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

Background Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. Objective To present nationally representative data on the prevalence and comorbidity of DSM-IV alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). Design Face-to-face survey. Setting The United States. Participants Household and group quarters' residents. Main Outcome Measures Prevalence and associations of substance use disorders and independent mood and anxiety disorders. Results The prevalences of 12-month DSM-IV independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant ( P Conclusions Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

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Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

Objective:To present nationally representative data on 12-month and lifetime prevalence, correlates, and comorbidity of DSM-IV major depressive disorder (MDD) among adults in the United States. Design/Setting/Participants:Face-to-face survey of more than 43000 adults aged 18 years and older residinginhouseholdsandgroupquartersintheUnitedStates. Main Outcome Measures: Prevalence and associationsofMDDwithsociodemographiccorrelatesandAxis I and II disorders. Results:Theprevalenceof12-monthandlifetimeDSM-IV MDD was 5.28% (95% confidence interval, 4.98-5.57) and 13.23% (95% confidence interval, 12.64-13.81), respectively. Being female; Native American; middleaged; widowed, separated, or divorced; and low income increased risk, and being Asian, Hispanic, or black decreased risk (P.05). Women were significantly more likely to receive treatment than men. Both current and lifetimeMDDweresignificantlyassociatedwithotherspecific psychiatric disorders, notably substance dependence, panic and generalized anxiety disorder, and several personality disorders. Conclusions:This large survey suggests a higher prevalence of MDD in the US population than large-sample estimates from the 1980s and 1990s. The shift in highest lifetime risk from young to middle-aged adults is an important transformation in the distribution of MDD in the United States and specificity in risk for an ageperiodcohort.AssociationsbetweenMDDandAxisIand II disorders were strong and significant, with variation within broad categories by specific diagnoses signaling the need for attention to the genetic and environmental reasons for such variation, as well as the implications for treatment response. Arch Gen Psychiatry. 2005;62:1097-1106

/pdf/epidemiology-of-major-depressive-disorder-results-from-the-d3vtw5sg3b.pdf

Epidemiology of Major Depressive Disorder: Results From the National Epidemiologic Survey on Alcoholism and Related Conditions

http://www.doctordeluca.com/Library/AddictionMeds/Prevalence&TrendsAlcAbuseDep90s04.pdf

The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-1992 and 2001-2002.

Borderline personality disorder (BPD) is a complex, serious psychiatric disorder characterized by pervasive instability in regulation of emotion, self-image, interpersonal relationships, and impulse control.1 BPD is the most prevalent personality disorder in clinical settings and is associated with severe functional impairment, substantial treatment utilization, and high rates of mortality by suicide.2–5 Clinical studies have also shown BPD to be highly comorbid with most substance use, mood, anxiety, and other personality disorders (PDs).6–12

Although BPD is among the most frequently studied PDs in clinical settings, little is known about its prevalence, correlates, disability, and comorbidity in general population samples. Several earlier community studies13–27 of BPD were limited by selection of small samples (n=133–799) not entirely representative of the general population. Others preselected individuals from larger general population samples based on responses to PD screening instruments or psychopathology,15,19,20,24 further limiting the size of the survey samples on which to base prevalence estimates. Of the 2 larger-scale epidemiologic surveys, the one conducted in Norway28 (n = 2,053) was compromised by a low response rate (57%), and the Australian survey29 (n=10,641) used a PD screening measure rather than a diagnostic assessment instrument to assess PDs. Because of these limitations, very little is known about the sociodemographic characteristics, disability, and comorbidity of BPD with other psychiatric disorders. The 1 study that presented data on disorder-specific comorbidity19 did not control for other comorbid disorders, thereby precluding analysis of common and unique factors underlying disorder-specific associations with BPD.

The lack of comprehensive and detailed information on DSM-IV BPD in the United States represents a gap in our knowledge relevant to prevention, treatment, and economic costs. The present study was designed to address this gap using data from the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).30 The Wave 2 NESARC covered DSM-IV alcohol and specific drug use disorders, and mood and anxiety disorders assessed in the 2001–2002 Wave 1 NESARC,31, 32 in addition to BPD, schizotypal and narcissistic PDs, and posttraumatic stress disorder (PTSD). The remaining DSM-IV PDs (avoidant, dependent, obsessive-compulsive, paranoid, schizoid, histrionic, and antisocial), were assessed in the Wave 1 NESARC. The sample size and high response rate of the Wave 2 NESARC allow for reliable and precise estimation of lifetime prevalence of BPD, especially among important sociodemographic subgroups of the population. Furthermore, comorbidity of BPD with each Axis I and II disorder was examined while controlling for both sociodemographic characteristics and additional psychiatric disorders to determine the unique relationship of each specific disorder to BPD. The importance of controlling for other disorders that are highly comorbid with one another represents an advance in our understanding of comorbidity recently highlighted in the epidemiologic literature.33, 34 This study also provides information on mental and physical disability associated with BPD. Because so little is known about sex differences in BPD, information on correlates, disability and comorbidity of BPD is presented for the total sample and by sex.

/pdf/prevalence-correlates-disability-and-comorbidity-of-dsm-iv-499oogcryf.pdf

Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions.

https://pure.uva.nl/ws/files/3039628/3201_29814y.pdf

R. Smeets

Papers

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results

WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: Overview of methods and results (vol 47, pg 161, 1997)