Development of Multimorbidity Indexes Based on Common Mental Health Conditions.

Abstract

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

Methods: 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.

Results: 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.

Conclusion: 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.