LIFETIME AND 12-MONTH PREVALENCE OF DSM-III-R PSYCHIATRIC-DISORDERS IN THE UNITED-STATES - RESULTS FROM THE NATIONAL-COMORBIDITY-SURVEY

Background: This study presents estimates of lifetime and 12-month pre valence of 14 DSM-III-R psychiatric disorders from the National Comorb idity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Metho ds: The DSM-III-R psychiatric disorders among persons aged 15 to 54 ye ars in the noninstitutionalized civilian population of the United Stat es were assessed with data collected by lay interviewers using a revis ed version of the Composite International Diagnostic Interview. Result s: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most com mon disorders were major depressive episode, alcohol dependence, socia l phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or mo re comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment d uring the past 12 months. Consistent with previous risk factor researc h, it was found that women had elevated rates of affective disorders a nd anxiety disorders, that men had elevated rates of substance use dis orders and antisocial personality disorder, and that most disorders de clined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously though t to be the case. Furthermore, this morbidity is more highly concentra ted than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the foc us of research attention. The majority of people with psychiatric diso rders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion w ho ever obtain specialty sector mental health treatment is less than 5 0%. These results argue for the importance of more outreach and more r esearch on barriers to professional help-seeking.