Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-26T03:39:30.325Z Has data issue: false hasContentIssue false
  • English
  • Français

Major depressive disorder, suicidal behaviour, bipolar disorder, and generalised anxiety disorder among emerging adults with and without chronic health conditions

Published online by Cambridge University Press:  08 September 2015

M. A. Ferro
M. A. Ferro*
Affiliation:
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
*
*Address for correspondence: M. A. Ferro, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada. (Email: ferroma@mcmaster.ca)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background.

Despite the considerable physical, emotional and social change that occurs during emerging adulthood, there is little research that examines the association between having a chronic health condition and mental disorder during this developmental period. The aims of this study were to examine the sex-specific prevalence of lifetime mental disorder in an epidemiological sample of emerging adults aged 15–30 years with and without chronic health conditions; quantify the association between chronic health conditions and mental disorder, adjusting for sociodemographic and health factors; and, examine potential moderating and mediating effects of sex, level of disability and pain.

Method.

Data come from the Canadian Community Health Survey-Mental Health. Respondents were 15–30 years of age (n = 5947) and self-reported whether they had a chronic health condition. Chronic health conditions were classified as: respiratory, musculoskeletal/connective tissue, cardiovascular, neurological and endocrine/digestive. The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess the presence of mental disorder (major depressive disorder, suicidal behaviour, bipolar disorder and generalised anxiety disorder).

Results.

Lifetime prevalence of mental disorder was significantly higher for individuals with chronic health conditions compared with healthy controls. Substantial heterogeneity in the prevalence of mental disorder was found in males, but not in females. Logistic regression models adjusting for several sociodemographic and health factors showed that the individuals with chronic health conditions were at elevated risk for mental disorder. There was no evidence that the level of disability or pain moderated the associations between chronic health conditions and mental disorder. Sex was found to moderate the association between musculoskeletal/connective tissue conditions and bipolar disorder (β = 1.71, p = 0.002). Exploratory analyses suggest that the levels of disability and pain mediate the association between chronic health conditions and mental disorder.

Conclusions.

Physical and mental comorbidity is prevalent among emerging adults and this relationship is not augmented, but may be mediated, by the level of disability or pain. Findings point to the integration and coordination of public sectors – health, education and social services – to facilitate the prevention and reduction of mental disorder among emerging adults with chronic health conditions.

Keywords

Anxiety disorderbipolar disorderchronic diseasedepressionepidemiological studiesmood disordersuicidality
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 25 , Issue 5 , October 2016 , pp. 462 - 474
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, G, Kemp, A, Sunderland, M, Von Korff, M, Üstün, TB (2009). Normative data for the 12 item WHO disability assessment Schedule 2.0. PLoS ONE 4, e8343.Google Scholar
Arnett, JJ (2000). Emerging adulthood. A theory of development from the late teens through the twenties. American Psychologist 55, 469–480.Google Scholar
Avenevoli, S, Swendsen, J, He, JP, Burstein, M, Merikangas, KR (2015). Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment. Journal of the American Academy of Child and Adolesclescent Psychiatry 54, 37–44.Google Scholar
Baggio, S, Iglesias, K, Deline, S, Studer, J, Henchoz, Y, Mohler-Kuo, M, Gmel, G (2015). Not in education, employment, or training status among young Swiss men. Longitudinal associations with mental health and substance use. Journal of Adolescent Health 56, 238–243.Google Scholar
Bandiera, FC, Ramirez, R, Arheart, KL, Canino, G, Goodwin, R.D (2013). Asthma and suicidal ideation and behavior among Puerto Rican older children and adolescents. Journal of Nervous and Mental Disease 201, 587–91.CrossRefGoogle ScholarPubMed
Campbell, G, Darke, S, Bruno, R, Degenhardt, L (2015). The prevalence and correlates of chronic pain and suicidality in a nationally representative sample. Australian and New Zealand Journal of Psychiatry. doi: 10.1177/0004867415569795.Google Scholar
Chaney, JM, Mullins, LL, Uretsky, DL, Pace, TM, Werden, D, Hartman, VL (1999). An experimental examination of learned helplessness in older adolescents and young adults with long-standing asthma. Journal of Pediatric Psychology 24, 259–270.CrossRefGoogle Scholar
Chen, H, Cohen, P, Crawford, TN, Kasen, S, Guan, B, Gorden, K (2009). Impact of early adolescent psychiatric and personality disorder on long-term physical health: a 20-year longitudinal follow-up study. Psychological Medicine 39, 865–874.CrossRefGoogle Scholar
Chung, JH, Moon, K, Kim, DH, Min, JW, Kim, TH, Hwang, HJ (2014). Suicidal ideation and suicide attempts among diabetes mellitus: The Korea National Health and Nutrition Examination Survey (KNHANES IV, V) from 2007 to 2012. Journal of Psychosomatic Research 77, 457–461.Google Scholar
Clarke, GN, Hawkins, W, Murphy, M, Sheeber, LB, Lewinsohn, PM, Seeley, JR (1995). Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. Journal of the American Academy of Child and Adolescent Psychiatry 34, 312–321.CrossRefGoogle Scholar
Cuijpers, P, Beekman, AT, Reynolds, CF (2012). Preventing depression: a global priority. JAMA 307, 1033–1034.Google Scholar
Davies, S, Heyman, I, Goodman, R (2003). A population survey of mental health problems in children with epilepsy. Developmental Medicine and Child Neurology 45, 292–295.CrossRefGoogle ScholarPubMed
Ettinger, AB, Reed, ML, Goldberg, JF, Hirschfeld, RM (2005). Prevalence of bipolar symptoms in epilepsy vs other chronic health disorders. Neurology 65, 535–540.Google Scholar
Evans-Lacko, SE, Zeber, JE, Gonzalez, JM, Olvera, RL (2009). Medical comorbidity among youth diagnosed with bipolar disorder in the United States. Journal of Clinical Psychiatry 70, 1461–6.Google Scholar
Federici, S, Meloni, F (2010). WHODAS II: disability self-evaluation in the ICF conceptual frame. In International Encyclopedia of Rehabilitation (ed. Stone, JH and Blouin, M), Center for International Rehabilitation Research Information and Exchange: Buffalo. Retrieved from http://cirrie.buffalo.edu/encyclopedia/en/article/299/ Google Scholar
Ferro, MA (2014). Adolescents and young adults with physical illness: a comparative study of psychological distress. Acta Paediatrica 103, e32–e37.Google Scholar
Ferro, MA, Boyle, MH (2013). Self-concept among children and adolescents with a chronic illness: a meta-analytic review. Health Psychology 32, 839–848.Google Scholar
Goodwin, RD, Fergusson, DM, Horwood, LJ (2004). Asthma and depressive and anxiety disorders among young persons in the community. Psychological Medicine 34, 1465–1474.CrossRefGoogle ScholarPubMed
Green, JG, McLaughlin, KA, Berglund, PA, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Kessler, RC (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication I: associations with first onset of DSM-IV disorders. Archives of General Psychiatry 67, 113–123.Google Scholar
Haarasilta, L, Marttunen, M, Kaprio, J, Aro, H (2005). Major depressive episode and physical health in adolescents and young adults: results from a population-based interview survey. European Journal of Public Health 15, 489–493.Google Scholar
Henkel, V, Bussfeld, P, Moller, HJ, Hegerl, U (2002). Cognitive-behavioural theories of helplessness/hopelessness: valid models of depression? European Archives of Psychiatry and Clinical Neuroscience 252, 240–249.Google Scholar
Holm, S (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics 6, 65–70.Google Scholar
Hsieh, FY (1989). Sample size tables for logistic regression. Statistics in Medicine 8, 795–802.Google Scholar
Hsieh, FY, Bloch, DA, Larsen, MD (1998). A simple method of sample size calculation for linear and logistic regression. Statistics in Medicine 17, 1623–1634.Google Scholar
Jacoby, A, Snape, D, Baker, GA (2005). Epilepsy and social identity: the stigma of a chronic neurological disorder. Lancet Neurology 4, 171–178.Google Scholar
Jeeva, F, Dickens, C, Coventry, P, Bundy, C, Davies, L (2013). Is treatment of depression cost-effective in people with diabetes? A systematic review of the economic evidence. International Journal of Technology Assessment in Health Care 29, 384–391.Google Scholar
Katon, W, Lozano, P, Russo, J, McCauley, E, Richardson, L, Bush, T (2007). The prevalence of DSM-IV anxiety and depressive disorders in youth with asthma compared with controls. Journal of Adolescent Health 41, 455–463.Google Scholar
Keethy, D, Mrakotsky, C, Szigethy, E (2014). Pediatric inflammatory bowel disease and depression: treatment implications. Current Opinion in Pediatrics 26, 561–567.Google Scholar
Kessler, RC, Üstün, TB (2004). The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.Google Scholar
Kessler, RC, Ormel, J, Demler, O, Stang, PE (2003). Comorbid mental disorders account for the role impairment of commonly occurring chronic physical disorders: results from the national comorbidity survey. Journal of Occupational and Environmental Medicine 45, 1257–1266.Google Scholar
Kessler, RC, Abelson, J, Demler, O, Escobar, JI, Gibbon, M, Guyer, ME, Howes, MJ, Jin, R, Vega, WA, Walters, EE, Wang, P, Zaslavsky, A, Zheng, H (2004). Clinical calibration of DSM-IV diagnoses in the World Mental Health (WMH) version of the World Health Organization (WHO) Composite International Diagnostic Interview (WMHCIDI). International Journal of Methods in Psychiatric Research 13, 122–139.Google Scholar
Kimber, M, Rehm, J, Ferro, MA (2015). Measurement Invariance of the WHODAS 2.0 in a population-based sample of youth. Manuscript Submitted for Publication.Google Scholar
Kratochwill, TR, Shernoff, ES (2004). Evidence-based practice: promoting evidence-based interventions in school psychology. School Psychology Quarterly 18, 389–408.Google Scholar
Liu, X, Kurita, H, Uchiyama, M, Okawa, M, Liu, L, Ma, D (2000). Life events, locus of control, and behavioral problems among Chinese adolescents. Journal of Clinical Psychology 56, 1565–1577.Google Scholar
Lowry-Webster, HM, Barrett, PM, Dadds, MR (2001). A universal prevention trial of anxiety and depressive symptomatology in childhood: preliminary data from an Australian study. Behaviour Change 18, 36–50.Google Scholar
MacKinnon, DP (2008). Introduction to Statistical Mediation Analysis. Erlbaum Psych Press: Hoboken.Google Scholar
Mackner, LM, Bickmeier, RM, Crandall, WV (2012). Academic achievement, attendance, and school-related quality of life in pediatric inflammatory bowel disease. Journal of Developmental and Behavioral Pediatrics 33, 106–111.Google Scholar
Maslow, GR, Haydon, A, McRee, AL, Ford, CA, Halpern, CT (2011 a). Growing up with a chronic illness: social success, educational/vocational distress. Journal of Adolescent Health 49, 206–212.CrossRefGoogle ScholarPubMed
Maslow, GR, Haydon, AA, Ford, CA, Halpern, CT (2011 b). Young adult outcomes of children growing up with chronic illness: an analysis of the National longitudinal study of adolescent health. Archives of Pediatrics and Adolescent Medicine 165, 256–261.Google Scholar
McLaughlin, KA, Green, JG, Gruber, MJ, Sampson, NA, Zaslavsky, AM, Kessler, RC (2010). Childhood adversities and adult psychiatric disorders in the national comorbidity survey replication II: associations with persistence of DSM-IV disorders. Archives of General Psychiatry 67, 124–132.Google Scholar
Merikangas, KR, Nakamura, EF, Kessler, RC (2009). Epidemiology of mental disorders in children and adolescents. Dialogues in Clinical Neuroscience 11, 7–20.Google Scholar
Merikangas, KR, Calkins, ME, Burstein, M, He, JP, Chiavacci, R, Lateef, T, Ruparel, K, Gur, RC, Lehner, T, Hakonarson, H, Gur, RE (2015). Comorbidity of physical and mental disorders in the neurodevelopmental genomics cohort study. Pediatrics 135, e927–e938.Google Scholar
Morgan, E, Patterson, CC, Cardwell, CR (2014). General practice-recorded depression and antidepressant use in young people with newly diagnosed type 1 diabetes: a cohort study using the clinical practice research datalink. Diabetic Medicine 31, 241–245.Google Scholar
Muggah, E, Graves, E, Bennett, C, Manuel, DG (2013). Ascertainment of chronic diseases using population health data: a comparison of health administrative data and patient self-report. BMC Public Health 13, 16.Google Scholar
National Research Council & Institute of Medicine (2009). Preventing Mental, Emotional, and Behaviorial Disorders among Young People: Progress and Possibilities. Committee on Prevention of Mental Disorders and Substance Abuse among Children, Youth, and Young Adults: Research Advances and Promising Interventions. The National Academies Press: Washington, DC.Google Scholar
Ontario Association of Community Care Access Centres (2013). Health Comes Home: A Conversation About Children With Complex Health Needs Part 3. Ontario Association of Community Care Access Centres: Toronto.Google Scholar
Ormel, J, Kempen, GI, Penninx, BW, Brilman, EI, Beekman, AT, van Sonderen, E (1997). Chronic medical conditions and mental health in older people: disability and psychosocial resources mediate specific mental health effects. Psychological Medicine 27, 1065–77.Google Scholar
Parekh, AK, Barton, MB (2010). The challenge of multiple comorbidity for the US health care system. JAMA 303, 1303–1304.Google Scholar
Patten, SB, Williams, JV, Wang, J (2006). Mental disorders in a population sample with musculoskeletal disorders. BMC Musculoskeletal Disorder 7, 37.Google Scholar
Pinquart, M, Shen, Y (2011a). Anxiety in children and adolescents with chronic physical illnesses: a meta-analysis. Acta Paediatrica 100, 1069–1076.Google Scholar
Pinquart, M, Shen, Y (2011 b). Behavior problems in children and adolescents with chronic physical illness: a meta-analysis. Journal of Pediatric Psychology 36, 1003–1016.Google Scholar
Pinquart, M, Shen, Y (2011 c). Depressive symptoms in children and adolescents with chronic physical illness: an updated meta-analysis. Journal of Pediatric Psychology 36, 375–384.CrossRefGoogle ScholarPubMed
Radobuljac, MD, Bratina, NU, Battelino, T, Tomori, M (2009). Lifetime prevalence of suicidal and self-injurious behaviors in a representative cohort of Slovenian adolescents with type 1 diabetes. Pediatric Diabetes 10, 424–431.Google Scholar
Reid, GJ, Irvine, MJ, McCrindle, BW, Sananes, R, Ritvo, PG, Siu, SC, Webb, GD (2004). Prevalence and correlates of successful transfer from pediatric to adult health care among a cohort of young adults with complex congenital heart defects. Pediatrics 113, e197–e205.Google Scholar
Saunders, B (2014). Stigma, deviance and morality in young adults' accounts of inflammatory bowel disease. Sociology of Health and Illness 36, 1020–1036.Google Scholar
Scott, KM, Bruffaerts, R, Tsang, A, Ormel, J, Alonso, J, Angermeyer, MC, Benjet, C, Bromet, E, de Girolamo, G, de Graaf, R, Gasquet, I, Gureje, O, Haro, JM, He, Y, Kessler, RC, Levinson, D, Mneimneh, ZN, Oakley Browne, MA, Posada-Villa, J, Stein, DJ, Takeshima, T, Von Korff, M (2007). Depression-anxiety relationships with chronic physical conditions: results from the World mental health surveys. Journal of Affective Disorders 103, 113–120.Google Scholar
Scott, KM, Von Korff, M, Alonso, J, Angermeyer, MC, Bromet, E, Fayyad, J, de Girolamo, G, Demyttenaere, K, Gasquet, I, Gureje, O, Haro, JM, He, Y, Kessler, RC, Levinson, D, Medina Mora, ME, Oakley Browne, M, Ormel, J, Posada-Villa, J, Watanabe, M, Williams, D (2009). Mental-physical co-morbidity and its relationship with disability: results from the World mental health surveys. Psychological Medicine 39, 33–43.Google Scholar
Scott, KM, Von Korff, M, Angermeyer, MC, Benjet, C, Bruffaerts, R, de Girolamo, G, Haro, JM, Lepine, JP, Ormel, J, Posada-Villa, J, Tachimori, H, Kessler, RC (2011). Association of childhood adversities and early-onset mental disorders with adult-onset chronic physical conditions. Archives of General Psychiatry 68, 838–844.CrossRefGoogle ScholarPubMed
Sidhom, Y, Ben Djebara, M, Hizem, Y, Abdelkefi, I, Kacem, I, Gargouri, A, Gouider, R (2014). Bipolar disorder and multiple sclerosis: a case series. Behavioural Neurology 2014, 536503.Google Scholar
Sobel, ME (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology 13, 290–312.Google Scholar
Statistics Canada (2013). Canadian Community Health Survey (CCHS) – Mental Health. User Guide: Microdata Files. Statistics Canada: Ottawa.Google Scholar
Stegmann, ME, Ormel, J, de Graaf, R, Haro, JM, de Girolamo, G, Demyttenaere, K, Kovess, V, Matschinger, H, Vilagut, G, Alonso, J, Burger, H, Investigators, EM (2010). Functional disability as an explanation of the associations between chronic physical conditions and 12-month major depressive episode. Journal of Affective Disorder 124, 38–44.Google Scholar
Szigethy, EM, Youk, AO, Benhayon, D, Fairclough, DL, Newara, MC, Kirshner, MA, Bujoreanu, SI, Mrakotsky, C, Bousvaros, A, Srinath, AI, Keljo, DJ, Kupfer, DJ, DeMaso, DR (2014). Depression subtypes in pediatric inflammatory bowel disease. Journal of Pediatric Gastroenterology and Nutrition 58, 574–581.Google Scholar
Tunks, ER, Crook, J, Weir, R (2008). Epidemiology of chronic pain with psychological comorbidity: prevalence, risk, course, and prognosis. Canadian Journal of Psychiatry 53, 224–34.Google Scholar
Üstün, TB, Chatterrji, S, Kostanjsek, N, Rehm, J, Kennedy, C, Epping-Jordan, J, Saxena, S, von Korff, M, Pull, C (2010 a). Developing the World Health Organization disability assessment Schedule 2.0. Bulletin of the World Health Organization 88, 815–823.Google Scholar
Üstün, TB, Kostanjsek, N, Chatterji, S, Rehm, J (2010 b). Measuring Health and Disability: Manual for WHO Disability Assessment Schedule: WHODAS 2.0. World Health Organization: Geneva.Google Scholar
Van Brakel, WH (2006). Measuring health-related stigma – a literature review. Psychology, Health and Medicine 11, 307–34.Google Scholar
Weare, K, Nind, M (2011). Mental health promotion and problem prevention in schools: what does the evidence say? Health Promotion Internation 26 (Suppl 1), i29–i69.Google Scholar
Word Health Organization (WHO) (2010). International Statisical Classification of Diseases and Related Health Problems. Retrieved 20 April 2015 from http://apps.who.int/classifications/icd10/browse/2010/en Google Scholar
Wotton, CJ, Goldacre, MJ (2014). Record-linkage studies of the coexistence of epilepsy and bipolar disorder. Social Psychiatry and Psychiatric Epidemiology 49, 1483–1488.Google Scholar
Zhang, XP, Norris, SL, Gregg, EW, Cheng, YLJ, Beckles, G, Kahn, HS (2005). Depressive symptoms and mortality among persons with and without diabetes. American Journal of Epidemiology 161, 652–660.Google Scholar