title: Relationship between psychiatric disorders and sexually transmitted diseases in a nationally representative sample.
abstract: OBJECTIVE
  Sexually transmitted diseases (STDs) are a significant public health concern. Numerous internalizing and externalizing psychiatric disorders have been found to be related to STD risk. However, to date, no studies have examined several psychiatric disorders simultaneously to account for STD risk. Given that psychiatric disorders often co-occur and can be explained by a limited number of latent dimensions of psychopathology, it is important to examine whether the relationship between STDs and psychiatric disorders is best explained by broad dimensions of psychopathology.
  
  
  METHODS
  The current study examined the associations between a range of Axis I and II psychiatric disorders at baseline and rates of STDs at a three-year follow-up in a large, nationally representative sample of adults in the United States (n=34,434). A confirmatory factor analysis (CFA) was conducted to fit three factors, two internalizing and one externalizing. Structural equation modeling (SEM) was used to assess the relationships between and among the factors and STD status and to test for mediation.
  
  
  RESULTS
  In bivariate analyses, most Axis I and Axis II disorders were associated with STD diagnosis at Wave 2, whereas the results of the structural model showed that only the externalizing factor was significantly associated with STD diagnosis at Wave 2. Further, the externalizing factor mediated the relationship between one of the internalizing factors and STD diagnosis.
  
  
  CONCLUSIONS
  Findings suggest the unique contribution of externalizing psychopathology to STD risk and the importance of examining latent dimensions of disorders when understanding this relationship between psychiatric disorders and STDs.
authors.affiliation: Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States; University of Maryland, College Park, MD, United States. Electronic address: JMAGIDSON@partners.org.
authors.forename: Jessica F
authors.initials: JF
authors.lastname: Magidson
authors.affiliation: Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Blashill
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, United States; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, United States.
authors.forename: Ivan C
authors.initials: IC
authors.lastname: Balan
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, United States.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: University of Maryland, College Park, MD, United States.
authors.forename: C W
authors.initials: CW
authors.lastname: Lejuez
authors.affiliation: Department of Psychiatry, New York State Psychiatric Institute/Columbia University, New York, NY, United States.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: Externalizing; Internalizing; Latent factors; Sexually transmitted disease; Structural model