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Papers by Koen Demyttenaere

Depression and Anxiety, Apr 1, 2010

Background: Although social anxiety disorder (SAD) is classified in the fourth edition of The Dia... more Background: Although social anxiety disorder (SAD) is classified in the fourth edition of The Diagnostic and Statistical Manual (DSM-IV) into generalized and non-generalized subtypes, community surveys in Western countries find no evidence of disjunctions in the dose-response relationship between number of social fears and outcomes to support this distinction. We aimed to determine whether this holds across a broader set of developed and developing countries, and whether subtyping according to number of performance versus interactional fears would be more useful. Methods: The World Health Organization's World Mental Health Survey Initiative undertook population epidemiological surveys in 11 developing and 9 developed countries, using the Composite International Diagnostic Interview to assess DSM-IV disorders. Fourteen performance and interactional fears were assessed.

Depression and Anxiety, Oct 24, 2016

Context-The scarcity of cross-national reports and the changes in DSM-5 regarding panic disorder ... more Context-The scarcity of cross-national reports and the changes in DSM-5 regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population. Objective-To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions. Design and Setting-Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0. Participants-Respondents (n=142,949) from 25 high, middle and lower-middle income countries across the world aged 18 years or older. Main Outcome Measures-PD and presence of single and recurrent PAs. Results-Lifetime prevalence of PAs was 13.2% (s.e. 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; s.e. 0.5%), while only 12.8% fulfilled DSM-5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8-2.2) and their course (OR 1.3; 95% CI 1.2-2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9-1.3 and OR 0.7; 95% CI 0.6-0.8). Cross-national lifetime prevalence estimates were 1.7% (s.e. 0.0%) for PD with a median age of onset of 32 (IQR 20-47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder. Conclusions-We extended previous epidemiological data to a cross-national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology. de Jonge et al.

Mental Disorders Around the World

International Journal of Methods in Psychiatric Research, 2019

ObjectivesMental disorders and suicidal thoughts and behaviors (STB) are common and burdensome am... more ObjectivesMental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the students with these conditions receive treatment, broad‐based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross‐nationally.MethodsWeb‐based self‐report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health–International College Student Initiative. The survey assessed lifetime and 12‐month common mental disorders/STB and treatment of these conditions.ResultsLifetime and 12‐month treatment rates were very low, with estimates of 25.3–36.3% for mental disorders and 29.5–36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and ...

Depression and Anxiety, 2018

Background: Major depressive disorder (MDD) in college students is associated with substantial bu... more Background: Major depressive disorder (MDD) in college students is associated with substantial burden. Aims: To assess 1-year incidence of MDD among incoming freshmen and predictors of MDDincidence in a representative sample of students. Method: Prospective cohort study of first-year college students (baseline: n = 2,519, 1-year follow-up: n = 958) Results: The incidence of MDD within the first year of college was 6.9% (SE = 0.8). The most important individual-level predictors of onset were prior suicide plans and/or attempts (OR = 9.5). The strongest population-level baseline predictors were history of childhood-adolescent trauma, stressful experience in the past 12 months, parental psychopathology, and other 12-month mental disorder. Multivariate cross-validated prediction (cross-validated AUC = 0.73) suggest that 36.1% of incident MDD cases in a replication sample would occur among the 10% of students at highest predicted risk (24.5% predicted incidence in this highest-risk subgroup). Conclusions: Screening at college entrance is a promising strategy to identify students at risk of MDD onset, which may improve the development and deployment of targeted preventive interventions. K E Y W O R D S depression, epidemiology, health services, mood disorders, suicide/self-harm This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Journal of abnormal psychology, Jan 13, 2018

Increasingly, colleges across the world are contending with rising rates of mental disorders, and... more Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time stu...

Depression and anxiety, Sep 30, 2018

College entrance is a stressful period with a high prevalence of mental disorders. To assess the ... more College entrance is a stressful period with a high prevalence of mental disorders. To assess the role impairment associated with 12-month mental disorders among incoming first-year college students within a large cross-national sample. Web-based self-report surveys assessing the prevalence of DSM-IV mental disorders and health-related role impairment (Sheehan Disability Scale) were obtained and analyzed from 13,984 incoming first-year college students (Response = 45.5%), across 19 universities in eight countries. Impairment was assessed in the following domains: home management, work (e.g., college-related problems), close personal relationships, and social life. Mean age of the sample was 19.3 (SD = 0.59) and 54.4% were female. Findings showed that 20.4% of students reported any severe role impairment (10% of those without a mental disorder vs. 42.9% of those with at least one disorder, P < 0.01). In bivariate analyses, panic disorder, and mania were associated most frequently w...

Social psychiatry and psychiatric epidemiology, Mar 16, 2018

The primary aims are to (1) obtain representative prevalence estimates of suicidal thoughts and b... more The primary aims are to (1) obtain representative prevalence estimates of suicidal thoughts and behaviors (STB) among college students worldwide and (2) investigate whether STB is related to matriculation to and attrition from college. Data from the WHO World Mental Health Surveys were analyzed, which include face-to-face interviews with 5750 young adults aged 18-22 spanning 21 countries (weighted mean response rate = 71.4%). Standardized STB prevalence estimates were calculated for four well-defined groups of same-aged peers: college students, college attriters (i.e., dropouts), secondary school graduates who never entered college, and secondary school non-graduates. Logistic regression assessed the association between STB and college entrance as well as attrition from college. Twelve-month STB in college students was 1.9%, a rate significantly lower than same-aged peers not in college (3.4%; OR 0.5; p < 0.01). Lifetime prevalence of STB with onset prior to age 18 among college ...

Journal of Affective Disorders, 2017

Background: College students are a worldwide increasing group of young people at risk for suicida... more Background: College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period. Methods: Using longitudinal data from the Leuven College Surveys, 2337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%). Results: One-year incidence of first-onset STB was 4.8-6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs=1.91-17.58) or population-level perspective (PARPs=3.4-34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23-12.25; PARPs=8.7-27.1%) and plans (ORs=6.57-17.58; PARPs=15.2-34.3%). Multivariate prediction (AUC=0.84-0.91) revealed that 50.7-65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk. Limitations: As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model. Conclusions: The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the costefficient clinical assessment of young adults in college.

JAMA psychiatry, May 15, 2017

Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, an... more Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. The Composite International Diagnostic Interview was used to assess GAD along with com...

Social psychiatry and psychiatric epidemiology, Mar 2, 2016

To examine the role of religious advisors in mental health care (MHC) according to disorder sever... more To examine the role of religious advisors in mental health care (MHC) according to disorder severity, socio-demographics, religious involvement and country income groups. Face to face household surveys in ten high income (HI), six upper-middle income (UMI) and five low/lower-middle (LLMI) income countries totalling 101,258 adults interviewed with the WMH CIDI plus questions on use of care for mental health problems and religiosity. 1.1% of participants turned to religious providers for MHC in the past year. Among those using services, 12.3% used religious services; as much as 30% in some LLMI countries, around 20% in some UMI; in the HI income countries USA, Germany, Italy and Japan are between 15 and 10% whenever the remaining countries are much lower. In LLMI 20.9% used religious advisors for the most severe mental disorders compared to 12.3 in UMI and 9.5% in HI. For severe cases most of religious providers use occurred together with formal care except in Nigeria, Iraq and Ukrain...

Archives of Public Health

Objective: Gaining knowledge on (a) the mental and pain comorbidity patterns of somatic disorders... more Objective: Gaining knowledge on (a) the mental and pain comorbidity patterns of somatic disorders in the Belgian general population, and (b) associated short-time work loss days. Method: A representative random sample of non-institutionalised inhabitants from Belgium aged 18 or older (n=2419) were interviewed between April 2001 and June 2002. DSM-IV mental disorders were assessed with the 3 rd version of the Composite International Diagnostic Interview (CIDI 3.0). The presence of chronic somatic disorders and chronic pain conditions was based on self-report. Results: Chronic somatic disorders were systematically associated with either chronic pain conditions (adjusted odds ratios [adjusted for

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2010

To compare the 12-month prevalence of common mental disorders among francophones in Canada, Franc... more To compare the 12-month prevalence of common mental disorders among francophones in Canada, France, and Belgium. This is the first article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations. This is a secondary analysis of data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) in 2002 and the European Study of Epidemiology of Mental Disorders-Mental Health Disability (ESEMeD) from 2001 to 2003, where comparable questionnaires were administered to representative samples of adults in Canada, France, and Belgium. In Canada, francophone respondents living in Quebec (n = 7571) and outside Quebec (n = 500) completed the French version of the CCHS 1.2 questionnaire. Francophone respondents in Belgium (n = 389) and in France (n = 1436) completed the French version of the ESEMeD population survey questionnaire. Major depressive episodes (MDEs), specific anxiety disorders (ADs), and alcohol abuse and (or) de...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2010

To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamp... more To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamples using data from national mental health surveys in Canada, Quebec, France, and Belgium. This is the second article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations. Comparable World Mental Health-Composite International Diagnostic Interviews (WMH-CIDI) were administered to representative samples of adults (aged 18 years and older) in Canada during 2002 and in France and Belgium from 2001 to 2003. Two groups of francophone adults in Canada, in Quebec (n = 7571) and outside Quebec (n = 500), and respondents in Belgium (n = 389) and France (n = 1436) completed the French version of the population survey. Prevalence rates of common mental health service use were examined for major depressive episodes and specific anxiety disorders (that is, agoraphobia, social phobia, and panic disorder). Overall, most francophones with mental disorde...

International Journal of Obesity, 2007

Objectives-(i) To investigate whether there is an association between obesity and mental disorder... more Objectives-(i) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (ii) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design-Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects-Household residing adults, 18 years and over (n = 62,277). Measurements-DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m2 or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results-Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.4) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders.

British Journal of Psychiatry, 2014

BackgroundPrevious research suggests that many people receiving mental health treatment do not me... more BackgroundPrevious research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.AimsTo examine the association of past-year mental health treatment with DSM-IV disorders.MethodThe World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.ResultsRoughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.ConclusionsThe vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected t...

Psychological Medicine, 2008

BackgroundThe relationship between mental and physical disorders is well established, but there i... more BackgroundThe relationship between mental and physical disorders is well established, but there is less consensus as to the nature of their joint association with disability, in part because additive and interactive models of co-morbidity have not always been clearly differentiated in prior research.MethodEighteen general population surveys were carried out among adults as part of the World Mental Health (WMH) Survey Initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions (arthritis, heart disease, respiratory disease, chronic back/neck pain, chronic headache, and diabetes) were ascertained using a standard checklist. Severe disability was defined as on or above the 90th percentile of the WMH version of the World Health Organization Disability Assessment Schedule (WHODAS-II).ResultsThe odds of severe disability among those with both mental disorder and each of th...

Pain, 2007

This paper reports cross-national data concerning back or neck pain comorbidity with mental disor... more This paper reports cross-national data concerning back or neck pain comorbidity with mental disorders. We assessed (a) the prevalence of chronic back/neck pain, (b) the prevalence of mental disorders among people with chronic back/neck pain, (c) which mental disorder had strongest associations with chronic back/neck pain, and (d) whether these associations are consistent across countries. Population surveys of community-dwelling adults were carried out in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (N = 85,088). Mental disorders were assessed with the Composite International Diagnostic Interview, third version (CIDI 3.0): anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social anxiety disorder), mood disorders (major depression and dysthymia), and alcohol abuse or dependence. Back/neck pain was ascertained by self-report. Between 10% and 42% reported chronic back/neck pain in the previous 12 months. After adjusting for age and sex, mental disorders were more common among persons with back/neck pain than among persons

Journal of Occupational and Environmental Medicine, 2005

Learning Objectives • Recall the estimated prevalence of attention-deficit/hyperactivity disorder... more Learning Objectives • Recall the estimated prevalence of attention-deficit/hyperactivity disorder (ADHD) in this national household survey of 3198 workers 18 to 44 years of age, and any demographic factors associated with a relatively high risk of this disorder. • Point out the impact of ADHD on lost work performance, and any association between type of work and the risk of this disorder. • Summarize how often affected workers had sought professional treatment in the past year for manifestations of ADHD and for other emotional problems.

Journal of Affective Disorders, 2010

Background: The prevalence of obsessive-compulsive symptom dimensions and their sociodemographic ... more Background: The prevalence of obsessive-compulsive symptom dimensions and their sociodemographic and psychopathological correlates at the population level are unknown. Method: Obsessive-compulsive symptom dimensions and mental disorders were assessed with the Composite International Diagnostic Interview 3.0 in a random subsample (n=2804) of individuals participating in a cross-sectional survey of the adult general population of six European countries. Results: The lifetime prevalence of any obsessive-compulsive symptom dimension was 13%. Harm/ Checking was the most prevalent dimension (8%) followed by Somatic obsessions (5%) and Symmetry/Ordering (3%). Females were more likely to have symptoms in Contamination/Cleaning (OR = 3, 95%CI = 1.06-8.51) and Somatic obsessions (OR= 1.88, 95%CI = 1.05-3.37). All symptom dimensions were associated with an increased risk of most mental (but not physical) disorders. There were some differences in prevalence between countries. Limitations: The interference associated with each symptom dimension could not be assessed. Few direct data are available on the validity of the CIDI to assess obsessive-compulsive symptom dimensions. Conclusions: Obsessive-compulsive symptom dimensions are relatively frequent in the general population. Their sociodemographic and psychopathological correlates may be slightly different in clinical and community samples. They are associated with an increased risk of most mental disorders.

Depression and Anxiety, Apr 1, 2010

Background: Although social anxiety disorder (SAD) is classified in the fourth edition of The Dia... more Background: Although social anxiety disorder (SAD) is classified in the fourth edition of The Diagnostic and Statistical Manual (DSM-IV) into generalized and non-generalized subtypes, community surveys in Western countries find no evidence of disjunctions in the dose-response relationship between number of social fears and outcomes to support this distinction. We aimed to determine whether this holds across a broader set of developed and developing countries, and whether subtyping according to number of performance versus interactional fears would be more useful. Methods: The World Health Organization's World Mental Health Survey Initiative undertook population epidemiological surveys in 11 developing and 9 developed countries, using the Composite International Diagnostic Interview to assess DSM-IV disorders. Fourteen performance and interactional fears were assessed.

Depression and Anxiety, Oct 24, 2016

Context-The scarcity of cross-national reports and the changes in DSM-5 regarding panic disorder ... more Context-The scarcity of cross-national reports and the changes in DSM-5 regarding panic disorder (PD) and panic attacks (PAs) call for new epidemiological data on PD and PAs and its subtypes in the general population. Objective-To present representative data about the cross-national epidemiology of PD and PAs in accordance with DSM-5 definitions. Design and Setting-Nationally representative cross-sectional surveys using the World Health Organization Composite International Diagnostic Interview version 3.0. Participants-Respondents (n=142,949) from 25 high, middle and lower-middle income countries across the world aged 18 years or older. Main Outcome Measures-PD and presence of single and recurrent PAs. Results-Lifetime prevalence of PAs was 13.2% (s.e. 0.1%). Among persons that ever had a PA, the majority had recurrent PAs (66.5%; s.e. 0.5%), while only 12.8% fulfilled DSM-5 criteria for PD. Recurrent PAs were associated with a subsequent onset of a variety of mental disorders (OR 2.0; 95% CI 1.8-2.2) and their course (OR 1.3; 95% CI 1.2-2.4) whereas single PAs were not (OR 1.1; 95% CI 0.9-1.3 and OR 0.7; 95% CI 0.6-0.8). Cross-national lifetime prevalence estimates were 1.7% (s.e. 0.0%) for PD with a median age of onset of 32 (IQR 20-47). Some 80.4% of persons with lifetime PD had a lifetime comorbid mental disorder. Conclusions-We extended previous epidemiological data to a cross-national context. The presence of recurrent PAs in particular is associated with subsequent onset and course of mental disorders beyond agoraphobia and PD, and might serve as a generic risk marker for psychopathology. de Jonge et al.

Mental Disorders Around the World

International Journal of Methods in Psychiatric Research, 2019

ObjectivesMental disorders and suicidal thoughts and behaviors (STB) are common and burdensome am... more ObjectivesMental disorders and suicidal thoughts and behaviors (STB) are common and burdensome among college students. Although available evidence suggests that only a small proportion of the students with these conditions receive treatment, broad‐based data on patterns of treatment are lacking. The aim of this study is to examine the receipt of mental health treatment among college students cross‐nationally.MethodsWeb‐based self‐report surveys were obtained from 13,984 first year students from 19 colleges in eight countries across the world as part of the World Health Organization's World Mental Health–International College Student Initiative. The survey assessed lifetime and 12‐month common mental disorders/STB and treatment of these conditions.ResultsLifetime and 12‐month treatment rates were very low, with estimates of 25.3–36.3% for mental disorders and 29.5–36.1% for STB. Treatment was positively associated with STB severity. However, even among severe cases, lifetime and ...

Depression and Anxiety, 2018

Background: Major depressive disorder (MDD) in college students is associated with substantial bu... more Background: Major depressive disorder (MDD) in college students is associated with substantial burden. Aims: To assess 1-year incidence of MDD among incoming freshmen and predictors of MDDincidence in a representative sample of students. Method: Prospective cohort study of first-year college students (baseline: n = 2,519, 1-year follow-up: n = 958) Results: The incidence of MDD within the first year of college was 6.9% (SE = 0.8). The most important individual-level predictors of onset were prior suicide plans and/or attempts (OR = 9.5). The strongest population-level baseline predictors were history of childhood-adolescent trauma, stressful experience in the past 12 months, parental psychopathology, and other 12-month mental disorder. Multivariate cross-validated prediction (cross-validated AUC = 0.73) suggest that 36.1% of incident MDD cases in a replication sample would occur among the 10% of students at highest predicted risk (24.5% predicted incidence in this highest-risk subgroup). Conclusions: Screening at college entrance is a promising strategy to identify students at risk of MDD onset, which may improve the development and deployment of targeted preventive interventions. K E Y W O R D S depression, epidemiology, health services, mood disorders, suicide/self-harm This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Journal of abnormal psychology, Jan 13, 2018

Increasingly, colleges across the world are contending with rising rates of mental disorders, and... more Increasingly, colleges across the world are contending with rising rates of mental disorders, and in many cases, the demand for services on campus far exceeds the available resources. The present study reports initial results from the first stage of the WHO World Mental Health International College Student project, in which a series of surveys in 19 colleges across 8 countries (Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, United States) were carried out with the aim of estimating prevalence and basic sociodemographic correlates of common mental disorders among first-year college students. Web-based self-report questionnaires administered to incoming first-year students (45.5% pooled response rate) screened for six common lifetime and 12-month DSM-IV mental disorders: major depression, mania/hypomania, generalized anxiety disorder, panic disorder, alcohol use disorder, and substance use disorder. We focus on the 13,984 respondents who were full-time stu...

Depression and anxiety, Sep 30, 2018

College entrance is a stressful period with a high prevalence of mental disorders. To assess the ... more College entrance is a stressful period with a high prevalence of mental disorders. To assess the role impairment associated with 12-month mental disorders among incoming first-year college students within a large cross-national sample. Web-based self-report surveys assessing the prevalence of DSM-IV mental disorders and health-related role impairment (Sheehan Disability Scale) were obtained and analyzed from 13,984 incoming first-year college students (Response = 45.5%), across 19 universities in eight countries. Impairment was assessed in the following domains: home management, work (e.g., college-related problems), close personal relationships, and social life. Mean age of the sample was 19.3 (SD = 0.59) and 54.4% were female. Findings showed that 20.4% of students reported any severe role impairment (10% of those without a mental disorder vs. 42.9% of those with at least one disorder, P < 0.01). In bivariate analyses, panic disorder, and mania were associated most frequently w...

Social psychiatry and psychiatric epidemiology, Mar 16, 2018

The primary aims are to (1) obtain representative prevalence estimates of suicidal thoughts and b... more The primary aims are to (1) obtain representative prevalence estimates of suicidal thoughts and behaviors (STB) among college students worldwide and (2) investigate whether STB is related to matriculation to and attrition from college. Data from the WHO World Mental Health Surveys were analyzed, which include face-to-face interviews with 5750 young adults aged 18-22 spanning 21 countries (weighted mean response rate = 71.4%). Standardized STB prevalence estimates were calculated for four well-defined groups of same-aged peers: college students, college attriters (i.e., dropouts), secondary school graduates who never entered college, and secondary school non-graduates. Logistic regression assessed the association between STB and college entrance as well as attrition from college. Twelve-month STB in college students was 1.9%, a rate significantly lower than same-aged peers not in college (3.4%; OR 0.5; p < 0.01). Lifetime prevalence of STB with onset prior to age 18 among college ...

Journal of Affective Disorders, 2017

Background: College students are a worldwide increasing group of young people at risk for suicida... more Background: College students are a worldwide increasing group of young people at risk for suicidal thoughts and behaviours (STB). However, no previous studies have prospectively investigated the first onset of STB during the college period. Methods: Using longitudinal data from the Leuven College Surveys, 2337 (response rate [RR]=66.6%) incoming freshmen provided baseline data on STB, parental psychopathology, childhood-adolescent traumatic experiences, 12-month risk for mental disorders, and 12-month stressful experiences. A total of 1253 baseline respondents provided data on 12-month STB in a two-year annual follow-up survey (conditional RR=53.6%; college dropout adjusted conditional RR=70.2%). Results: One-year incidence of first-onset STB was 4.8-6.4%. Effect sizes of the included risk factors varied considerably whether viewed from individual-level (ORs=1.91-17.58) or population-level perspective (PARPs=3.4-34.3%). Dating violence prior to the age of 17, physical abuse prior to the age of 17, and 12month betrayal by someone else than the partner were most strong predictors for first-onset suicidal ideation (ORs=4.23-12.25; PARPs=8.7-27.1%) and plans (ORs=6.57-17.58; PARPs=15.2-34.3%). Multivariate prediction (AUC=0.84-0.91) revealed that 50.7-65.7% of first-onset STB cases were concentrated in the 10% at highest predicted risk. Limitations: As this is a first investigation of STB onset in college, future studies should use validation samples to test the accuracy of our multivariate prediction model. Conclusions: The first onset of STB in college appears to be higher than in the general population. Screening at college entrance is a promising strategy to identify those students at highest prospective risk, enabling the costefficient clinical assessment of young adults in college.

JAMA psychiatry, May 15, 2017

Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, an... more Generalized anxiety disorder (GAD) is poorly understood compared with other anxiety disorders, and debates persist about the seriousness of this disorder. Few data exist on GAD outside a small number of affluent, industrialized nations. No population-based data exist on GAD as it is currently defined in DSM-5. To provide the first epidemiologic data on DSM-5 GAD and explore cross-national differences in its prevalence, course, correlates, and impact. Data come from the World Health Organization World Mental Health Survey Initiative. Cross-sectional general population surveys were carried out in 26 countries using a consistent research protocol and assessment instrument. A total of 147 261 adults from representative household samples were interviewed face-to-face in the community. The surveys were conducted between 2001 and 2012. Data analysis was performed from July 22, 2015, to December 12, 2016. The Composite International Diagnostic Interview was used to assess GAD along with com...

Social psychiatry and psychiatric epidemiology, Mar 2, 2016

To examine the role of religious advisors in mental health care (MHC) according to disorder sever... more To examine the role of religious advisors in mental health care (MHC) according to disorder severity, socio-demographics, religious involvement and country income groups. Face to face household surveys in ten high income (HI), six upper-middle income (UMI) and five low/lower-middle (LLMI) income countries totalling 101,258 adults interviewed with the WMH CIDI plus questions on use of care for mental health problems and religiosity. 1.1% of participants turned to religious providers for MHC in the past year. Among those using services, 12.3% used religious services; as much as 30% in some LLMI countries, around 20% in some UMI; in the HI income countries USA, Germany, Italy and Japan are between 15 and 10% whenever the remaining countries are much lower. In LLMI 20.9% used religious advisors for the most severe mental disorders compared to 12.3 in UMI and 9.5% in HI. For severe cases most of religious providers use occurred together with formal care except in Nigeria, Iraq and Ukrain...

Archives of Public Health

Objective: Gaining knowledge on (a) the mental and pain comorbidity patterns of somatic disorders... more Objective: Gaining knowledge on (a) the mental and pain comorbidity patterns of somatic disorders in the Belgian general population, and (b) associated short-time work loss days. Method: A representative random sample of non-institutionalised inhabitants from Belgium aged 18 or older (n=2419) were interviewed between April 2001 and June 2002. DSM-IV mental disorders were assessed with the 3 rd version of the Composite International Diagnostic Interview (CIDI 3.0). The presence of chronic somatic disorders and chronic pain conditions was based on self-report. Results: Chronic somatic disorders were systematically associated with either chronic pain conditions (adjusted odds ratios [adjusted for

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2010

To compare the 12-month prevalence of common mental disorders among francophones in Canada, Franc... more To compare the 12-month prevalence of common mental disorders among francophones in Canada, France, and Belgium. This is the first article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations. This is a secondary analysis of data from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2) in 2002 and the European Study of Epidemiology of Mental Disorders-Mental Health Disability (ESEMeD) from 2001 to 2003, where comparable questionnaires were administered to representative samples of adults in Canada, France, and Belgium. In Canada, francophone respondents living in Quebec (n = 7571) and outside Quebec (n = 500) completed the French version of the CCHS 1.2 questionnaire. Francophone respondents in Belgium (n = 389) and in France (n = 1436) completed the French version of the ESEMeD population survey questionnaire. Major depressive episodes (MDEs), specific anxiety disorders (ADs), and alcohol abuse and (or) de...

Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2010

To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamp... more To compare 12-month and lifetime service use for common mental disorders in 4 francophone subsamples using data from national mental health surveys in Canada, Quebec, France, and Belgium. This is the second article in a 2-part series comparing mental disorders and service use prevalence of French-speaking populations. Comparable World Mental Health-Composite International Diagnostic Interviews (WMH-CIDI) were administered to representative samples of adults (aged 18 years and older) in Canada during 2002 and in France and Belgium from 2001 to 2003. Two groups of francophone adults in Canada, in Quebec (n = 7571) and outside Quebec (n = 500), and respondents in Belgium (n = 389) and France (n = 1436) completed the French version of the population survey. Prevalence rates of common mental health service use were examined for major depressive episodes and specific anxiety disorders (that is, agoraphobia, social phobia, and panic disorder). Overall, most francophones with mental disorde...

International Journal of Obesity, 2007

Objectives-(i) To investigate whether there is an association between obesity and mental disorder... more Objectives-(i) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (ii) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design-Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects-Household residing adults, 18 years and over (n = 62,277). Measurements-DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m2 or greater; severe obesity as BMI 35+. Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results-Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.4) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders.

British Journal of Psychiatry, 2014

BackgroundPrevious research suggests that many people receiving mental health treatment do not me... more BackgroundPrevious research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.AimsTo examine the association of past-year mental health treatment with DSM-IV disorders.MethodThe World Health Organization's World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.ResultsRoughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose–response associations were found between number of indicators of need and treatment.ConclusionsThe vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected t...

Psychological Medicine, 2008

BackgroundThe relationship between mental and physical disorders is well established, but there i... more BackgroundThe relationship between mental and physical disorders is well established, but there is less consensus as to the nature of their joint association with disability, in part because additive and interactive models of co-morbidity have not always been clearly differentiated in prior research.MethodEighteen general population surveys were carried out among adults as part of the World Mental Health (WMH) Survey Initiative (n=42 697). DSM-IV disorders were assessed using face-to-face interviews with the Composite International Diagnostic Interview (CIDI 3.0). Chronic physical conditions (arthritis, heart disease, respiratory disease, chronic back/neck pain, chronic headache, and diabetes) were ascertained using a standard checklist. Severe disability was defined as on or above the 90th percentile of the WMH version of the World Health Organization Disability Assessment Schedule (WHODAS-II).ResultsThe odds of severe disability among those with both mental disorder and each of th...

Pain, 2007

This paper reports cross-national data concerning back or neck pain comorbidity with mental disor... more This paper reports cross-national data concerning back or neck pain comorbidity with mental disorders. We assessed (a) the prevalence of chronic back/neck pain, (b) the prevalence of mental disorders among people with chronic back/neck pain, (c) which mental disorder had strongest associations with chronic back/neck pain, and (d) whether these associations are consistent across countries. Population surveys of community-dwelling adults were carried out in 17 countries in Europe, the Americas, the Middle East, Africa, Asia, and the South Pacific (N = 85,088). Mental disorders were assessed with the Composite International Diagnostic Interview, third version (CIDI 3.0): anxiety disorders (generalized anxiety disorder, panic disorder/agoraphobia, posttraumatic stress disorder, and social anxiety disorder), mood disorders (major depression and dysthymia), and alcohol abuse or dependence. Back/neck pain was ascertained by self-report. Between 10% and 42% reported chronic back/neck pain in the previous 12 months. After adjusting for age and sex, mental disorders were more common among persons with back/neck pain than among persons

Journal of Occupational and Environmental Medicine, 2005

Learning Objectives • Recall the estimated prevalence of attention-deficit/hyperactivity disorder... more Learning Objectives • Recall the estimated prevalence of attention-deficit/hyperactivity disorder (ADHD) in this national household survey of 3198 workers 18 to 44 years of age, and any demographic factors associated with a relatively high risk of this disorder. • Point out the impact of ADHD on lost work performance, and any association between type of work and the risk of this disorder. • Summarize how often affected workers had sought professional treatment in the past year for manifestations of ADHD and for other emotional problems.

Journal of Affective Disorders, 2010

Background: The prevalence of obsessive-compulsive symptom dimensions and their sociodemographic ... more Background: The prevalence of obsessive-compulsive symptom dimensions and their sociodemographic and psychopathological correlates at the population level are unknown. Method: Obsessive-compulsive symptom dimensions and mental disorders were assessed with the Composite International Diagnostic Interview 3.0 in a random subsample (n=2804) of individuals participating in a cross-sectional survey of the adult general population of six European countries. Results: The lifetime prevalence of any obsessive-compulsive symptom dimension was 13%. Harm/ Checking was the most prevalent dimension (8%) followed by Somatic obsessions (5%) and Symmetry/Ordering (3%). Females were more likely to have symptoms in Contamination/Cleaning (OR = 3, 95%CI = 1.06-8.51) and Somatic obsessions (OR= 1.88, 95%CI = 1.05-3.37). All symptom dimensions were associated with an increased risk of most mental (but not physical) disorders. There were some differences in prevalence between countries. Limitations: The interference associated with each symptom dimension could not be assessed. Few direct data are available on the validity of the CIDI to assess obsessive-compulsive symptom dimensions. Conclusions: Obsessive-compulsive symptom dimensions are relatively frequent in the general population. Their sociodemographic and psychopathological correlates may be slightly different in clinical and community samples. They are associated with an increased risk of most mental disorders.