scholarly journals Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A)

2012 ◽  
Vol 42 (9) ◽  
pp. 1997-2010 ◽  
Author(s):  
R. C. Kessler ◽  
S. Avenevoli ◽  
K. A. McLaughlin ◽  
J. Greif Green ◽  
M. D. Lakoma ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Prior History ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity ◽  
The Us ◽  
Dsm Iv ◽  
Subsequent Onset

BackgroundResearch on the structure of co-morbidity among common mental disorders has largely focused on current prevalence rather than on the development of co-morbidity. This report presents preliminary results of the latter type of analysis based on the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).MethodA national survey was carried out of adolescent mental disorders. DSM-IV diagnoses were based on the Composite International Diagnostic Interview (CIDI) administered to adolescents and questionnaires self-administered to parents. Factor analysis examined co-morbidity among 15 lifetime DSM-IV disorders. Discrete-time survival analysis was used to predict first onset of each disorder from information about prior history of the other 14 disorders.ResultsFactor analysis found four factors representing fear, distress, behavior and substance disorders. Associations of temporally primary disorders with the subsequent onset of other disorders, dated using retrospective age-of-onset (AOO) reports, were almost entirely positive. Within-class associations (e.g. distress disorders predicting subsequent onset of other distress disorders) were more consistently significant (63.2%) than between-class associations (33.0%). Strength of associations decreased as co-morbidity among disorders increased. The percentage of lifetime disorders explained (in a predictive rather than a causal sense) by temporally prior disorders was in the range 3.7–6.9% for earliest-onset disorders [specific phobia and attention deficit hyperactivity disorder (ADHD)] and much higher (23.1–64.3%) for later-onset disorders. Fear disorders were the strongest predictors of most other subsequent disorders.ConclusionsAdolescent mental disorders are highly co-morbid. The strong associations of temporally primary fear disorders with many other later-onset disorders suggest that fear disorders might be promising targets for early interventions.

scholarly journals Should excessive worry be required for a diagnosis of generalized anxiety disorder? Results from the US National Comorbidity Survey Replication

2005 ◽  
Vol 35 (12) ◽  
pp. 1761-1772 ◽  
Author(s):  
AYELET MERON RUSCIO ◽  
MICHAEL LANE ◽  
PETER ROY-BYRNE ◽  
PAUL E. STANG ◽  
DAN J. STEIN ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Large Scale ◽  
Familial Aggregation ◽  
Generalized Anxiety ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity ◽  
The Us ◽  
Dsm Iv

Background. Excessive worry is required by DSM-IV, but not ICD-10, for a diagnosis of generalized anxiety disorder (GAD). No large-scale epidemiological study has ever examined the implications of this requirement for estimates of prevalence, severity, or correlates of GAD.Method. Data were analyzed from the US National Comorbidity Survey Replication, a nationally representative, face-to-face survey of adults in the USA household population that was fielded in 2001–2003. DSM-IV GAD was assessed with Version 3.0 of the WHO Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-IV criteria for GAD were compared with respondents who met full GAD criteria as well as with other survey respondents to consider the implications of removing the excessiveness requirement.Results. The estimated lifetime prevalence of GAD increases by ~40% when the excessiveness requirement is removed. Excessive GAD begins earlier in life, has a more chronic course, and is associated with greater symptom severity and psychiatric co-morbidity than non-excessive GAD. However, non-excessive cases nonetheless evidence substantial persistence and impairment of GAD, high rates of treatment-seeking, and significantly elevated co-morbidity compared with respondents without GAD. Non-excessive cases also have sociodemographic characteristics and familial aggregation of GAD comparable to excessive cases.Conclusions. Individuals who meet all criteria for GAD other than excessiveness have a somewhat milder presentation than those with excessive worry, yet resemble excessive worriers in a number of important ways. These findings challenge the validity of the excessiveness requirement and highlight the need for further research into the optimal definition of GAD.

scholarly journals Age differences in major depression: results from the National Comorbidity Survey Replication (NCS-R)

2009 ◽  
Vol 40 (2) ◽  
pp. 225-237 ◽  
Author(s):  
R. C. Kessler ◽  
H. Birnbaum ◽  
E. Bromet ◽  
I. Hwang ◽  
N. Sampson ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Old Age ◽  
Age Differences ◽  
Late Life ◽  
The Elderly ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Co Morbidity ◽  
Physical Disorders ◽  
Dsm Iv

BackgroundAlthough depression appears to decrease in late life, this could be due to misattribution of depressive symptom to physical disorders that increase in late life.MethodWe studied age differences in major depressive episodes (MDE) in the National Comorbidity Survey Replication, a national survey of the US household population. DSM-IV MDE was defined without organic exclusions or diagnostic hierarchy rules to facilitate analysis of co-morbidity. Physical disorders were assessed with a standard chronic conditions checklist and mental disorders with the WHO Composite International Diagnostic Interview (CIDI) version 3.0.ResultsLifetime and recent DSM-IV/CIDI MDE were significantly less prevalent among respondents aged ⩾65 years than among younger adults. Recent episode severity, but not duration, was also lower among the elderly. Despite prevalence of mental disorders decreasing with age, co-morbidity of hierarchy-free MDE with these disorders was either highest among the elderly or unrelated to age. Co-morbidity of MDE with physical disorders, in comparison, generally decreased with age despite prevalence of co-morbid physical disorders usually increasing. Somewhat more than half of respondents with 12-month MDE received past-year treatment, but the percentage in treatment was lowest and most concentrated in the general medical sector among the elderly.ConclusionsGiven that physical disorders increase with age independent of depression, their lower associations with MDE in old age argue that causal effects of physical disorders on MDE weaken in old age. This result argues against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders.

scholarly journals Barriers to mental health treatment: results from the National Comorbidity Survey Replication

2010 ◽  
Vol 41 (8) ◽  
pp. 1751-1761 ◽  
Author(s):  
R. Mojtabai ◽  
M. Olfson ◽  
N. A. Sampson ◽  
R. Jin ◽  
B. Druss ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Mental Health Treatment ◽  
Common Mental Disorders ◽  
Drop Out ◽  
Common Reason ◽  
Treatment Seeking ◽  
Structural Barriers ◽  
National Comorbidity Survey Replication ◽  
Perceived Need ◽  
National Comorbidity Survey

BackgroundThe aim was to examine barriers to initiation and continuation of treatment among individuals with common mental disorders in the US general population.MethodRespondents in the National Comorbidity Survey Replication with common 12-month DSM-IV mood, anxiety, substance, impulse control and childhood disorders were asked about perceived need for treatment, structural barriers and attitudinal/evaluative barriers to initiation and continuation of treatment.ResultsLow perceived need was reported by 44.8% of respondents with a disorder who did not seek treatment. Desire to handle the problem on one's own was the most common reason among respondents with perceived need both for not seeking treatment (72.6%) and for dropping out of treatment (42.2%). Attitudinal/evaluative factors were much more important than structural barriers both to initiating (97.4% v. 22.2%) and to continuing (81.9% v. 31.8%) of treatment. Reasons for not seeking treatment varied with illness severity. Low perceived need was a more common reason for not seeking treatment among individuals with mild (57.0%) than moderate (39.3%) or severe (25.9%) disorders, whereas structural and attitudinal/evaluative barriers were more common among respondents with more severe conditions.ConclusionsLow perceived need and attitudinal/evaluative barriers are the major barriers to treatment seeking and staying in treatment among individuals with common mental disorders. Efforts to increase treatment seeking and reduce treatment drop-out need to take these barriers into consideration as well as to recognize that barriers differ as a function of sociodemographic and clinical characteristics.

scholarly journals Childhood adversities and adult psychopathology in the National Comorbidity Survey Replication (NCS-R) III: Associations with functional impairment related to DSM-IV disorders

2009 ◽  
Vol 40 (5) ◽  
pp. 847-859 ◽  
Author(s):  
K. A. McLaughlin ◽  
J. G. Green ◽  
M. J. Gruber ◽  
N. A. Sampson ◽  
A. M. Zaslavsky ◽  
...  
Keyword(s):  
Life Course ◽  
Functional Impairment ◽  
Childhood Adversities ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Increased Risk ◽  
Co Morbidity ◽  
Dsm Iv ◽  
The Life Course ◽  
Days Out Of Role

BackgroundDespite evidence that childhood adversities (CAs) are associated with increased risk of mental disorders, little is known about their associations with disorder-related impairment. We report the associations between CAs and functional impairment associated with 12-month DSM-IV disorders in a national sample.MethodWe used data from the US National Comorbidity Survey Replication (NCS-R). Respondents completed diagnostic interviews that assessed 12-month DSM-IV disorder prevalence and impairment. Associations of 12 retrospectively reported CAs with impairment among cases (n=2242) were assessed using multiple regression analysis. Impairment measures included a dichotomous measure of classification in the severe range of impairment on the Sheehan Disability Scale (SDS) and a measure of self-reported number of days out of role due to emotional problems in the past 12 months.ResultsCAs were positively and significantly associated with impairment. Predictive effects of CAs on the SDS were particularly pronounced for anxiety disorders and were significant in predicting increased days out of role associated with mood, anxiety and disruptive behavior disorders. Predictive effects persisted throughout the life course and were not accounted for by disorder co-morbidity. CAs associated with maladaptive family functioning (MFF; parental mental illness, substance disorder, criminality, family violence, abuse, neglect) were more consistently associated with impairment than other CAs. The joint effects of co-morbid MFF CAs were significantly subadditive. Simulations suggest that CAs account for 19.6% of severely impairing disorders and 17.4% of days out of role.ConclusionsCAs predict greater disorder-related impairment, highlighting the ongoing clinical significance of CAs at every stage of the life course.

Parental bonding and adult psychopathology: results from the US National Comorbidity Survey

2002 ◽  
Vol 32 (6) ◽  
pp. 997-1008 ◽  
Author(s):  
M. W. ENNS ◽  
B. J. COX ◽  
I. CLARA
Keyword(s):  
Mental Disorders ◽  
Paternal Care ◽  
Common Mental Disorders ◽  
Parental Bonding ◽  
Externalizing Disorders ◽  
Men And Women ◽  
National Comorbidity Survey ◽  
The Us ◽  
The Impact ◽  
Adult Psychopathology

Background. Research using the parental bonding instrument (PBI) has suggested that lack of parental care and/or overprotection may be important risk factors for adult mental disorders. Much of this research, however, has relied on clinical populations with one or two disorders, or has used highly select community samples.Method. The association between parenting experiences and the occurrence of 13 common mental disorders in adulthood was evaluated in the US National Comorbidity Survey (N = 5877). The effect of sociodemographic variables (age, education, income) was statistically controlled and the effects of six parenting variables (maternal and paternal care, overprotection and authoritarianism) were examined simultaneously. The effects in men and women were examined separately.Results. Lack of care was the parenting variable most consistently associated with adult psychopathology. Parenting experiences with one's mother were more consistently associated with adult mental disorders. In general the impact of parenting was diagnostically non-specific. However, there appeared to be some unique effects for externalizing disorders (substance use disorders and antisocial personality disorder) in males; paternal overprotection and authoritarianism conferred a reduced risk of externalizing disorders in adult males. The overall impact of parenting as assessed by the PBI was modest, accounting for about 1 to 5% of the variance in the occurrence of adult mental disorders.Conclusion. Parenting experiences, particularly lack of care, are potentially causally related in a non-specific manner to a wide variety of forms of adult psychopathology in both men and women. The overall magnitude of the effect is small but statistically significant in a nationally representative US sample.

scholarly journals The Prevalence and Correlates of DSM-IV Intermittent Explosive Disorder in the National Comorbidity Survey Replication

2006 ◽  
Vol 63 (6) ◽  
pp. 669 ◽  
Author(s):  
Ronald C. Kessler ◽  
Emil F. Coccaro ◽  
Maurizio Fava ◽  
Savina Jaeger ◽  
Robert Jin ◽  
...  
Keyword(s):  
Intermittent Explosive Disorder ◽  
National Comorbidity Survey Replication ◽  
National Comorbidity Survey ◽  
Dsm Iv

Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey

1996 ◽  
Vol 168 (S30) ◽  
pp. 17-30 ◽  
Author(s):  
R. C. Kessler ◽  
C. B. Nelson ◽  
K. A. McGonagle ◽  
J. Liu ◽  
M. Swartz ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
General Population ◽  
Depressive Disorder ◽  
Composite International Diagnostic Interview ◽  
Population Data ◽  
Diagnostic Interview ◽  
Prior History ◽  
Major Depressive ◽  
National Comorbidity Survey ◽  
The Us

General population data are presented on the prevalence and correlates of comorbidity between DSM–III–R major depressive disorder (MDD) and other DSM–III–R disorders. The data come from the US National Comorbidity Survey, a large general population survey of persons aged 15–54 years in the non-institutionalised civilian population. Diagnoses are based on a modified version of the Composite International Diagnostic Interview (CIDI). The analysis shows that most cases of lifetime MDD are secondary, in the sense that they occur in people with a prior history of another DSM–III–R disorder. Anxiety disorders are the most common primary disorders. The time-lagged effects of most primary disorders on the risk of subsequent MDD continue for many years without change in magnitude. Secondary MDD is, in general, more persistent and severe than pure or primary MDD. This has special public health significance because lifetime prevalence of secondary MDD has increased in recent cohorts, while the prevalence of pure and primary depression has remained unchanged.

scholarly journals Lifetime co-morbidities between social phobia and mood disorders in the US National Comorbidity Survey

1999 ◽  
Vol 29 (3) ◽  
pp. 555-567 ◽  
Author(s):  
R. C. KESSLER ◽  
P. STANG ◽  
H.-U. WITTCHEN ◽  
M. STEIN ◽  
E. E. WALTERS
Keyword(s):  
Social Phobia ◽  
Mood Disorders ◽  
Age Of Onset ◽  
Population Attributable Risk ◽  
Population Data ◽  
Major Depressive ◽  
National Comorbidity Survey ◽  
Increased Risk ◽  
The Us ◽  
Subsequent Onset

Background. General population data were used to study co-morbidities between lifetime social phobia and mood disorders.Methods. Data come from the US National Comorbidity Survey (NCS).Results. Strong associations exist between lifetime social phobia and major depressive disorder (odds ratio 2·9), dysthymia (2·7) and bipolar disorder (5·9). Odds ratios increase in magnitude with number of social fears. Reported age of onset is earlier for social phobia than mood disorders in the vast majority of co-morbid cases. Temporally-primary social phobia predicts subsequent onset of mood disorders, with population attributable risk proportions of 10–15%. Social phobia is also associated with severity and persistence of co-morbid mood disorders.Conclusions. Social phobia is a commonly occurring, chronic and seriously impairing disorder that is seldom treated unless it occurs in conjunction with another co-morbid condition. The adverse consequences of social phobia include increased risk of onset, severity and course of subsequent mood disorders. Early outreach and treatment of primary social phobia might not only reduce the prevalence of this disorder itself, but also the subsequent onset of mood disorders.

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