Development of Multimorbidity Indexes Based on Common Mental Health Conditions

TL;DR

Researchers created new tools to measure the combined impact of multiple mental health conditions on disability, using data from a large French cohort.

Contribution

The study introduces general and sex-specific mental multimorbidity indexes that better predict disability than simple disorder counts.

Findings

General and sex-specific mental multimorbidity indexes were developed and validated.

The new indexes showed slightly better predictive performance than counting mental disorders alone.

Both indexes were significantly associated with disability scores.

Abstract

Numerous multimorbidity indexes exist, focused primarily or solely on somatic conditions. We developed mental multimorbidity indexes as epidemiological tools.

Participants in the French NutriNet-Santé cohort (73.5% women; mean age = 59.5 ± 13.7 years; index development N = 20,000; index comparison N = 7,259) completed self-report questionnaires (2020–2022) regarding depressive symptoms, anxiety, eating disorders, insomnia, alcohol use disorders, cognitive difficulties, and the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). Using established cutoffs, participants were split into 2 groups for each condition. Tweedie regression analyses were performed with the 6 mental health conditions as exposures and the WHODAS 2.0 score as the outcome. Performance (C-index) and calibration of the indexes were compared with a simple count.

A general and a sex-specific mental multimorbidity indexes were developed; both were significantly associated with the disability score. The new indexes had slightly better predictive performance than simple counts of mental disorders.

We developed mental multimorbidity indexes as epidemiological research tools. Future prospective studies could investigate their predictive potential regarding outcomes such as medication use, healthcare utilization, and quality of life.