title: Mental disorder comorbidity and treatment utilization.
abstract: Effective interventions have been developed for myriad common psychological and substance use disorders, though they remain highly underutilized. Previous research has shown that the likelihood of treatment utilization varies across disorder diagnosis. However, studies that focus on individual disorders have resulted in a large, piecemeal literature that neglects the high rates of multivariate comorbidity. The current study investigated the association between treatment utilization and transdiagnostic comorbidity factors.
  
  
  
  In a nationally representative sample of the United States adult population (N=34,653), we applied the internalizing-externalizing latent comorbidity model to examine its association with lifetime utilization of various treatments for mood, anxiety, and substance use disorders.
  
  
  
  Both internalizing and externalizing transdiagnostic factors were positively associated with all forms of treatment utilization. Stronger within-domain domain (e.g., internalizing's association with mood or anxiety treatment) than between-domain (e.g., internalizing's association with substance use disorder treatment) associations were found. Significant antagonistic internalizing-by-externalizing interactions were also observed.
  
  
  
  These results underscore the importance of applying a nuanced approach to modeling comorbidity when predicting treatment utilization. Clinical implications are discussed.
authors.affiliation: Department of Psychology, Stony Brook University, Stony Brook, NY, USA. Electronic address: craig.rodriguez-seijas@stonybrook.edu.
authors.forename: Craig
authors.initials: C
authors.lastname: Rodriguez-Seijas
authors.affiliation: Department of Psychology, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Nicholas R
authors.initials: NR
authors.lastname: Eaton
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA.
authors.forename: Malki
authors.initials: M
authors.lastname: Stohl
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Pia M
authors.initials: PM
authors.lastname: Mauro
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D017831:Diagnosis, Dual (Psychiatry) / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D008875:Middle Aged; D008960:Models, Psychological; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology