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Title: Transdiagnostic development of internalizing psychopathology throughout the life course up to age 45: a World Mental Health Surveys report
Authors: de Vries, Ymkje Anna
Al-Hamzawi, Ali
Alonso, Jordi
Andrade, Laura Helena
Benjet, Corina
Bruffaerts, Ronny
Bunting, Brendan
de Girolamo, Giovanni
Florescu, Silvia
Gureje, Oye
Haro, Josep Maria
Karam, Aimee
Kawakami, Norito
Kovess-Masfety, Viviane
Lee, Sing
Mneimneh, Zeina
Navarro-Mateu, Fernando
Ojagbemi, Akin
Posada-Villa, José
Scott, Kate
Stagnaro, Juan Carlos
Torres, Yolanda
Xavier, Miguel
Zarkov, Zahari N
Kessler, Ronald C
de Jonge, Peter
Karam, Elie
Affiliations: Faculty of Medicine 
Keywords: Anxiety disorders
Internalizing disorders
Latent class growth analysis
Issue Date: 2022-08
Part of: Psychological Medicine
Volume: 52
Issue: 11
Start page: 2134
End page: 2143
Depressive and anxiety disorders are highly comorbid, which has been theorized to be due to an underlying internalizing vulnerability. We aimed to identify groups of participants with differing vulnerabilities by examining the course of internalizing psychopathology up to age 45.

We used data from 24158 participants (aged 45+) in 23 population-based cross-sectional World Mental Health Surveys. Internalizing disorders were assessed with the Composite International Diagnostic Interview (CIDI). We applied latent class growth analysis (LCGA) and investigated the characteristics of identified classes using logistic or linear regression.

The best-fitting LCGA solution identified eight classes: a healthy class (81.9%), three childhood-onset classes with mild (3.7%), moderate (2.0%), or severe (1.1%) internalizing comorbidity, two puberty-onset classes with mild (4.0%) or moderate (1.4%) comorbidity, and two adult-onset classes with mild comorbidity (2.7% and 3.2%). The childhood-onset severe class had particularly unfavorable sociodemographic outcomes compared to the healthy class, with increased risks of being never or previously married (OR = 2.2 and 2.0, p < 0.001), not being employed (OR = 3.5, p < 0.001), and having a low/low-average income (OR = 2.2, p < 0.001). Moderate or severe (v. mild) comorbidity was associated with 12-month internalizing disorders (OR = 1.9 and 4.8, p < 0.001), disability (B = 1.1–2.3, p < 0.001), and suicidal ideation (OR = 4.2, p < 0.001 for severe comorbidity only). Adult (v. childhood) onset was associated with lower rates of 12-month internalizing disorders (OR = 0.2, p < 0.001).

We identified eight transdiagnostic trajectories of internalizing psychopathology. Unfavorable outcomes were concentrated in the 1% of participants with childhood onset and severe comorbidity. Early identification of this group may offer opportunities for preventive interventions.
ISSN: 00332917
DOI: 10.1017/S0033291720004031
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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