María Elena Medina-Mora

Associations between DSM-IV mental disorders and subsequent self-reported diagnosis of cancer

OBJECTIVEnThe associations between mental disorders and cancer remain unclear. It is also unknown whether any associations vary according to life stage or gender. This paper examines these research questions using data from the World Mental Health Survey Initiative.nnnMETHODSnThe World Health Organization Composite International Diagnostic Interview retrospectively assessed the lifetime prevalence of 16 DSM-IV mental disorders in face-to-face household population surveys in nineteen countries (n = 52,095). Cancer was indicated by self-report of diagnosis. Smoking was assessed in questions about current and past tobacco use. Survival analyses estimated associations between first onset of mental disorders and subsequently reported cancer.nnnRESULTSnAfter adjustment for comorbidity, panic disorder, specific phobia and alcohol abuse were associated with a subsequently self-reported diagnosis of cancer. There was an association between number of mental disorders and the likelihood of reporting a cancer diagnosis following the onset of the mental disorder. This suggests that the associations between mental disorders and cancer risk may be generalised, rather than specific to a particular disorder. Depression is more strongly associated with self-reported cancers diagnosed early in life and in women. PTSD is also associated with cancers diagnosed early in life.nnnCONCLUSIONnThis study reports the magnitude of the associations between mental disorders and a self-reported diagnosis of cancer and provides information about the relevance of comorbidity, gender and the impact at different stages of life. The findings point to a link between the two conditions and lend support to arguments for early identification and treatment of mental disorders.

Descriptive Epidemiology of Depression in Latin America and Hispanics in the United States

I am a psychologist by training with further studies and interest in the area of epidemiology and public mental health. My areas of interest are methodological, psychosocial, and epidemiological issues as they relate to addictions and mental health. My special focus of interest, in which I have been working for the last years, is how alcohol and drug consumption is related to several medical and social problems, such as liver cirrhosis, infant health, suicide, and accidents. These topics lead me to further interests in the role of mental health in the modern societies, especially Mexico. I got deeply involved in research on the epidemiology of psychiatric disorders with a special emphasis in the study of suicide with the Consortium of Psychiatric Epidemiology and the WHO World Mental Health Survey Initiative, which includes national household surveys in more than 20 countries around the globe. In the study of suicidality, depression stands as a main topic of interest given its strong relationship with all types of suicide and suicide related behavior. Finally, being a national immigrant since I was about 3 years old, and an international immigrant since I was 14, it is not a surprise that I got interested on mental health issues of Latinos and, more specifically, the Mexican migration to the United States. The work of my colleagues in Mexico and other Hispanic academic leaders in the United States, concerned with the side-effect of immigration on the mental health, profoundly impacted me and has been an incentive for my own intellectual development.

Associations between DSM-IV mental disorders and subsequent onset of arthritis

OBJECTIVEnWe investigated the associations between DSM-IV mental disorders and subsequent arthritis onset, with and without mental disorder comorbidity adjustment. We aimed to determine whether specific types of mental disorders and increasing numbers of mental disorders were associated with the onset of arthritis later in life.nnnMETHODnData were collected using face-to-face household surveys, conducted in 19 countries from different regions of the world (n=52,095). Lifetime prevalence and age at onset of 16 DSM-IV mental disorders were assessed retrospectively with the World Health Organization (WHO) Composite International Diagnostic Interview (WHO-CIDI). Arthritis was assessed by self-report of lifetime history of arthritis and age at onset. Survival analyses estimated the association of initial onset of mental disorders with subsequent onset of arthritis.nnnRESULTSnAfter adjusting for comorbidity, the number of mood, anxiety, impulse-control, and substance disorders remained significantly associated with arthritis onset showing odds ratios (ORs) ranging from 1.2 to 1.4. Additionally, the risk of developing arthritis increased as the number of mental disorders increased from one to five or more disorders.nnnCONCLUSIONnThis study suggests links between mental disorders and subsequent arthritis onset using a large, multi-country dataset. These associations lend support to the idea that it may be possible to reduce the severity of mental disorder-arthritis comorbidity through early identification and effective treatment of mental disorders.