Observational studyEpidemiology and psychiatric sciences2020
Comorbidity within mental disorders: a comprehensive analysis based on 145 990 survey respondents from 27 countries.
Observational study in Epidemiology and psychiatric sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 8 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
123 citing papers in PubMed, 8 syntheses or guidelines pooled it, 225 citations in OpenAlex.
- Socioenvironmental determinants of polypharmacy in mental health disorders: a systematic review.BMC public health · 2026Pooled it
- A systematic review and meta-analysis of the prevalence of alcohol and other drug use and problematic use among people accessing mental health treatment in Australia.The Australian and New Zealand journal of psychiatry · 2025Pooled it
- Association between androgenetic alopecia and psychological well-being: a systematic review and meta-analysis.Frontiers in psychiatry · 2025Pooled it
- Pooled it
- Depression pathophysiology, risk prediction of recurrence and comorbid psychiatric disorders using genome-wide analyses.Nature medicine · 2023Pooled it
- A transdiagnostic network for psychiatric illness derived from atrophy and lesions.Nature human behaviour · 2023Pooled it
- Co-morbidity between mood and anxiety disorders: A systematic review and meta-analysis.Depression and anxiety · 2021Pooled it
- Genetic and Environmental Risk Factors for Intermittent Explosive Disorder, ADHD and Conduct Disorder: Shared and Unique Influences.Clinical psychology & psychotherapyPooled it
- Associations Between Transdiagnostic Psychological Processes and Global Symptom Severity Among Outpatients With Various Mental Disorders: A Cross-Sectional Study.Clinical psychology & psychotherapyTrial
- Peripheral blood DNA methylation partially reports on immune cell type composition in the frontal brain.Brain, behavior, & immunity - health · 2026Article
- Cerebellar Functional Alterations During Executive Functioning Are Associated With General Psychopathology in a Cross-Diagnostic Sample.Biological psychiatry. Cognitive neuroscience and neuroimaging · 2026Article
- Schizophrenia Spectrum Biomarkers Consortium: Establishment of a Biorepository for the Discovery of Quantitative Fluid Biomarkers.Schizophrenia bulletin · 2026Article
- Polygenic scores in psychiatric research and clinical practice.Medizinische Genetik : Mitteilungsblatt des Berufsverbandes Medizinische Genetik e.V · 2026Article
- Screening Performance of the DSM-5 Level 1 Cross-Cutting Symptom Measure to Detect Psychiatric Comorbidity Among Youth: A Community-Based Study.Early intervention in psychiatry · 2026Article
- Community health worker implementation of transdiagnostic evidence-based treatment in Spanish: protocol for refinement, implementation, and a feasibility pilot RCT.Implementation science communications · 2026Article
- Therapy after therapy: Entry rates into subsequent psychological treatment among patients receiving therapist-guided internet-delivered or face-to-face psychotherapy.The British journal of clinical psychology · 2026Article
- Knock down the first domino: in silico intervention for age-tailored prevention and treatment targets in adolescent mental health.European child & adolescent psychiatry · 2026Article
- Alterations in resting-state functional connectivity relate to psychopathology trajectories during emerging adolescence.JCPP advances · 2026Article
- Post-traumatic stress disorder.Nature reviews. Disease primers · 2026Review
- The Bonny Method of Guided Imagery and Music as a trauma-informed approach in eating disorder treatment: theoretical framework and case illustrations.Journal of eating disorders · 2026Article
63 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
42 authors at 20 institutions in 26 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsEpidemiological studies indicate that individuals with one type of mental disorder have an increased risk of subsequently developing other types of mental disorders. This study aimed to undertake a comprehensive analysis of pair-wise lifetime comorbidity across a range of common mental disorders based on a diverse range of population-based surveys.
methodsThe WHO World Mental Health (WMH) surveys assessed 145 990 adult respondents from 27 countries. Based on retrospectively-reported age-of-onset for 24 DSM-IV mental disorders, associations were examined between all 548 logically possible temporally-ordered disorder pairs. Overall and time-dependent hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models. Absolute risks were estimated using the product-limit method. Estimates were generated separately for men and women.
resultsEach prior lifetime mental disorder was associated with an increased risk of subsequent first onset of each other disorder. The median HR was 12.1 (mean = 14.4; range 5.2-110.8, interquartile range = 6.0-19.4). The HRs were most prominent between closely-related mental disorder types and in the first 1-2 years after the onset of the prior disorder. Although HRs declined with time since prior disorder, significantly elevated risk of subsequent comorbidity persisted for at least 15 years. Appreciable absolute risks of secondary disorders were found over time for many pairs.
conclusionsSurvey data from a range of sites confirms that comorbidity between mental disorders is common. Understanding the risks of temporally secondary disorders may help design practical programs for primary prevention of secondary disorders.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.