pays: United States
ID NLM: 0372612
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
19
07
2019
revised:
02
07
2020
accepted:
10
07
2020
pubmed:
31
7
2020
medline:
22
12
2020
entrez:
31
7
2020
Statut:
ppublish
Résumé
Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality. In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview. Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality. We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up. MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.
Sections du résumé
BACKGROUND
Studies on mental disorders prevalence and comorbidity, including suicidality, are scarce in low and middle-income settings. We aimed to describe the pattern of comorbidity between mental disorders and their association with suicidality.
METHODS
In 1982, all hospital deliveries in Pelotas (Southern Brazil) were identified (n = 5914) and have been prospectively followed. Participants were evaluated for the presence of common mental disorders (CMD) at the ages of 18-19, 23 and 30 years. In 2012-13 (30 years of age), trained psychologists evaluated 3657 individuals for disorders using the Mini International Neuropsychiatric Interview.
RESULTS
Prevalence of suicidal wishing, suicidal planning and lifetime suicidal attempt was 4.9%, 3.8% and 6.6%, respectively. Suicidal wishing was most strongly associated with having joint major depressive episode (MD) and lifetime suicidal attempt (OR = 26.4, 95%CI:13.9-50.4) with comorbid MD with mania/hypomania (OR = 21.2, 95%CI:6.93-65.1). Suicidal planning was most strongly associated with having joint MD and lifetime suicidal attempt (OR = 44.7, 95%CI:22.6-88.4), with comorbid MD and social anxiety disorder (OR = 30.6, 95%CI:13.0-72.0), and joint social anxiety disorder with lifetime suicidal attempt (OR = 26.3, 95%CI:8.33-82.7). Independently of other disorders, prospective and cross-sectional measures of CMD were associated with higher rates of suicidality.
LIMITATIONS
We do not have data on suicide deaths in follow-up and the diagnostic instrument used at 30 years of age was not used in all previous follow-up.
CONCLUSION
MD and social anxiety have independent and combined associations with suicidality, and also with they occur with lifetime suicidal attempt and other mental disorders.
Identifiants
pubmed: 32730959
pii: S0010-440X(20)30036-5
doi: 10.1016/j.comppsych.2020.152194
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
152194Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Informations de copyright
Copyright © 2020. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None declared.