Abstract
BackgroundWhile research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables.ObjectiveWe aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life.MethodsAn online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age.ResultsA 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders.ConclusionsComorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools. Results provided support for the transdiagnostic approaches and confirmed the positive relationship between comorbidity and suicidal ideation, the negative relationship between comorbidity and social support, and the negative relationship comorbidity and quality of life.Trial RegistrationAustralian and New Zealand Clinical Trials Registry ACTRN121611000704998; http://www.anzctr.org.au/trial_view.aspx?ID=336143 (Archived by WebCite at http://www.webcitation.org/618r3wvOG)
Highlights
The comorbidity of psychological disorders is a common problem that has serious implications for the delivery of health care
Comorbidities of several psychological disorders using an online assessment tool within a Web-based population were similar to those found in face-to-face clinics using traditional assessment tools
Of the 858 males, 1761 females, and 2649 overall who received a primary diagnosis of major depressive episode (MDE), there were 207 (24.13%) males, 505 (28.68%) females, and 712 (26.88%) overall who received a secondary diagnosis of panic disorder with or without agoraphobia (PD/A), respectively
Summary
The comorbidity of psychological disorders is a common problem that has serious implications for the delivery of health care. Because there are more people diagnosed with anxiety disorders than people diagnosed with eating disorders, it is easier to have larger samples, and more accuracy, when the reference group is anxiety-disordered rather than eating-disordered. The second approach identifies the psychological disorders of a group of individuals, based on discrete or dimensional scales, and uses factor analysis to identify clusters of disorders, the underlying structure or dimensions of comorbidity is addressed. While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables
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