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The NEMESIS Study

Wilma A. M. Vollebergh, PhD; Jurjen Iedema, PhD; Rob V. Bijl, PhD; Ron de Graaf, PhD; Filip Smit, MSc; Johan Ormel, PhD

Arch Gen Psychiatry. 2001;58:597-603.

Background  We analyzed the underlying latent structure of 12-month DSM-III-R diagnoses of 9 common disorders for the general population in the Netherlands. In addition, we sought to establish (1) the stability of the latent structure underlying mental disorders across a 1-year period (structural stability) and (2) the stability of individual differences in mental disorders at the level of the latent dimensions (differential stability).

Methods  Data were obtained from the first and second measurement of the Netherlands Mental Health Survey and Incidence Study (NEMESIS) (response rate at baseline: 69.7%, n = 7076; 1 year later, 79.4%, n = 5618). Nine common DSM-III-R diagnoses were assessed twice with the Composite International Diagnostic Interview with a time lapse of 1 year. Using structural equation modeling, the number of latent dimensions underlying these diagnoses was determined, and the structural and differential stability were assessed.

Results  A 3-dimensional model was established as having the best fit: a first dimension underlying substance use disorders (alcohol dependence, drug dependence); a second dimension for mood disorders (major depression, dysthymia), including generalized anxiety disorder; and a third dimension underlying anxiety disorders (simple phobia, social phobia, agoraphobia, and panic disorder). The structural stability of this model during a 1-year period was substantial, and the differential stability of the 3 latent dimensions was considerable.

Conclusions  Our results confirm the 3-dimensional model for 12-month prevalence of mental disorders. Results underline the argument for focusing on core psychopathological processes rather than on their manifestation as distinguished disorders in future population studies on common mental disorders.

From the Trimbos-Institute, Netherlands Institute of Mental Health and Addiction, Utrecht (Drs Vollebergh, Bijl, and de Graaf and Mr Smit); the Social and Cultural Planning Office, The Hague (Dr Iedema); and the Department of Social Psychiatry, University of Groningen, Groningen (Dr Ormal), the Netherlands.

Corresponding author and reprints: Wilma A. M. Vollebergh, PhD, Trimbos-Institute, PO Box 725, 3500 AS Utrecht, The Netherlands.

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