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Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey

Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results... Abstract Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social 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 more 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 during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated 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 focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking. References 1. The President's Commission on Mental Health and Illness, eds. Reportto the President From the President's Commission on Mental Health, Volume I. Washington, DC: US Government Printing Office; 1978. Stock No. 040-000-00390-8. 2. Robins LN, Helzer JE, Croughan JL, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 3. Robins LN, Locke BZ, Regier DA. An overview of psychiatric disorders in America . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:328-366. 4. Bourdon KH, Rae DA, Locke BZ, Narrow WE, Regier DA. Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Study . Public Health Rep . 1992;107:663-668. 5. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de Facto US Mental and Addictive Disorders Service System: Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services . Arch Gen Psychiatry . 1993;50:85-94.Crossref 6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 8. Task Force on DSM-IV: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition Draft Criteria . Washington, DC: American Psychiatric Association; March 1993. 9. World Health Organization. Mental health and behavioral disorders (including disorders of psychological development). In: International Classification of Diseases—10th Revision. Geneva, Switzerland: World Health Organization; 1991: chap 5. Diagnostic Criteria for Research, Draft for Field Trials. 10. Endicott J, Andreasen N, Spitzer RL. Family History Research Diagnostic Criteria . New York, NY: Biometrics Research, New York State Psychiatric Institute; 1978. 11. 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;79:1006-1010.Crossref 12. Eaton WW, Anthony JC, Tepper S, Dryman A. Psychopathology and attrition in the Epidemiologic Catchment Area Study . Am J Epidemiol . 1992;135:1051-1059. 13. US Department of Health and Human Services. National Health Interview Survey: 1989 (Computer File). Hyattsville, Md: National Center for Health Statistics; 1992. 14. World Health Organization. Composite International Diagnostic Interview (CIDI), Version 1.0. Geneva, Switzerland: World Health Organization; 1990. 15. Robins LN, Wing J, Wittchen H-U, Helzer JE. The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures . Arch Gen Psychiatry . 1988;45:1069-1077.Crossref 16. Wittchen H-U, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier DA, and Participants in the Multicentre WHO/ADAMHA Field Trials. Cross-cultural feasibility, reliability and sources of variance in the Composite International Diagnostic Interview (CIDI) . Br J Psychiatry . 1991;159:645-653.Crossref 17. Cottler LB, Robins LN, Grant BF, Blaine J, Towle LH, Wittchen H-U, Sartorius N, and Participants in the WHO/ADAMHA Field Trials. The CIDI-core substance abuse and dependence questions: cross-cultural and nosological issues . Br J Psychiatry . 1991;159:653-658.Crossref 18. Semler G, von Cranach M, Wittchen H-U, eds. Comparison between the Composite International Diagnostic Interview and the Present State Examination. Report to the WHO/ADAMHA Task Force on Instrument Development ; February 1987; Geneva, Switzerland. 19. Wacker HR, Battegay R, Mullejans R, Schlosser C. Using the CIDI-C in the general population . In: Stefanis CN, Rabavilas AD, Soldatos CR, eds. Psychiatry: A World Perspective . Amsterdam, the Netherlands: Elsevier Science Publishers; 1990:138-143. 20. Semler G, ed. Reliabilitat und Validitat des Composite International Diagnostic Interview: Inaugural-Dissertation zur Erlangung des akademischen Grades eines Doktors der Philosophie . Mannheim, Germany: Universitat Mannheim; 1989. 21. Spengler P, Wittchen H-U. Procedural validity of standardized symptom questions for the assessment of psychotic symptoms: a comparison of the CIDI with two clinical methods . Compr Psychiatry . 1989;29:309-322.Crossref 22. Janca A, Robins LN, Cottler LB, Early TS. Clinical observation of CIDI assessments: an analysis of the CIDI field trials—wave II at the St. Louis site . Br J Psychiatry . 1992;160:815-818.Crossref 23. Leitmeyer P, ed. Zur Symptomerfassung mit dem standarisierten Interview CIDI-C in der Allgemeinpraxis: Inaugural Dissertation zur Erlangung des medizinischen Doktorgrades fur klinische Medizin . Mannheim, Germany: Universitat Mannheim; 1990. 24. Farmer AE, Katz R, McGuffin P, Bebbington P. A comparison between the Present State Examination and the Composite International Diagnostic Interview . Arch Gen Psychiatry . 1987;44:1064-1068.Crossref 25. Farmer AE, Jenkins PL, Katz R, Ryder L. Comparison of CATEGO-derived ICD-8 and DSM-III classifications using the Composite International Diagnostic Interview in severely ill subjects . Br J Psychiatry . 1991;158:177-182.Crossref 26. Wittchen H-U, Burke JD, Semler G, Pfister H. Recall and dating of psychiatric symptoms: test-retest reliability of time-related symptom questions in a standardized psychiatric interview . Arch Gen Psychiatry . 1989;46:437-443.Crossref 27. Anthony JC, Folstein M, Romanoski AJ, von Korff MR, Nestadt GR, Chahal R, Merchant A, Brown CH, Shapiro S, Kramer M, Gruenberg EM. Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: experience in eastern Baltimore . Arch Gen Psychiatry . 1985;42:667-675.Crossref 28. Helzer JE, Robins LN, McEvoy LT, Spitznagel E. A comparison of clinical and Diagnostic Interview Schedule diagnoses . Arch Gen Psychiatry . 1985;42:657-666.Crossref 29. Spitzer RL, Williams JBW, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID), I: history, rationale, and description . Arch Gen Psychiatry . 1992;49:624-629.Crossref 30. Williams JBW, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MJ, Kane J, Harrison GP Jr, Rounsaville B, Wittchen H-U. The structured clinical interview for DSM-III-R (SCID), II: multisite test-retest reliability . Arch Gen Psychiatry . 1992;49:630-636.Crossref 31. Woodruff RS, Causey BD. Computerized method for approximating the variance of a complicated estimate . J Am Stat Assoc . 1976;71:315-321.Crossref 32. University of Michigan. OSIRIS VII. Ann Arbor, Mich: Institute for Social Research, The University of Michigan; 1981. 33. Kish L, Frankel MR. Balanced repeated replications for standard errors . J Am Stat Assoc . 1970;65:1071-1094.Crossref 34. Koch GG, Leneshow S. An application of multivariate analysis to complex sample survey data . J Am Stat Assoc . 1972;67:780-782.Crossref 35. SAS Institute. SAS 6.03. Cary, NC: SAS Institute; 1988. 36. Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991. 37. Canino GJ, Bird HR, Shrout PE, Rubio-Stipec M, Bravo M, Martinez R, Sesman M, Guevara L. The prevalence of specific psychiatric disorders in Puerto Rico . Arch Gen Psychiatry . 1987;44:727-735.Crossref 38. Hwu H-G, Yeh EK, Chang LY. Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule . Acta Psychiatr Scand . 1989;79:136-147.Crossref 39. Wells JE, Bushnell JA, Hornblow AR, Joyce PR, Oakley-Browne MA. Christchurch Psychiatric Epidemiology Study, I: methodology and lifetime prevalence for specific psychiatric disorders . Aust N Z J Psychiatry . 1989;23:315-326.Crossref 40. Wittchen H-U, Essau CA, von Zerssen D, Krieg JC, Zaudig M. Lifetime and six-month prevalence of mental disorders in the Munich follow-up study . Eur Arch Psychiatry Clin Neurosci . 1992;241:247-258.Crossref 41. Keith SJ, Regier DA, Rae DS. Schizophrenic disorders . In: Regier DA, Robins LN, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:33-52. 42. Gurin G, Veroff J, Feld SC. Americans View Their Mental Health . New York, NY: Basic Books Inc Publishers; 1960. 43. Veroff J, Kulka RA, Douvan E. Mental Health in America: Patterns of Help-Seeking From 1957 to 1976 . New York, NY: Basic Books Inc Publishers; 1981. 44. Shapiro S, Skinner EA, Kessler LG, von Korff M, German PS, Tischler GL, Leaf PJ, Benham L, Cottler L, Regier DA. Utilization of health and mental health services: three Epidemiological Catchment Area sites . Arch Gen Psychiatry . 1984;41:971-978.Crossref 45. Cross-National Collaborative Group. The changing rate of major depression . JAMA . 1992;268:3098-3105.Crossref 46. Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C III. Affective disorders . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:53-80. 47. Helzer JE, Burnam A, McEvoy LT. Alcohol abuse and dependence . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:81-115. 48. Anthony JC, Helzer JE. Syndromes of drug abuse and dependence . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:116-154. 49. Horwath E, Johnson J, Hornig CD. Epidemiology of panic disorder in African-Americans . Am J Psychiatry . 1993;150:465-469. 50. Eaton WW, Dryman A, Weissman MM. Panic and phobia . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:155-179. 51. Bruce ML, Takeuchi DT, Leaf PJ. Poverty and psychiatric status: longitudinal evidence from the New Haven Epidemiologic Catchment Area Study . Arch Gen Psychiatry . 1991;48:470-474.Crossref 52. Holzer CE, Shea B, Swanson JW, Leaf PJ, Myers JK, George L, Weissman MM, Bednarski P. The increased risk for specific psychiatric disorders among persons of low socioeconomic status . Am J Psychiatry . 1986;6:259-271. 53. Stansfeld SA, Marmot MG. Social class and minor psychiatric disorder in British civil servants: a validated screening survey using the General Health Questionnaire . Psychol Med . 1992;22:739-749.Crossref 54. Myers JK. Social factors related to psychiatric disorders . Soc Psychiatry Psychiatr Epidemiol . 1984;19:53-61. 55. Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD Jr, Regier DA. Lifetime prevalence of specific psychiatric disorders in three sites . Arch Gen Psychiatry . 1984;41:949-958.Crossref 56. Boyd JH, Weissman MM. Epidemiology of affective disorders: a reexamination and future directions . Arch Gen Psychiatry . 1981;38:1039-1046.Crossref 57. Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ. A population-based twin study of major depression in women . Arch Gen Psychiatry . 1992;49:257-266.Crossref 58. Weissman MM, Myers JK, Harding PS. Psychiatric disorders in a U.S. urban community: 1975-1976 . Am J Psychiatry . 1978;135:459-462. 59. Helzer JE, Pryzbeck TR. The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment . J Stud Alcohol . 1988;49:219-224. 60. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study . JAMA . 1990;264:2511-2518.Crossref 61. Bukstein OG, Brent DA, Kaminer Y. Comorbidity of substance abuse and other psychiatric disorders in adolescents . Am J Psychiatry . 1989;146:1131-1141. 62. Hesselbrock MN, Meyer RE, Keener JJ. Psychopathology in hospitalized alcoholics . Arch Gen Psychiatry . 1985;42:1050-1055.Crossref 63. Kessler RC, McGonagle KA, Carnelley KB, Nelson CB, Farmer MA, Regier DA. Comorbidity of mental disorders and substance use disorders: a review and agenda for future research . In: Leaf P, ed. Research in Community and Mental Health . Greenwich, Conn: JAI Press Inc. In press. 64. Marlatt GA, Gordon JR. Determinants of relapse: implications for the maintenance of behavioral change . In: Davidson P, Davidson S, eds. Behavioral Medicine: Changing Health and Lifestyles . New York, NY: Brunner/Mazel Inc; 1980. 65. Vaillant GE. Natural history of male psychological health VIII: antecedents of alcoholism and 'orality.' Am J Psychiatry . 1980;137:181-186.Crossref 66. Rosenblatt PC. Farming Is in Our Blood: Farm Families in Economic Crisis . Ames: Iowa State University Press; 1990. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey

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References (64)

Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1994.03950010008002
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. Methods: The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Results: Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social 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 more 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 during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. Conclusions: The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated 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 focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking. References 1. The President's Commission on Mental Health and Illness, eds. Reportto the President From the President's Commission on Mental Health, Volume I. Washington, DC: US Government Printing Office; 1978. Stock No. 040-000-00390-8. 2. Robins LN, Helzer JE, Croughan JL, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics and validity . Arch Gen Psychiatry . 1981;38:381-389.Crossref 3. Robins LN, Locke BZ, Regier DA. An overview of psychiatric disorders in America . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:328-366. 4. Bourdon KH, Rae DA, Locke BZ, Narrow WE, Regier DA. Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Study . Public Health Rep . 1992;107:663-668. 5. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de Facto US Mental and Addictive Disorders Service System: Epidemiologic Catchment Area prospective 1-year prevalence rates of disorders and services . Arch Gen Psychiatry . 1993;50:85-94.Crossref 6. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition . Washington, DC: American Psychiatric Association; 1987. 7. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third Edition . Washington, DC: American Psychiatric Association; 1980. 8. Task Force on DSM-IV: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition Draft Criteria . Washington, DC: American Psychiatric Association; March 1993. 9. World Health Organization. Mental health and behavioral disorders (including disorders of psychological development). In: International Classification of Diseases—10th Revision. Geneva, Switzerland: World Health Organization; 1991: chap 5. Diagnostic Criteria for Research, Draft for Field Trials. 10. Endicott J, Andreasen N, Spitzer RL. Family History Research Diagnostic Criteria . New York, NY: Biometrics Research, New York State Psychiatric Institute; 1978. 11. 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;79:1006-1010.Crossref 12. Eaton WW, Anthony JC, Tepper S, Dryman A. Psychopathology and attrition in the Epidemiologic Catchment Area Study . Am J Epidemiol . 1992;135:1051-1059. 13. US Department of Health and Human Services. National Health Interview Survey: 1989 (Computer File). Hyattsville, Md: National Center for Health Statistics; 1992. 14. World Health Organization. Composite International Diagnostic Interview (CIDI), Version 1.0. Geneva, Switzerland: World Health Organization; 1990. 15. Robins LN, Wing J, Wittchen H-U, Helzer JE. The Composite International Diagnostic Interview: an epidemiologic instrument suitable for use in conjunction with different diagnostic systems and in different cultures . Arch Gen Psychiatry . 1988;45:1069-1077.Crossref 16. Wittchen H-U, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier DA, and Participants in the Multicentre WHO/ADAMHA Field Trials. Cross-cultural feasibility, reliability and sources of variance in the Composite International Diagnostic Interview (CIDI) . Br J Psychiatry . 1991;159:645-653.Crossref 17. Cottler LB, Robins LN, Grant BF, Blaine J, Towle LH, Wittchen H-U, Sartorius N, and Participants in the WHO/ADAMHA Field Trials. The CIDI-core substance abuse and dependence questions: cross-cultural and nosological issues . Br J Psychiatry . 1991;159:653-658.Crossref 18. Semler G, von Cranach M, Wittchen H-U, eds. Comparison between the Composite International Diagnostic Interview and the Present State Examination. Report to the WHO/ADAMHA Task Force on Instrument Development ; February 1987; Geneva, Switzerland. 19. Wacker HR, Battegay R, Mullejans R, Schlosser C. Using the CIDI-C in the general population . In: Stefanis CN, Rabavilas AD, Soldatos CR, eds. Psychiatry: A World Perspective . Amsterdam, the Netherlands: Elsevier Science Publishers; 1990:138-143. 20. Semler G, ed. Reliabilitat und Validitat des Composite International Diagnostic Interview: Inaugural-Dissertation zur Erlangung des akademischen Grades eines Doktors der Philosophie . Mannheim, Germany: Universitat Mannheim; 1989. 21. Spengler P, Wittchen H-U. Procedural validity of standardized symptom questions for the assessment of psychotic symptoms: a comparison of the CIDI with two clinical methods . Compr Psychiatry . 1989;29:309-322.Crossref 22. Janca A, Robins LN, Cottler LB, Early TS. Clinical observation of CIDI assessments: an analysis of the CIDI field trials—wave II at the St. Louis site . Br J Psychiatry . 1992;160:815-818.Crossref 23. Leitmeyer P, ed. Zur Symptomerfassung mit dem standarisierten Interview CIDI-C in der Allgemeinpraxis: Inaugural Dissertation zur Erlangung des medizinischen Doktorgrades fur klinische Medizin . Mannheim, Germany: Universitat Mannheim; 1990. 24. Farmer AE, Katz R, McGuffin P, Bebbington P. A comparison between the Present State Examination and the Composite International Diagnostic Interview . Arch Gen Psychiatry . 1987;44:1064-1068.Crossref 25. Farmer AE, Jenkins PL, Katz R, Ryder L. Comparison of CATEGO-derived ICD-8 and DSM-III classifications using the Composite International Diagnostic Interview in severely ill subjects . Br J Psychiatry . 1991;158:177-182.Crossref 26. Wittchen H-U, Burke JD, Semler G, Pfister H. Recall and dating of psychiatric symptoms: test-retest reliability of time-related symptom questions in a standardized psychiatric interview . Arch Gen Psychiatry . 1989;46:437-443.Crossref 27. Anthony JC, Folstein M, Romanoski AJ, von Korff MR, Nestadt GR, Chahal R, Merchant A, Brown CH, Shapiro S, Kramer M, Gruenberg EM. Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: experience in eastern Baltimore . Arch Gen Psychiatry . 1985;42:667-675.Crossref 28. Helzer JE, Robins LN, McEvoy LT, Spitznagel E. A comparison of clinical and Diagnostic Interview Schedule diagnoses . Arch Gen Psychiatry . 1985;42:657-666.Crossref 29. Spitzer RL, Williams JBW, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID), I: history, rationale, and description . Arch Gen Psychiatry . 1992;49:624-629.Crossref 30. Williams JBW, Gibbon M, First MB, Spitzer RL, Davies M, Borus J, Howes MJ, Kane J, Harrison GP Jr, Rounsaville B, Wittchen H-U. The structured clinical interview for DSM-III-R (SCID), II: multisite test-retest reliability . Arch Gen Psychiatry . 1992;49:630-636.Crossref 31. Woodruff RS, Causey BD. Computerized method for approximating the variance of a complicated estimate . J Am Stat Assoc . 1976;71:315-321.Crossref 32. University of Michigan. OSIRIS VII. Ann Arbor, Mich: Institute for Social Research, The University of Michigan; 1981. 33. Kish L, Frankel MR. Balanced repeated replications for standard errors . J Am Stat Assoc . 1970;65:1071-1094.Crossref 34. Koch GG, Leneshow S. An application of multivariate analysis to complex sample survey data . J Am Stat Assoc . 1972;67:780-782.Crossref 35. SAS Institute. SAS 6.03. Cary, NC: SAS Institute; 1988. 36. Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991. 37. Canino GJ, Bird HR, Shrout PE, Rubio-Stipec M, Bravo M, Martinez R, Sesman M, Guevara L. The prevalence of specific psychiatric disorders in Puerto Rico . Arch Gen Psychiatry . 1987;44:727-735.Crossref 38. Hwu H-G, Yeh EK, Chang LY. Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule . Acta Psychiatr Scand . 1989;79:136-147.Crossref 39. Wells JE, Bushnell JA, Hornblow AR, Joyce PR, Oakley-Browne MA. Christchurch Psychiatric Epidemiology Study, I: methodology and lifetime prevalence for specific psychiatric disorders . Aust N Z J Psychiatry . 1989;23:315-326.Crossref 40. Wittchen H-U, Essau CA, von Zerssen D, Krieg JC, Zaudig M. Lifetime and six-month prevalence of mental disorders in the Munich follow-up study . Eur Arch Psychiatry Clin Neurosci . 1992;241:247-258.Crossref 41. Keith SJ, Regier DA, Rae DS. Schizophrenic disorders . In: Regier DA, Robins LN, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:33-52. 42. Gurin G, Veroff J, Feld SC. Americans View Their Mental Health . New York, NY: Basic Books Inc Publishers; 1960. 43. Veroff J, Kulka RA, Douvan E. Mental Health in America: Patterns of Help-Seeking From 1957 to 1976 . New York, NY: Basic Books Inc Publishers; 1981. 44. Shapiro S, Skinner EA, Kessler LG, von Korff M, German PS, Tischler GL, Leaf PJ, Benham L, Cottler L, Regier DA. Utilization of health and mental health services: three Epidemiological Catchment Area sites . Arch Gen Psychiatry . 1984;41:971-978.Crossref 45. Cross-National Collaborative Group. The changing rate of major depression . JAMA . 1992;268:3098-3105.Crossref 46. Weissman MM, Bruce ML, Leaf PJ, Florio LP, Holzer C III. Affective disorders . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:53-80. 47. Helzer JE, Burnam A, McEvoy LT. Alcohol abuse and dependence . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:81-115. 48. Anthony JC, Helzer JE. Syndromes of drug abuse and dependence . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:116-154. 49. Horwath E, Johnson J, Hornig CD. Epidemiology of panic disorder in African-Americans . Am J Psychiatry . 1993;150:465-469. 50. Eaton WW, Dryman A, Weissman MM. Panic and phobia . In: Robins LN, Regier DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study . New York, NY: Free Press; 1991:155-179. 51. Bruce ML, Takeuchi DT, Leaf PJ. Poverty and psychiatric status: longitudinal evidence from the New Haven Epidemiologic Catchment Area Study . Arch Gen Psychiatry . 1991;48:470-474.Crossref 52. Holzer CE, Shea B, Swanson JW, Leaf PJ, Myers JK, George L, Weissman MM, Bednarski P. The increased risk for specific psychiatric disorders among persons of low socioeconomic status . Am J Psychiatry . 1986;6:259-271. 53. Stansfeld SA, Marmot MG. Social class and minor psychiatric disorder in British civil servants: a validated screening survey using the General Health Questionnaire . Psychol Med . 1992;22:739-749.Crossref 54. Myers JK. Social factors related to psychiatric disorders . Soc Psychiatry Psychiatr Epidemiol . 1984;19:53-61. 55. Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD Jr, Regier DA. Lifetime prevalence of specific psychiatric disorders in three sites . Arch Gen Psychiatry . 1984;41:949-958.Crossref 56. Boyd JH, Weissman MM. Epidemiology of affective disorders: a reexamination and future directions . Arch Gen Psychiatry . 1981;38:1039-1046.Crossref 57. Kendler KS, Neale MC, Kessler RC, Heath AC, Eaves LJ. A population-based twin study of major depression in women . Arch Gen Psychiatry . 1992;49:257-266.Crossref 58. Weissman MM, Myers JK, Harding PS. Psychiatric disorders in a U.S. urban community: 1975-1976 . Am J Psychiatry . 1978;135:459-462. 59. Helzer JE, Pryzbeck TR. The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment . J Stud Alcohol . 1988;49:219-224. 60. Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, Goodwin FK. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study . JAMA . 1990;264:2511-2518.Crossref 61. Bukstein OG, Brent DA, Kaminer Y. Comorbidity of substance abuse and other psychiatric disorders in adolescents . Am J Psychiatry . 1989;146:1131-1141. 62. Hesselbrock MN, Meyer RE, Keener JJ. Psychopathology in hospitalized alcoholics . Arch Gen Psychiatry . 1985;42:1050-1055.Crossref 63. Kessler RC, McGonagle KA, Carnelley KB, Nelson CB, Farmer MA, Regier DA. Comorbidity of mental disorders and substance use disorders: a review and agenda for future research . In: Leaf P, ed. Research in Community and Mental Health . Greenwich, Conn: JAI Press Inc. In press. 64. Marlatt GA, Gordon JR. Determinants of relapse: implications for the maintenance of behavioral change . In: Davidson P, Davidson S, eds. Behavioral Medicine: Changing Health and Lifestyles . New York, NY: Brunner/Mazel Inc; 1980. 65. Vaillant GE. Natural history of male psychological health VIII: antecedents of alcoholism and 'orality.' Am J Psychiatry . 1980;137:181-186.Crossref 66. Rosenblatt PC. Farming Is in Our Blood: Farm Families in Economic Crisis . Ames: Iowa State University Press; 1990.

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Jan 1, 1994

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