The structure of common mental disorders.

Area of Science:

• Psychiatry
• Psychology
• Epidemiology

Background:

• Analyzes patterns of comorbidity among 10 common mental disorders.
• Utilizes data from the National Comorbidity Survey, a representative sample of US adults.
• Employs structured diagnostic interviews for data collection.

Purpose of the Study:

• To investigate the underlying factor structure of mental disorder comorbidity.
• To compare different models explaining the co-occurrence of mental health conditions.

Main Methods:

• Confirmatory factor analyses were performed on a large sample (N=8098).
• Four models were compared: 1-factor, 2-factor (internalizing/externalizing), 3-factor (internalizing subtypes), and 4-factor (affective, anxiety, substance, antisocial).
• Analyses were conducted on the full sample, random halves, and gender-specific subsamples.

Main Results:

• A 3-factor model (affective, anxiety, substance dependence, antisocial) best fit the general population data.
• The 'anxious-misery' and 'fear' factors were highly correlated, suggesting a higher-order 'internalizing' factor.
• A 2-factor model fit best for the subsample receiving professional mental health treatment.

Conclusions:

• Comorbidity appears to arise from common, underlying psychopathological processes.
• Suggests a shift in research focus towards these core processes rather than distinct disorder manifestations.
• Provides a novel perspective on understanding the etiology of mental disorder co-occurrence.