Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative

Background: Mental disorders are highly prevalent among students worldwide. This study aims to examine comorbidity and temporal associations between mental disorders among students. Methods: The study included 72,288 students from 18 countries as part of the World Mental Health International College...

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Authors: Roest, Annelieke M., de Vries, Ymkje Anna, Pozuelo, Julia R., Petukhova, Maria V., Lee, Sue, Sampson, Nancy A., Albor, Yesica, Alhadi, Ahmad N., Alonso, Jordi, Al-Saud, Nouf, Altwaijri, Yasmin, Andersson, Claes, Atwoli, Lukoye, Auerbach, Randy P., Muaka, Caroline Ayuya, Baez-Mansur, Patricia M., Ballester, Laura, Bantjes, Jason, Baumeister, Harald, Bendtsen, Marcus, Benjet, Corina, Berman, Anne H., Bruffaerts, Ronny, Carrasco, Paula, Chan, Silver C. N., Cohut, Irina, Couder, Maria Anabell Covarrubias Diaz, Crockett, Marcelo A., Cuijpers, Pim, David, Oana A., Dong, Dong, Ebert, David D., Gaete, Jorge, Forero, Carlos Garcia, Gili, Margalida, Gutierrez-Garcia, Raul, Haro, Josep Maria, Hasking, Penelope, Hunt, Xanthe, Husky, Mathilde M., Jaguga, Florence, Langer, Alvaro I., Leniz, Irene, Liu, Yan, Mac-Ginty, Scarlett, Martinez, Vania, McLafferty, Margaret, Miranda, Andrea, Monroy-Velasco, Iris Ruby, Murray, Elaine K., Musyoka, Catherine M., Nedelcea, Catalin, Nunez, Daniel, O'Neill, Siobhan M., Piqueras, Jose A., Popescu, Codruta A., Prescivalli, Ana Paula, Rapsey, Charlene, Robinson, Kealagh, Rodriguez-Jimenez, Tiscar, Saal, Wylene, Siu, Oi-Ling, Stein, Dan J., Struijs, Sascha Y., Tomoiaga, Cristina T., Valdes-Garcia, Karla Patricia, Vargas-Contreras, Eunice, Vigo, Daniel V., Wang, Angel Y., Wong, Samuel Y. S., Kessler, Ronald C.
Format: article
Status:Published version
Publication Date:2025
Country:España
Institution:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repository:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p19343
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/19343
Access Level:Open access
Keyword:Internalizing
Externalizing
Comorbidity
College students
Substance use disorders
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spelling Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiativeRoest, Annelieke M.de Vries, Ymkje AnnaPozuelo, Julia R.Petukhova, Maria V.Lee, SueSampson, Nancy A.Albor, YesicaAlhadi, Ahmad N.Alonso, JordiAl-Saud, NoufAltwaijri, YasminAndersson, ClaesAtwoli, LukoyeAuerbach, Randy P.Muaka, Caroline AyuyaBaez-Mansur, Patricia M.Ballester, LauraBantjes, JasonBaumeister, HaraldBendtsen, MarcusBenjet, CorinaBerman, Anne H.Bruffaerts, RonnyCarrasco, PaulaChan, Silver C. N.Cohut, IrinaCouder, Maria Anabell Covarrubias DiazCrockett, Marcelo A.Cuijpers, PimDavid, Oana A.Dong, DongEbert, David D.Gaete, JorgeForero, Carlos GarciaGili, MargalidaGutierrez-Garcia, RaulHaro, Josep MariaHasking, PenelopeHunt, XantheHusky, Mathilde M.Jaguga, FlorenceLanger, Alvaro I.Leniz, IreneLiu, YanMac-Ginty, ScarlettMartinez, VaniaMcLafferty, MargaretMiranda, AndreaMonroy-Velasco, Iris RubyMurray, Elaine K.Musyoka, Catherine M.Nedelcea, CatalinNunez, DanielO'Neill, Siobhan M.Piqueras, Jose A.Popescu, Codruta A.Prescivalli, Ana PaulaRapsey, CharleneRobinson, KealaghRodriguez-Jimenez, TiscarSaal, WyleneSiu, Oi-LingStein, Dan J.Struijs, Sascha Y.Tomoiaga, Cristina T.Valdes-Garcia, Karla PatriciaVargas-Contreras, EuniceVigo, Daniel V.Wang, Angel Y.Wong, Samuel Y. S.Kessler, Ronald C.InternalizingExternalizingComorbidityCollege studentsSubstance use disordersBackground: Mental disorders are highly prevalent among students worldwide. This study aims to examine comorbidity and temporal associations between mental disorders among students. Methods: The study included 72,288 students from 18 countries as part of the World Mental Health International College Student (WMH-ICS) Initiative, with cross-sectional data collected between 2017 and 2023. Screening for common DSM-5 disorders was conducted using validated screening measures. Latent variables were examined using exploratory principal axis factor analysis on a correlation matrix among the lifetime mental disorders. Based on age-of-onset information, multivariable poisson regression models were used to examine associations of prior disorders with the first onset of other disorders. Results: 27.0 % of students screened positive for only one lifetime disorder, 17.1 % for two, 10.9 % for three, and 10.6 % for 4+ disorders. In the factor analysis, three latent variables were found, comprising: internalizing disorders (generalized anxiety disorder, major depressive episode, post-traumatic stress disorder, and panic disorder), substance use disorders (drug use disorder and alcohol use disorder), and externalizing disorders (attention deficit/hyperactivity disorder and mania/hypomania). Prior internalizing and externalizing disorders were associated with the subsequent first onset of all other disorders with risk ratios ranging from 1.5-7.5. Substance use disorders were less consistently associated with the subsequent first onset of other disorders, but alcohol use disorder was associated with the first onset of drug use disorder and vice versa. Conclusions: Mental disorder comorbidity is common among students, and students with disorders across the internalizing and externalizing spectrum have an increased risk of future mental disorder comorbidities.ELSEVIER IRELAND LTD2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/19343PSYCHIATRY RESEARCHISSN: 01651781ISSNe: 18727123reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p193432026-06-11T12:45:17Z
dc.title.none.fl_str_mv Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
title Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
spellingShingle Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
Roest, Annelieke M.
Internalizing
Externalizing
Comorbidity
College students
Substance use disorders
title_short Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
title_full Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
title_fullStr Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
title_full_unstemmed Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
title_sort Comorbidity and temporal associations between mental disorders among college students in the world mental health international college student initiative
dc.creator.none.fl_str_mv Roest, Annelieke M.
de Vries, Ymkje Anna
Pozuelo, Julia R.
Petukhova, Maria V.
Lee, Sue
Sampson, Nancy A.
Albor, Yesica
Alhadi, Ahmad N.
Alonso, Jordi
Al-Saud, Nouf
Altwaijri, Yasmin
Andersson, Claes
Atwoli, Lukoye
Auerbach, Randy P.
Muaka, Caroline Ayuya
Baez-Mansur, Patricia M.
Ballester, Laura
Bantjes, Jason
Baumeister, Harald
Bendtsen, Marcus
Benjet, Corina
Berman, Anne H.
Bruffaerts, Ronny
Carrasco, Paula
Chan, Silver C. N.
Cohut, Irina
Couder, Maria Anabell Covarrubias Diaz
Crockett, Marcelo A.
Cuijpers, Pim
David, Oana A.
Dong, Dong
Ebert, David D.
Gaete, Jorge
Forero, Carlos Garcia
Gili, Margalida
Gutierrez-Garcia, Raul
Haro, Josep Maria
Hasking, Penelope
Hunt, Xanthe
Husky, Mathilde M.
Jaguga, Florence
Langer, Alvaro I.
Leniz, Irene
Liu, Yan
Mac-Ginty, Scarlett
Martinez, Vania
McLafferty, Margaret
Miranda, Andrea
Monroy-Velasco, Iris Ruby
Murray, Elaine K.
Musyoka, Catherine M.
Nedelcea, Catalin
Nunez, Daniel
O'Neill, Siobhan M.
Piqueras, Jose A.
Popescu, Codruta A.
Prescivalli, Ana Paula
Rapsey, Charlene
Robinson, Kealagh
Rodriguez-Jimenez, Tiscar
Saal, Wylene
Siu, Oi-Ling
Stein, Dan J.
Struijs, Sascha Y.
Tomoiaga, Cristina T.
Valdes-Garcia, Karla Patricia
Vargas-Contreras, Eunice
Vigo, Daniel V.
Wang, Angel Y.
Wong, Samuel Y. S.
Kessler, Ronald C.
author Roest, Annelieke M.
author_facet Roest, Annelieke M.
de Vries, Ymkje Anna
Pozuelo, Julia R.
Petukhova, Maria V.
Lee, Sue
Sampson, Nancy A.
Albor, Yesica
Alhadi, Ahmad N.
Alonso, Jordi
Al-Saud, Nouf
Altwaijri, Yasmin
Andersson, Claes
Atwoli, Lukoye
Auerbach, Randy P.
Muaka, Caroline Ayuya
Baez-Mansur, Patricia M.
Ballester, Laura
Bantjes, Jason
Baumeister, Harald
Bendtsen, Marcus
Benjet, Corina
Berman, Anne H.
Bruffaerts, Ronny
Carrasco, Paula
Chan, Silver C. N.
Cohut, Irina
Couder, Maria Anabell Covarrubias Diaz
Crockett, Marcelo A.
Cuijpers, Pim
David, Oana A.
Dong, Dong
Ebert, David D.
Gaete, Jorge
Forero, Carlos Garcia
Gili, Margalida
Gutierrez-Garcia, Raul
Haro, Josep Maria
Hasking, Penelope
Hunt, Xanthe
Husky, Mathilde M.
Jaguga, Florence
Langer, Alvaro I.
Leniz, Irene
Liu, Yan
Mac-Ginty, Scarlett
Martinez, Vania
McLafferty, Margaret
Miranda, Andrea
Monroy-Velasco, Iris Ruby
Murray, Elaine K.
Musyoka, Catherine M.
Nedelcea, Catalin
Nunez, Daniel
O'Neill, Siobhan M.
Piqueras, Jose A.
Popescu, Codruta A.
Prescivalli, Ana Paula
Rapsey, Charlene
Robinson, Kealagh
Rodriguez-Jimenez, Tiscar
Saal, Wylene
Siu, Oi-Ling
Stein, Dan J.
Struijs, Sascha Y.
Tomoiaga, Cristina T.
Valdes-Garcia, Karla Patricia
Vargas-Contreras, Eunice
Vigo, Daniel V.
Wang, Angel Y.
Wong, Samuel Y. S.
Kessler, Ronald C.
author_role author
author2 de Vries, Ymkje Anna
Pozuelo, Julia R.
Petukhova, Maria V.
Lee, Sue
Sampson, Nancy A.
Albor, Yesica
Alhadi, Ahmad N.
Alonso, Jordi
Al-Saud, Nouf
Altwaijri, Yasmin
Andersson, Claes
Atwoli, Lukoye
Auerbach, Randy P.
Muaka, Caroline Ayuya
Baez-Mansur, Patricia M.
Ballester, Laura
Bantjes, Jason
Baumeister, Harald
Bendtsen, Marcus
Benjet, Corina
Berman, Anne H.
Bruffaerts, Ronny
Carrasco, Paula
Chan, Silver C. N.
Cohut, Irina
Couder, Maria Anabell Covarrubias Diaz
Crockett, Marcelo A.
Cuijpers, Pim
David, Oana A.
Dong, Dong
Ebert, David D.
Gaete, Jorge
Forero, Carlos Garcia
Gili, Margalida
Gutierrez-Garcia, Raul
Haro, Josep Maria
Hasking, Penelope
Hunt, Xanthe
Husky, Mathilde M.
Jaguga, Florence
Langer, Alvaro I.
Leniz, Irene
Liu, Yan
Mac-Ginty, Scarlett
Martinez, Vania
McLafferty, Margaret
Miranda, Andrea
Monroy-Velasco, Iris Ruby
Murray, Elaine K.
Musyoka, Catherine M.
Nedelcea, Catalin
Nunez, Daniel
O'Neill, Siobhan M.
Piqueras, Jose A.
Popescu, Codruta A.
Prescivalli, Ana Paula
Rapsey, Charlene
Robinson, Kealagh
Rodriguez-Jimenez, Tiscar
Saal, Wylene
Siu, Oi-Ling
Stein, Dan J.
Struijs, Sascha Y.
Tomoiaga, Cristina T.
Valdes-Garcia, Karla Patricia
Vargas-Contreras, Eunice
Vigo, Daniel V.
Wang, Angel Y.
Wong, Samuel Y. S.
Kessler, Ronald C.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
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author
dc.subject.none.fl_str_mv Internalizing
Externalizing
Comorbidity
College students
Substance use disorders
topic Internalizing
Externalizing
Comorbidity
College students
Substance use disorders
description Background: Mental disorders are highly prevalent among students worldwide. This study aims to examine comorbidity and temporal associations between mental disorders among students. Methods: The study included 72,288 students from 18 countries as part of the World Mental Health International College Student (WMH-ICS) Initiative, with cross-sectional data collected between 2017 and 2023. Screening for common DSM-5 disorders was conducted using validated screening measures. Latent variables were examined using exploratory principal axis factor analysis on a correlation matrix among the lifetime mental disorders. Based on age-of-onset information, multivariable poisson regression models were used to examine associations of prior disorders with the first onset of other disorders. Results: 27.0 % of students screened positive for only one lifetime disorder, 17.1 % for two, 10.9 % for three, and 10.6 % for 4+ disorders. In the factor analysis, three latent variables were found, comprising: internalizing disorders (generalized anxiety disorder, major depressive episode, post-traumatic stress disorder, and panic disorder), substance use disorders (drug use disorder and alcohol use disorder), and externalizing disorders (attention deficit/hyperactivity disorder and mania/hypomania). Prior internalizing and externalizing disorders were associated with the subsequent first onset of all other disorders with risk ratios ranging from 1.5-7.5. Substance use disorders were less consistently associated with the subsequent first onset of other disorders, but alcohol use disorder was associated with the first onset of drug use disorder and vice versa. Conclusions: Mental disorder comorbidity is common among students, and students with disorders across the internalizing and externalizing spectrum have an increased risk of future mental disorder comorbidities.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/19343
url https://fisabio.portalinvestigacion.com/publicaciones/19343
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER IRELAND LTD
publisher.none.fl_str_mv ELSEVIER IRELAND LTD
dc.source.none.fl_str_mv PSYCHIATRY RESEARCH
ISSN: 01651781
ISSNe: 18727123
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429