The architecture of co-morbidity networks of physical and mental health conditions in military veterans

Aaron F. Alexander-Bloch, Armin Raznahan, Russell T. Shinohara, Samuel R. Mathias, Harini Bathulapalli, Ish P. Bhalla, Joseph L. Goulet, Theodore D. Satterthwaite, Danielle S. Bassett, David C. Glahn, Cynthia A. Brandt

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Co-morbidity between medical and psychiatric conditions is commonly considered between individual pairs of conditions. However, an important alternative is to consider all conditions as part of a co-morbidity network, which encompasses all interactions between patients and a healthcare system. Analysis of co-morbidity networks could detect and quantify general tendencies not observed by smaller-scale studies. Here, we investigate the co-morbidity network derived from longitudinal healthcare records from approximately 1 million United States military veterans, a population disproportionately impacted by psychiatric morbidity and psychological trauma. Network analyses revealed marked and heterogenous patterns of co-morbidity, including a multi-scale community structure composed of groups of commonly co-morbid conditions. Psychiatric conditions including posttraumatic stress disorder were strong predictors of future medical morbidity. Neurological conditions and conditions associated with chronic pain were particularly highly co-morbid with psychiatric conditions. Across conditions, the degree of co-morbidity was positively associated with mortality. Co-morbidity was modified by biological sex and could be used to predict future diagnostic status, with out-of-sample prediction accuracy of 90-92%. Understanding complex patterns of disease co-morbidity has the potential to lead to improved designs of systems of care and the development of targeted interventions that consider the broader context of mental and physical health.

Original languageEnglish
Article number0790
JournalProceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences
Issue number2239
StatePublished - Jul 2020
Externally publishedYes


  • co-morbidity
  • modularity
  • network science
  • psychiatry
  • veterans


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