Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Christina Studts, PhD

Committee Member

Richard Crosby, PhD

Committee Member

Robin Vanderpool, DrPH, CHES


Background - Population-level data on the prevalence of comorbidity between anxiety-, eating-, and personality disorders remain relatively unexplored. Additionally, the potential existence of a temporal relationship among these three classes of mental disorder is also of interest.

Methods - Lifetime prevalence of, and temporal relationships among, anxiety-, eating-, and personality disorders were assessed using Part II WHO Composite International Diagnostic Interview data from the National Comorbidity Survey- Replication, a nationally representative household survey (n=5692).

Results - Lifetime prevalence estimates for any anxiety-, eating-, and personality disorder were 59.8%, 2.8%, and 13.5%, respectively, among those diagnosed with at least one core (Axis I of DSM-IV) disorder. Of respondents diagnosed with any eating disorder, 31.1% also met criteria for at least one personality disorder during their lifetime (OR=3.01, CI=2.13–4.23). Forty-nine respondents met criteria for all three types of mental disorders (OR=3.73, CI=2.61–5.33). Mean age of onset for any anxiety- or eating disorder was significantly younger in respondents who were diagnosed with lifetime comorbidity (M=11.8 and 18.7, respectively) than respondents with no comorbidity during their life (M=15.1 and 23.3), ps<0.01. Of respondents who met diagnostic criteria for at least one anxiety- and eating disorder, 82.6% experienced anxiety symptoms prior to their symptoms of any eating disorder. The average difference in age of onset between anxiety and eating disorders between those with and without personality disorders was not found to be statistically significant.

Conclusions - Earlier development of key mental health disorders may signify those at greater risk for comorbidity during their lifetime, making earlier detection and interventions critical.

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