Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel

Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study.

Publication ,  Journal Article
Caspi, A; Houts, RM; Ambler, A; Danese, A; Elliott, ML; Hariri, A; Harrington, H; Hogan, S; Poulton, R; Ramrakha, S; Rasmussen, LJH; Reuben, A ...
Published in: JAMA network open
April 2020

Mental health professionals typically encounter patients at 1 point in patients' lives. This cross-sectional window understandably fosters focus on the current presenting diagnosis. Research programs, treatment protocols, specialist clinics, and specialist journals are oriented to presenting diagnoses, on the assumption that diagnosis informs about causes and prognosis. This study tests an alternative hypothesis: people with mental disorders experience many different kinds of disorders across diagnostic families, when followed for 4 decades.To describe mental disorder life histories across the first half of the life course.This cohort study involved participants born in New Zealand from 1972 to 1973 who were enrolled in the population-representative Dunedin Study. Participants were observed from birth to age 45 years (until April 2019). Data were analyzed from May 2019 to January 2020.Diagnosed impairing disorders were assessed 9 times from ages 11 to 45 years. Brain function was assessed through neurocognitive examinations conducted at age 3 years, neuropsychological testing during childhood and adulthood, and midlife neuroimaging-based brain age.Of 1037 original participants (535 male [51.6%]), 1013 had mental health data available. The proportions of participants meeting the criteria for a mental disorder were as follows: 35% (346 of 975) at ages 11 to 15 years, 50% (473 of 941) at age 18 years, 51% (489 of 961) at age 21 years, 48% (472 of 977) at age 26 years, 46% (444 of 969) at age 32 years, 45% (429 of 955) at age 38 years, and 44% (407 of 927) at age 45 years. The onset of the disorder occurred by adolescence for 59% of participants (600 of 1013), eventually affecting 86% of the cohort (869 of 1013) by midlife. By age 45 years, 85% of participants (737 of 869) with a disorder had accumulated comorbid diagnoses. Participants with adolescent-onset disorders subsequently presented with disorders at more past-year assessments (r = 0.71; 95% CI, 0.68 to 0.74; P < .001) and met the criteria for more diverse disorders (r = 0.64; 95% CI, 0.60 to 0.67; P < .001). Confirmatory factor analysis summarizing mental disorder life histories across 4 decades identified a general factor of psychopathology, the p-factor. Longitudinal analyses showed that high p-factor scores (indicating extensive mental disorder life histories) were antedated by poor neurocognitive functioning at age 3 years (r = -0.18; 95% CI, -0.24 to -0.12; P < .001), were accompanied by childhood-to-adulthood cognitive decline (r = -0.11; 95% CI, -0.17 to -0.04; P < .001), and were associated with older brain age at midlife (r = 0.14; 95% CI, 0.07 to 0.20; P < .001).These findings suggest that mental disorder life histories shift among different successive disorders. Data from the present study, alongside nationwide data from Danish health registers, inform a life-course perspective on mental disorders. This perspective cautions against overreliance on diagnosis-specific research and clinical protocols.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA network open

DOI

EISSN

2574-3805

ISSN

2574-3805

Publication Date

April 2020

Volume

3

Issue

4

Start / End Page

e203221

Related Subject Headings

  • Young Adult
  • New Zealand
  • Middle Aged
  • Mental Disorders
  • Male
  • Longitudinal Studies
  • Humans
  • Female
  • Comorbidity
  • Child
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Caspi, A., Houts, R. M., Ambler, A., Danese, A., Elliott, M. L., Hariri, A., … Moffitt, T. E. (2020). Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA Network Open, 3(4), e203221. https://doi.org/10.1001/jamanetworkopen.2020.3221
Caspi, Avshalom, Renate M. Houts, Antony Ambler, Andrea Danese, Maxwell L. Elliott, Ahmad Hariri, HonaLee Harrington, et al. “Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study.JAMA Network Open 3, no. 4 (April 2020): e203221. https://doi.org/10.1001/jamanetworkopen.2020.3221.
Caspi A, Houts RM, Ambler A, Danese A, Elliott ML, Hariri A, et al. Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA network open. 2020 Apr;3(4):e203221.
Caspi, Avshalom, et al. “Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study.JAMA Network Open, vol. 3, no. 4, Apr. 2020, p. e203221. Epmc, doi:10.1001/jamanetworkopen.2020.3221.
Caspi A, Houts RM, Ambler A, Danese A, Elliott ML, Hariri A, Harrington H, Hogan S, Poulton R, Ramrakha S, Rasmussen LJH, Reuben A, Richmond-Rakerd L, Sugden K, Wertz J, Williams BS, Moffitt TE. Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA network open. 2020 Apr;3(4):e203221.

Published In

JAMA network open

DOI

EISSN

2574-3805

ISSN

2574-3805

Publication Date

April 2020

Volume

3

Issue

4

Start / End Page

e203221

Related Subject Headings

  • Young Adult
  • New Zealand
  • Middle Aged
  • Mental Disorders
  • Male
  • Longitudinal Studies
  • Humans
  • Female
  • Comorbidity
  • Child