Lifetime XXXX comorbidity in the National Comorbidity Survey.

@entity162 @entity308 @entity4697
BACKGROUND: The National Comorbidity Survey is a nationally representative survey of the prevalences and correlates of DSM-III-R disorders in the US household population. METHODS: Retrospective age-at-onset reports were used to study predictive relationships between lifetime @entity4697 and @entity308 . RESULTS: Strong associations were found between the lifetime prevalences of @entity4697 and major @entity308 (odds ratios: for @entity4697 with @entity308 , 6.2; for @entity4697 with @entity308 , 6.8). These associations were not significantly influenced by the inclusion or exclusion of respondents with @entity162 . Temporally primary @entity308 predicted a first onset of subsequent @entity4697 but not of @entity4697 . Temporally primary @entity4697 , with or without @entity4697 and whether or not the @entity4697 was persistent, predicted a first onset of subsequent @entity308 . The associations between @entity4697 and @entity308 were attenuated in models that controlled for prior traumatic life experiences and histories of other DSM-III-R disorders. CONCLUSIONS: Lifetime @entity308 comorbidity characterizes most community respondents with @entity4697 and a substantial few of those with @entity308 . The absence of a dose-response relationship suggests that primary @entity4697 is a marker, rather than a causal risk factor, of subsequent @entity308 . Primary @entity308 , in comparison, appears to be a genuine risk factor for secondary @entity4697 . That primary @entity308 predicts @entity4697 but not @entity4697 suggests that secondary @entity4697 is a severity marker of @entity308 rather than a comorbid condition. These results are far from definitive because they are based on retrospective reports, lay-administered diagnostic interviews, and only 1 survey. However, they raise important questions that could lead to a fundamental rethinking of @entity308 comorbidity if they are replicated in future epidemiological and clinical studies.
