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Risk clustering and psychopathology from a multi-center cohort of Indian children, adolescents, and young adults
Development and Psychopathology  (IF5.317),  Pub Date : 2022-04-08, DOI: 10.1017/s0954579422000050
Debasish Basu, Abhishek Ghosh, Chandrima Naskar, Srinivas Balachander, Gwen Fernandes, Nilakshi Vaidya, Kalyanaraman Kumaran, Murali Krishna, Gareth J. Barker, Eesha Sharma, Pratima Murthy, Bharath Holla, Sanjeev Jain, Dimitri Papadopoulos Orfanos, Kartik Kalyanram, Meera Purushottam, Rose Dawn Bharath, Mathew Varghese, Kandavel Thennarasu, Amit Chakrabarti, Rajkumar Lenin Singh, Roshan Lourembam Singh, Subodh Bhagyalakshmi Nanjayya, Chirag Kamal Ahuja, Kamakshi Kartik, Ghattu Krishnaveni, Rebecca Kuriyan, Sunita Simon Kurpad, Sylvane Desrivieres, Udita Iyengar, Yuning Zhang, Matthew Hickman, Alex Spiers, Mireille Toledano, Gunter Schumann, Vivek Benegal

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.