Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication | Anxiety Disorders | JAMA Psychiatry | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.185.54. Please contact the publisher to request reinstatement.
1.
Kessler  RCMerikangas  KR The National Comorbidity Survey Replication (NCS-R): background and aims.  Int J Methods Psychiatr Res 2004;1360- 68PubMedGoogle ScholarCrossref
2.
Robins  LNedRegier  DAed Psychiatric Disorders in America: The Epidemiologic Catchment Area Study.  New York, NY Free Press1991;
3.
Kessler  RCMcGonagle  KAZhao  SNelson  CBHughes  MEshleman  SWittchen  HUKendler  KS Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey.  Arch Gen Psychiatry 1994;518- 19PubMedGoogle ScholarCrossref
4.
Kaplan  ELMeier  P Nonparametric estimation from incomplete observations.  J Am Stat Assoc 1958;53457- 481Google ScholarCrossref
5.
Halli  SSRao  KV Advanced Techniques of Population Analysis.  New York, NY Plenum1992;
6.
Kessler  RCUstun  TB The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI).  Int J Methods Psychiatr Res 2004;1393- 121PubMedGoogle ScholarCrossref
7.
World Health Organization, International Classification of Diseases, 10th Revision (ICD-10).  Geneva, Switzerland World Health Organization1992;
8.
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR).  Washington, DC American Psychiatric Association2000;
9.
First  MBSpitzer  RLGibbon  MWilliams  JBW Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP).  New York, NY Biometrics Research, New York State Psychiatric Institute2002;
10.
Simon  GEVon Korff  M Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research.  Epidemiol Rev 1995;17221- 227PubMedGoogle Scholar
11.
Knauper  BCannell  CFSchwarz  NBruce  MLKessler  RC Improving the accuracy of major depression age of onset reports in the US National Comorbidity Survey.  Int J Methods Psychiatr Res 1999;839- 48Google ScholarCrossref
12.
 SAS/STAT Software: Changes and Enhancements, Release 8.2.  Cary, NC SAS Institute Inc2001;
13.
Efron  B Logistic regression, survival analysis, and the Kaplan-Meier curve.  J Am Stat Assoc 1988;83414- 425Google ScholarCrossref
14.
Wolter  KM Introduction to Variance Estimation.  New York, NY Springer-Verlag1985;
15.
 SUDAAN: Professional Software for Survey Data Analysis [computer program]. Version 8.0.1. Research Triangle Park, NC Research Triangle Institute2002;
16.
Kish  LFrankel  MR Inferences from complex samples.  J R Stat Soc [Ser A] 1974;361- 37Google Scholar
17.
Allgulander  C Psychoactive drug use in a general population sample, Sweden: correlates with perceived health, psychiatric diagnoses, and mortality in an automated record-linkage study.  Am J Public Health 1989;791006- 1010PubMedGoogle ScholarCrossref
18.
Kessler  RCBerglund  PChiu  W-TDemler  OHeeringa  SHiripi  EJin  RPennell  BEWalters  EEZaslavsky  AZheng  H The US National Comorbidity Survey Replication (NCS-R): design and field procedures.  Int J Methods Psychiatr Res 2004;1369- 92PubMedGoogle ScholarCrossref
19.
Cannell  CFMarquis  KHLaurent  A A summary of studies of interviewing methodology.  Vital Health Stat 1 1977;Series 2(69):i-viii1- 78PubMedGoogle Scholar
20.
Turner  CFKu  LRogers  SMLindberg  LDPleck  JHSonenstein  FL Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology.  Science 1998;280867- 873PubMedGoogle ScholarCrossref
21.
Kessler  RCAndrews  GMroczek  DUstun  BWittchen  H-U The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF).  Int J Methods Psychiatr Res 1998;7171- 185Google ScholarCrossref
22.
Giuffra  LARisch  N Diminished recall and the cohort effect of major depression: a simulation study.  Psychol Med 1994;24375- 383PubMedGoogle ScholarCrossref
23.
Regier  DAKaelber  CTRae  DSFarmer  MEKnauper  BKessler  RCNorquist  GS Limitations of diagnostic criteria and assessment instruments for mental disorders: implications for research and policy.  Arch Gen Psychiatry 1998;55109- 115PubMedGoogle ScholarCrossref
24.
Demyttenaere  KBruffaerts  RPosada-Villa  JGasquet  IKovess  VLepine  JPAngermeyer  MCBernert  Sde Girolamo  GMorosini  PPolidori  GKikkawa  TKawakami  NOno  YTakeshima  TUda  HKaram  EGFayyad  JAKaram  ANMneimneh  ZNMedina-Mora  MEBorges  GLara  Cde Graaf  ROrmel  JGureje  OShen  YHuang  YZhang  MAlonso  JHaro  JMVilagut  GBromet  EJGluzman  SWebb  CKessler  RCMerikangas  KRAnthony  JCVon Korff  MRWang  PSBrugha  TSAguilar-Gaxiola  SLee  SHeeringa  SPennell  BEZaslavsky  AMUstun  TBChatterji  SWHO World Mental Health Survey Consortium, Prevalence, severity and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys.  JAMA 2004;2912581- 2590PubMedGoogle ScholarCrossref
25.
WHO International Consortium in Psychiatric Epidemiology, Cross-national comparisons of the prevalences and correlates of mental disorders.  Bull World Health Organ 2000;78413- 426PubMedGoogle Scholar
26.
Scahill  LSchwab-Stone  M Epidemiology of ADHD in school-age children.  Child Adolesc Psychiatr Clin N Am 2000;9541- 555PubMedGoogle Scholar
27.
Loeber  RBurke  JDLahey  BBWinters  AZera  M Oppositional defiant and conduct disorder: a review of the past 10 years, part I.  J Am Acad Child Adolesc Psychiatry 2000;391468- 1484PubMedGoogle ScholarCrossref
28.
Olvera  RL Intermittent explosive disorder: epidemiology, diagnosis and management.  CNS Drugs 2002;16517- 526PubMedGoogle ScholarCrossref
29.
Brugha  TSBebbington  PEJenkins  R A difference that matters: comparisons of structured and semi-structured psychiatric diagnostic interviews in the general population.  Psychol Med 1999;291013- 1020PubMedGoogle ScholarCrossref
30.
Narrow  WERae  DSRobins  LNRegier  DA Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys’ estimates.  Arch Gen Psychiatry 2002;59115- 123PubMedGoogle ScholarCrossref
31.
Peck  MCScheffler  RM An analysis of the definitions of mental illness used in state parity laws.  Psychiatr Serv 2002;531089- 1095PubMedGoogle ScholarCrossref
32.
Kendell  RE Five criteria for an improved taxonomy of mental disorders. Helzer  JEHudziak  JJeds. Defining Psychopathology in the 21st Century: DSM-V and Beyond. Washington, DC American Psychiatric Publishing2002;3- 17Google Scholar
33.
Spitzer  RL Diagnosis and need for treatment are not the same.  Arch Gen Psychiatry 1998;55120PubMedGoogle ScholarCrossref
34.
Kessler  RCChiu  WTDemler  OWalters  EE Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.  Arch Gen Psychiatry 2005;62617- 627Google ScholarCrossref
35.
Nissen  SETuzcu  EMSchoenhagen  PBrown  BGGanz  PVogel  RACrowe  THoward  GCooper  CJBrodie  BGrines  CLDeMaria  ANREVERSAL Investigators, Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial.  JAMA 2004;2911071- 1080PubMedGoogle ScholarCrossref
36.
Cannon  CPBraunwald  EMcCabe  CHRader  DJRouleau  JLBelder  RJoyal  SVHill  KAPfeffer  MASkene  AMPravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis in Myocardial Infarction 22 Investigators, Comparison of intensive and moderate lipid lowering with statins after acute coronary syndromes.  N Engl J Med 2004;3501495- 1504PubMedGoogle ScholarCrossref
37.
Topol  EJ Intensive statin therapy—a sea change in cardiovascular prevention.  N Engl J Med 2004;3501562- 1564PubMedGoogle ScholarCrossref
38.
Sacks  FM High-intensity statin treatment for coronary heart disease.  JAMA 2004;2911132- 1134PubMedGoogle ScholarCrossref
39.
Christie  KABurke  JDJRegier  DARae  DSBoyd  JHLocke  BZ Epidemiologic evidence for early onset of mental disorders and higher risk of drug-abuse in young-adults.  Am J Psychiatry 1988;145971- 975PubMedGoogle Scholar
40.
Murray  CJLLopez  AD Global Health Statistics.  Cambridge, Mass Harvard University Press1996;
41.
Bruce  MLLeaf  PJ Psychiatric disorders and 15-month mortality in a community sample of older adults.  Am J Public Health 1989;79727- 730PubMedGoogle ScholarCrossref
42.
Badawi  MAEaton  WWMyllyluoma  JWeimer  LGGallo  J Psychopathology and attrition in the Baltimore ECA 15-year follow-up 1981-1996.  Soc Psychiatry Psychiatr Epidemiol 1999;3491- 98PubMedGoogle ScholarCrossref
Original Article
June 2005

Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication

Author Affiliations

Author Affiliations: Department of Health Care Policy, Harvard Medical School, Boston, Mass (Dr Kessler; Mss Demler and Walters; and Mr Jin); Institute for Social Research, University of Michigan, Ann Arbor (Ms Berglund); and Section on Developmental Genetic Epidemiology, National Institute of Mental Health, Rockville, Md (Dr Merikangas).

Arch Gen Psychiatry. 2005;62(6):593-602. doi:10.1001/archpsyc.62.6.593
Abstract

Context  Little is known about lifetime prevalence or age of onset of DSM-IV disorders.

Objective  To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication.

Design and Setting  Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview.

Participants  Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older.

Main Outcome Measures  Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders.

Results  Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups.

Conclusions  About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

×