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Associations Between General and Specific Mental Health Conditions in Young Adulthood and Cardiometabolic Complications in Middle Adulthood: A 40-Year Longitudinal Familial Coaggregation Study of 672,823 Swedish Individuals
Karolinska Institutet, Solna, Sweden.
Karolinska Institutet, Solna, Sweden.
Karolinska Institutet, Solna, Sweden.
Indiana University, Bloomington, United States .
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2024 (English)In: American Journal of Psychiatry, ISSN 0002-953X, E-ISSN 1535-7228, Vol. 181, no 7, p. 651-657Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability to psychopathology or confounded by unmeasured familial factors. The authors investigated the association between psychiatric conditions in young adulthood and the risk of cardiometabolic complications in middle adulthood, up to 40 years later.

METHODS: This cohort study (N=672,823) identified all individuals and their siblings born in Sweden between 1955 and 1962 and followed the cohort through 2013. Logistic regression models were used to estimate the bivariate associations between 10 psychiatric conditions or criminal convictions and five cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the comorbidity among psychiatric conditions and criminal convictions. The cardiometabolic complications were then regressed on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs.

RESULTS: Each psychiatric condition significantly increased the risk of cardiometabolic complications. These associations appeared nonspecific, as multivariate models indicated that most were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals' general psychopathology and their siblings' cardiometabolic complications. The same pattern was evident for the specific internalizing and psychotic factors.

CONCLUSIONS: Associations between mental disorders in early life and later long-term risk of cardiometabolic complications appeared to be attributable to a general liability to psychopathology. Familial coaggregation analyses suggested that the elevated risk could not be attributed to confounders shared within families. One possibility is that lifestyle-based interventions may reduce the risk of later cardiometabolic complications for patients with several mental disorders.

Place, publisher, year, edition, pages
HighWire Press , 2024. Vol. 181, no 7, p. 651-657
Keywords [en]
Cardiovascular Disease, Comorbidity, Familial Coaggregation, General Psychopathology Model, Mental Disorders, Metabolic Syndrome
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-111033DOI: 10.1176/appi.ajp.20220951ISI: 001280771400016PubMedID: 38263878Scopus ID: 2-s2.0-85197960411OAI: oai:DiVA.org:oru-111033DiVA, id: diva2:1833679
Funder
Region Stockholm, 20190712Swedish Research Council, 2017-01358
Note

Supported by the Swedish Research Council for Health (grant 2017-01358) , ALF Funding from the Stockholm Region (grant 20190712), and the China Scholarship Council.

Available from: 2024-02-01 Created: 2024-02-01 Last updated: 2024-08-19Bibliographically approved

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Larsson, Henrik

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