Population-Based Epidemiologic Research

National Institute Of Mental Health

Investigators

Linked publications, trials & patents

Abstract

During the past year we have conducted a number of studies addressing the aims above. Although the NCS-A survey was conducted 10 years ago, it remains the richest source of data on DSM mental disorders and risk factors in a nationally-representative sample of U.S. adolescents. During the past year, we conducted 3 studies of comorbidity in mental disorder. One investigated prior mental disorders as risk factors for transition between stages of alcohol and drug use and abuse/dependence (Conway et al, 2016). We found that both anxiety disorders and behavioral disorders were important predictors of progression, but that they operated at different stages in substance use. We have also investigated comorbidities between mental and physical disorders. We examined physical health comorbidities of ADHD in adolescents and found that allergies, asthma, enuresis, headache/migraine, and serious stomach or bowel problems were more common in those with ADHD (Jameson et al, 2016). We also documented the high burden of adverse social and economic consequences of those who have both migraine and PTSD among adults in the NCS-R (Rao et al, 2015). The Zurich Study is one of only a few longitudinal studies in psychiatric epidemiology that performed multiple diagnostic interviews in a community-based sample from young adulthood into middle age. In collaboration with our colleagues in Zurich, we have recently completed an analysis of the trajectory of mental disorder risk across ages 20 to 50 (Paksarian et al, in press). We found that trajectories differed between men and women. We also found that while very few people had persistent mental disorder across the entire age period studied, one trajectory that was consistently identified indicated high risk from the late 20s until the early 40s. Our collaboration with researchers at UPENN has continued through data analysis of the PNC study. In the past year we have published our findings regarding racial-ethnic disparities in sub-clinical psychosis (Paksarian et al, 2016). We found that ethnic minority youth were more likely to manifest sub-threshold psychosis symptoms than were non-Hispanic white youth. However, there was some indication that these associations differed between minority groups and were strongest for non-Hispanic black youth. In the past year we have continued to collaborate with researchers from the COLAUS study in Switzerland. We found support for the independence of familial aggregation of bipolar disorder from major depressive disorder and the heterogeneity of bipolar disorder based on patterns of onset (Preisig et al, 2016). Additionally, we assessed the associations between serum leptin and adiponectin levels and migraine or migraine subtypes and found that high leptin might be a contributing factor in the role of migraine and migraine with and without aura (Pisanu et al, in press). Public Health Impact: These studies provide valuable insight into the nature of mental disorders and their burden among children, adolescents, and adults across time. The NCS-A study was the first with comprehensive domains of emotional and behavior disorders in a nationally representative sample of U.S. youth, and the results have had significant public health impact. The PNC is also destined to become a high-impact project because it consists of a large, systematically obtained pediatric sample with enriched information from electronic medical records and direct interviews. Our studies of comorbidity in adolescents and youth, such as that between mental and substance use disorders or between sleep patterns and mental disorders, highlight the potential for identification of opportunities for intervention in adolescent mental health. The findings highlight the importance of capturing the roots of both physical and mental disorders in childhood in order to trace their evolution into chronic diseases causing major public health concerns. The Zurich Cohort Study is an extremely valuable data source, as it is the longest community-based longitudinal study in which participants were enrolled at the beginning of adulthood. Data on the frequency and persistence of mental disorders are important for planning interventions and service delivery as well as for research on etiology. Lastly, our work on the COLAUS study has substantial potential for public health impact because it combines information regarding cardiovascular risk factors and mental disorders in a longitudinal study. Given the major public health impact of both, the study of the mechanisms underlying their associations is of high clinical and scientific relevance. Our recent work represents only the beginning of a research program that we hope will help to tease apart the longitudinal relationships between physical and mental health in the population. Future Plans: We plan to continue to analyze these rich data sources, both within our research group and the NIMH, as well as to provide support to investigators outside the National Institutes of Health. We will continue to focus on the aims stated above when generating hypotheses and designing studies. Several important manuscripts are now in progress that will continue to provide knowledge about adolescent and adult mental health in the general population. We are currently focusing on the following areas: 1) mental-physical comorbidities among adolescents; 2) perinatal risk factors for emotional and behavior disorders; 3) the consistency of age-of-onset reports for mental disorders in general population samples; 4) disparities in mental disorder prevalence among adolescents based on race-ethnicity and immigrant status; and 5) psychosocial and health risk factors including sleep, activity and stress for emotional and behavior disorders.