Background Current and comprehensive information on the epidemiology of DSM-IV 12-month and lifetime drug use disorders in the United States has not been available. Objectives To present detailed information on drug abuse and dependence prevalence, correlates, and comorbidity with other Axis I and II disorders. Design, Setting, and Participants Face-to-face interviews using the Alcohol Use Disorder and Associated Disabilities Interview Schedule of the National Institute on Alcohol Abuse and Alcoholism in a large representative sample of US adults (N = 43 093). Main Outcome Measures Twelve-month and lifetime prevalence of drug abuse and dependence and the associated correlates, treatment rates, disability, and comorbidity with other Axis I and II disorders. Results Prevalences of 12-month and lifetime drug abuse (1.4% and 7.7%, respectively) exceeded rates of drug dependence (0.6% and 2.6%, respectively). Rates of abuse and dependence were generally greater among men, Native Americans, respondents aged 18 to 44 years, those of lower socioeconomic status, those residing in the West, and those who were never married or widowed, separated, or divorced (all P Conclusions Most individuals with drug use disorders have never been treated, and treatment disparities exist among those at high risk, despite substantial disability and comorbidity. Comorbidity of drug use disorders with other substance use disorders and antisocial personality disorder, as well as dependence with mood disorders and generalized anxiety disorder, appears to be due in part to unique factors underlying each pair of these disorders studied. The persistence of low treatment rates despite the availability of effective treatments indicates the need for vigorous educational efforts for the public and professionals.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/482282/yoa60081_566_576.pdf

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Context Although young adulthood is often characterized by rapid intellectual and social development, college-aged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. Objectives To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non–college-attending peers in the United States. Design, Setting, and Participants Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43 093). Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n = 2904) college in the previous year. Main Outcome Measures Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non–college-attending peers. Results Almost half of college-aged individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non–college-attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non–college-attending peers (odds ratio = 1.25; 95% confidence interval, 1.04-1.50), although not after adjusting for background sociodemographic characteristics (adjusted odds ratio = 1.19; 95% confidence interval, 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non–college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non–college-attending peers. Conclusions Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population. Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-aged individuals.

/pdf/mental-health-of-college-students-and-their-non-college-3u7yeq8nb0.pdf

Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions.

Stigma associated with mental illness has malignant effects on the lives of people with serious mental illnesses. Many strategies have been used to combat public stigma—the prejudice and discrimination endorsed by the general population. To identify the most effective approaches, researchers conducted a meta-analysis of data from 72 outcome studies in 14 countries. Overall, strategies that include education about mental illness and contact with people who have mental illness are effective. For adults, contact appears to be more effective, whereas education seems to work best among adolescents.

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201100529

Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies

The effectiveness of efforts designed to address mental illness stigma will rest on our ability to understand stigma processes, the factors that produce and sustain such processes, and the mechanisms that lead from stigmatization to harmful consequences. Critical to such an understanding is our capacity to observe and measure the essential components of stigma processes. This article is designed to assist researchers in selecting or creating measures that can address critical research questions regarding stigma. Our conceptualization of stigma processes leads us to consider components of labeling, stereotyping, cognitive separating, emotional reactions, status loss, and discrimination. We review 123 empirical articles published between January 1995 and June 2003 that have sought to assess mental illness stigma and use these articles to provide a profile of current measurement in this area. From the articles we identify commonly used and promising measures and describe those measures in more detail so that readers can decide whether the described measures might be appropriate for their studies. We end by identifying gaps in stigma measurement in terms of concepts covered and populations assessed.

Measuring Mental Illness Stigma

Objective: To provide a review of population-based attitude research in psychiatry during the past 15 years.

Method:  An electronic search using PubMed, Medline, and Academic Search Premier plus a hand search of the literature was carried out for studies on public beliefs about mental illness and attitudes towards the mentally ill published between 1990 and 2004.

Results:  Thirty-three national studies and 29 local and regional studies were identified, mostly from Europe. Although the majority are of descriptive nature, more recent publications include studies testing theory-based models of the stigmatization of mentally ill people, analyses of time trends and cross-cultural comparisons, and evaluations of antistigma interventions.

Conclusion:  Attitude research in psychiatry made considerable progress over the past 15 years. However, there is still much to be done to provide an empirical basis for evidence-based interventions to reduce misconceptions about mental illness and improve attitudes towards persons with mental illness.

Public beliefs about and attitudes towards people with mental illness: a review of population studies

Background Recognition of the additional social handicaps and distress that people with mental illnesses experience as a result of prejudice.

Aims To determine opinions of the British adult population concerning those with mental illnesses as baseline data for a campaign to combat stigmatisation.

Method Survey of adults ( n =1737 interviewed ; 65% response) regarding seven types of common mental disorders. Responses evaluated concerned eight specified perceptions.

Results Respondents commonly perceived people with schizophrenia, alcoholism and drug addiction as unpredictable and dangerous. The two latter conditions were also viewed as self-inflicted. People with any of the seven disorders were perceived as hard to talk with. Opinions about effects of treatment and prognosis suggested reasonable knowledge. About half the respondents reported knowing someone with a mental illness.

Conclusions Negative opinions indiscriminately overemphasise social handicaps that can accompany mental disorders. They contribute to social isolation, distress and difficulties in employment faced by sufferers. A campaign against stigma should take account of the differences in opinions about the seven disorders studied.

/pdf/stigmatisation-of-people-with-mental-illnesses-4waatbfbt6.pdf

Stigmatisation of people with mental illnesses.

During 1972-74 nine populations of schoolgirls were surveyed in respect of the occurrence of anorexia nervosa. As well as the current school year, previous years (going back variously 3-6 years) were also carefully studied within seven of the schools. Anorexia nervosa was only identified as present or having been present if the diagnosis was unequivocal: for instance, seemingly evident and severe cases which could not be traced were excluded. The condition in severe form was found to be relatively common in the independent sector of education, probably implying a social class factor. In all such schools, the prevalence was one severe case in approximately every 200 girls. In those aged 16 and over it amounted to one severe case in about every 100 girls. Overall, these schools encountered one 'new' severe case in every 250 pupils aged 16 years and over. The condition is likely to be even more common than this study allows because of the stringent limits set here on inclusion of cases and the age-bands studied. It is concluded that severe anorexia nervosa is a common condition and is probably getting more common.

How common is anorexia nervosa? A prevalence study.

A population survey before the start of the Changing Minds campaign showed that negative opinions about people with mental illnesses were widely held, and that opinions about different disorders differed in important ways. We repeated the survey 5 years later, when the campaign had ended. Interviews were again conducted with a representative population sample (1725 interviews; response rate 65%), enquiring about demographic variables, about eight opinions concerning seven common mental disorders, and whether the respondents knew anyone with one of these mental disorders. The pattern of response in this second survey resembled that in the first. However, there were significant changes. Though often small, apart from reported opinions concerning treatment and outcome, they were all reductions in the percentages of stigmatizing opinions. Seventy seven percent of respondents reported knowing someone with one of the seven disorders. Those who did so in respect of severe depression or panic and phobias were less likely to have stigmatizing opinions about people with the corresponding disorder, but the same did not apply to the other disorders. The greatest proportion of negative opinions was in the 16-19 year age group, and respondents with higher education were less likely than the rest to express such views. We conclude that stigmatizing opinions are frequent in the community but the various disorders are not stigmatized in the same way. Campaigns to reduce stigma should take account of these differences, and of the need to address young people.

Stigmatization of people with mental illnesses: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists RESEARCH REPORT

Arthur Crisp

Papers

Stigmatisation of people with mental illnesses.

How common is anorexia nervosa? A prevalence study.

Stigmatization of people with mental illnesses: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists RESEARCH REPORT

Stigmatization of people with mental illnesses: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists.