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Risk clustering and psychopathology from a multi-center cohort of Indian children, adolescents, and young adults

Published online by Cambridge University Press:  08 April 2022

Debasish Basu
Affiliation:
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Abhishek Ghosh*
Affiliation:
Drug Deaddiction and Treatment Center, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Chandrima Naskar
Affiliation:
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Srinivas Balachander
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Gwen Fernandes
Affiliation:
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
Nilakshi Vaidya
Affiliation:
Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
Kalyanaraman Kumaran
Affiliation:
Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
Murali Krishna
Affiliation:
Foundation for Research and Advocacy in Mental Health, Mysore, India
Gareth J. Barker
Affiliation:
Department of Neuroimaging, Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, UK
Eesha Sharma
Affiliation:
Department of Child & Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Pratima Murthy
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Bharath Holla
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Sanjeev Jain
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Dimitri Papadopoulos Orfanos
Affiliation:
NeuroSpin, CEA, Université Paris-Saclay, Paris, France
Kartik Kalyanram
Affiliation:
Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
Meera Purushottam
Affiliation:
Molecular Genetics Laboratory, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Rose Dawn Bharath
Affiliation:
Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
Mathew Varghese
Affiliation:
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
Kandavel Thennarasu
Affiliation:
Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bangalore, India
Amit Chakrabarti
Affiliation:
Centre on Non-Communicable Diseases Division of Non-Communicable Diseases (NCD) Indian Council of Medical Research (ICMR), Kolkata, India
Rajkumar Lenin Singh
Affiliation:
Department of Psychiatry, Regional Institute of Medical Sciences, Imphal, Manipur, India
Roshan Lourembam Singh
Affiliation:
Department of Psychology, Regional Institute of Medical Sciences, Imphal, Manipur, India
Subodh Bhagyalakshmi Nanjayya
Affiliation:
Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Chirag Kamal Ahuja
Affiliation:
Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education & Research, Chandigarh, India
Kamakshi Kartik
Affiliation:
Rishi Valley, Rural Health Centre, Madanapalle, Andhra Pradesh, India
Ghattu Krishnaveni
Affiliation:
Epidemiology Research Unit, CSI Holdsworth Memorial Hospital, Mysore, India
Rebecca Kuriyan
Affiliation:
Division of Nutrition, St John’s Research Institute, Bangalore, India
Sunita Simon Kurpad
Affiliation:
Department of Psychiatry & Department of Medical Ethics, St. John’s Medical College & Hospital, Bangalore, India
Sylvane Desrivieres
Affiliation:
Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, UK
Udita Iyengar
Affiliation:
Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, UK
Yuning Zhang
Affiliation:
Centre for Population Neuroscience and Precision Medicine, MRC Social, Genetic, Developmental Psychiatry Centre, Institute of Psychology, Psychiatry & Neuroscience, King’s College London, London, UK
Matthew Hickman
Affiliation:
Bristol Medical School, University of Bristol, Bristol, UK
Alex Spiers
Affiliation:
Department for Epidemiology and Biostatistics, School of Public Health, Imperial College of Science, London, UK
Mireille Toledano
Affiliation:
MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
Gunter Schumann
Affiliation:
Centre for Population Neuroscience and Precision Medicine, Charité Mental Health, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany Department of Psychiatry and Psychotherapy and PONS Centre, Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
Vivek Benegal
Affiliation:
Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences, Bangalore, India
*
Corresponding author: Abhishek Ghosh, email: ghoshabhishek12@gmail.com

Abstract

Developmental adversities early in life are associated with later psychopathology. Clustering may be a useful approach to group multiple diverse risks together and study their relation with psychopathology. To generate risk clusters of children, adolescents, and young adults, based on adverse environmental exposure and developmental characteristics, and to examine the association of risk clusters with manifest psychopathology. Participants (n = 8300) between 6 and 23 years were recruited from seven sites in India. We administered questionnaires to elicit history of previous exposure to adverse childhood environments, family history of psychiatric disorders in first-degree relatives, and a range of antenatal and postnatal adversities. We used these variables to generate risk clusters. Mini-International Neuropsychiatric Interview-5 was administered to evaluate manifest psychopathology. Two-step cluster analysis revealed two clusters designated as high-risk cluster (HRC) and low-risk cluster (LRC), comprising 4197 (50.5%) and 4103 (49.5%) participants, respectively. HRC had higher frequencies of family history of mental illness, antenatal and neonatal risk factors, developmental delays, history of migration, and exposure to adverse childhood experiences than LRC. There were significantly higher risks of any psychiatric disorder [Relative Risk (RR) = 2.0, 95% CI 1.8–2.3], externalizing (RR = 4.8, 95% CI 3.6–6.4) and internalizing disorders (RR = 2.6, 95% CI 2.2–2.9), and suicidality (2.3, 95% CI 1.8–2.8) in HRC. Social-environmental and developmental factors could classify Indian children, adolescents and young adults into homogeneous clusters at high or low risk of psychopathology. These biopsychosocial determinants of mental health may have practice, policy and research implications for people in low- and middle-income countries.

Type
Regular Article
Copyright
© The Author(s), 2022. Published by Cambridge University Press

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