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Published Online: 5 June 2015

Pediatric-Onset and Adult-Onset Separation Anxiety Disorder Across Countries in the World Mental Health Survey

Derrick Silove, M.D., Ph.D., Jordi Alonso, M.D., Ph.D., Evelyn Bromet, Ph.D., Mike Gruber, M.S., Nancy Sampson, B.A., Kate Scott, Ph.D., Laura Andrade, M.D., Ph.D., Corina Benjet, Ph.D., Jose Miguel Caldas de Almeida, M.D., Ph.D., Giovanni De Girolamo, M.D., Peter de Jonge, Ph.D., Koen Demyttenaere, M.D., Ph.D., Fabian Fiestas, M.D., Silvia Florescu, M.D., Ph.D., Oye Gureje, Ph.D., Yanling He, M.D., Elie Karam, M.D., Jean-Pierre Lepine, Ph.D., Sam Murphy, Ph.D., Jose Villa-Posada, M.D., Zahari Zarkov, M.D., and Ronald C. Kessler, Ph.D.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 172, Number 7
https://doi.org/10.1176/appi.ajp.2015.14091185
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Abstract

Objective:

The age-at-onset criterion for separation anxiety disorder was removed in DSM-5, making it timely to examine the epidemiology of separation anxiety disorder as a disorder with onsets spanning the life course, using cross-country data.

Method:

The sample included 38,993 adults in 18 countries in the World Health Organization (WHO) World Mental Health Surveys. The WHO Composite International Diagnostic Interview was used to assess a range of DSM-IV disorders that included an expanded definition of separation anxiety disorder allowing onsets in adulthood. Analyses focused on prevalence, age at onset, comorbidity, predictors of onset and persistence, and separation anxiety-related role impairment.

Results:

Lifetime separation anxiety disorder prevalence averaged 4.8% across countries (interquartile range [25th–75th percentiles]=1.4%−6.4%), with 43.1% of lifetime onsets occurring after age 18. Significant time-lagged associations were found between earlier separation anxiety disorder and subsequent onset of internalizing and externalizing DSM-IV disorders and conversely between these disorders and subsequent onset of separation anxiety disorder. Other consistently significant predictors of lifetime separation anxiety disorder included female gender, retrospectively reported childhood adversities, and lifetime traumatic events. These predictors were largely comparable for separation anxiety disorder onsets in childhood, adolescence, and adulthood and across country income groups. Twelve-month separation anxiety disorder prevalence was considerably lower than lifetime prevalence (1.0% of the total sample; interquartile range=0.2%–1.2%). Severe separation anxiety-related 12-month role impairment was significantly more common in the presence (42.4%) than absence (18.3%) of 12-month comorbidity.

Conclusions:

Separation anxiety disorder is a common and highly comorbid disorder that can have onset across the lifespan. Childhood adversity and lifetime trauma are important antecedents, and adverse effects on role function make it a significant target for treatment.

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Information & Authors

Information

Published In

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Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 172 • Number 7 • July 01, 2015
Pages: 647 - 656
PubMed: 26046337

History

Received: 23 September 2014
Revision received: 17 January 2015
Accepted: 2 February 2015
Published online: 5 June 2015
Published in print: July 01, 2015

Authors

Affiliations

Derrick Silove, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Jordi Alonso, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Evelyn Bromet, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Mike Gruber, M.S.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Nancy Sampson, B.A.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Kate Scott, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Laura Andrade, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Corina Benjet, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Jose Miguel Caldas de Almeida, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Giovanni De Girolamo, M.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Peter de Jonge, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Koen Demyttenaere, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Fabian Fiestas, M.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Silvia Florescu, M.D., Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Sam Murphy, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Jose Villa-Posada, M.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Zahari Zarkov, M.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Ronald C. Kessler, Ph.D.
From the Psychiatry Research and Teaching Unit and Ingham Institute, School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF) and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain; Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, N.Y.; Department of Health Care Policy, Harvard Medical School, Boston; Department of Psychological Medicine, University of Otago, Otago, New Zealand; Department/Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portgual; IRCCS St. John of God Clinical Research Centre and IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychiatry, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium; Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institutes of Health, Lima, Peru; National School of Public Health, Management and Professional Development, Bucharest, Romania; Department of Psychiatry, University College Hospital, Ibadan, Nigeria; Shanghai Mental Health Center, Shanghai, the People’s Republic of China; Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, Beirut, Lebanon; Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut, Lebanon; Institute for Development Research Advocacy and Applied Care (IDRAAC), Beirut, Lebanon; Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, University Paris Diderot and Paris Descartes Paris, Paris; School of Psychology, University of Ulster, Northern Ireland; Colegio Mayor de Cundinamarva University, Bogota, Colombia; National Center of Public Health and Analyses, Sofia, Bulgaria.
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Notes

Address correspondence to Dr. Silove ([email protected]).

Competing Interests

Dr. Silove receives royalties from Little, Brown Book Group and Oxford University Press; and he has served as a consultant for Counterpart International. Dr. Demyttenaere serves on the speaker’s bureaus and/or advisory panels of AstraZeneca, Eli Lilly, Johnson and Johnson, Lundbeck, Neurex, Servier, Shire, and Takeda and has also received research grants from Eli Lilly and Fonds voor Wetenschappelijk onderzoek Vlaanderen. Dr. Fiestas is an employee of the Peruvian National Institutes of Health. Dr. Kessler has served as a consultant for Hoffmann-La Roche and Johnson and Johnson Wellness and Prevention; he has also served on advisory boards for Johnson and Johnson Services Lake Nona Life Project, the Mensante Corporation, and U.S. Preventive Medicine; and he is a shareholder with DataStat. All other authors report no financial relationships with commercial interests.

Funding Information

Ortho-McNeil Pharmaceutical
GlaxoSmithKline10.13039/100004330
National Institute of Mental Health10.13039/100000025: R01 MH070884
Bristol-Myers Squibb10.13039/100002491
Imclone10.13039/100006524
Pan American Health Organization
The Fogarty International Center: FIRCA R03-TW006481
US Public Health Service : R01 DA016558
The John D. and Catherine T. MacArthur Foundation: R13-MH066849
Pfizer Foundation: R01-MH069864
The World Health Organization (WHO) World Mental Health Survey Initiative is supported by NIMH (R01 MH070884, R13 MH066849, and R01 MH069864), the National Institute on Drug Abuse (R01 DA016558), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb. None of these funders had any role in the design, analysis, interpretation of results, or preparation of this article. (A complete list of World Mental Health publications is available online [http://www.hcp.med.harvard.edu/wmh/].) The 2007 Australian National Survey of Mental Health and Wellbeing was funded by the Australian Government Department of Health and Ageing. The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation Thematic Project (grant 03/00204-3). The Bulgarian Epidemiological Study of common mental disorders is supported by the Ministry of Health and the National Center for Public Health Protection. The Colombian National Study of Mental Health is supported by the Ministry of Social Protection. The ESEMeD project is funded by the European Commission (contracts QLG5-1999-01042, SANCO 2004123, and EAHC 20081308), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain, Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP), and other local agencies and by an unrestricted educational grant from GlaxoSmithKline. The Lebanese National Mental Health Survey (L.E.B.A.N.O.N.) is supported by the Lebanese Ministry of Public Health, WHO (Lebanon), National Institutes of Health/Fogarty International Center (R03 TW006481-01), Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences, anonymous private donations to IDRAAC, Lebanon, and research grants from AstraZeneca, Eli Lilly, GlaxoSmithKline, Lundbeck, Novartis, Roche, and Servier. The Nigerian Survey of Mental Health and Wellbeing is supported by WHO (Geneva), WHO (Nigeria), and the Federal Ministry of Health, Abuja, Nigeria. The Northern Ireland Study of Mental Health was funded by the Health and Social Care Research and Development Division of the Public Health Agency. The Chinese World Mental Health Survey Initiative is supported by the Pfizer Foundation. The Portuguese Mental Health Study was carried out by the Department of Mental Health, Faculty of Medical Sciences, NOVA University of Lisbon, with collaboration of the Portuguese Catholic University, and was funded by the Champalimaud Foundation, the Gulbenkian Foundation, the Foundation for Science and Technology and Ministry of Health. The Romania World Mental Health study projects “Policies in Mental Health Area” and “National Study regarding Mental Health and Services Use” were carried out by the National School of Public Health and Health Services Management (former National Institute for Research and Development in Health, present National School of Public Health Management and Professional Development, Bucharest), with technical support from Metro Media Transylvania, the National Institute of Statistics-National Centre for Training in Statistics, SC, Cheyenne Services SRL, Statistics Netherlands and were funded by the Ministry of Public Health (former Ministry of Health), with supplemental support from Eli Lilly Romania SRL. The U.S. National Comorbidity Survey Replication is supported by NIMH (U01-MH60220), with supplemental support from the National Institute of Drug Abuse, the Substance Abuse and Mental Health Services Administration, the Robert Wood Johnson Foundation (grant 044708), and the John W. Alden Trust. The de-identified survey data are stored and were analyzed on secure servers at the World Mental Health Data Analysis Coordination Center at Harvard Medical School, Boston.

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