Context Little is known about lifetime prevalence or age of onset of DSM-IV disorders. Objective To estimate lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the recently completed National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using the fully structured World Health Organization World Mental Health Survey version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents aged 18 years and older. Main Outcome Measures Lifetime DSM-IV anxiety, mood, impulse-control, and substance use disorders. Results Lifetime prevalence estimates are as follows: anxiety disorders, 28.8%; mood disorders, 20.8%; impulse-control disorders, 24.8%; substance use disorders, 14.6%; any disorder, 46.4%. Median age of onset is much earlier for anxiety (11 years) and impulse-control (11 years) disorders than for substance use (20 years) and mood (30 years) disorders. Half of all lifetime cases start by age 14 years and three fourths by age 24 years. Later onsets are mostly of comorbid conditions, with estimated lifetime risk of any disorder at age 75 years (50.8%) only slightly higher than observed lifetime prevalence (46.4%). Lifetime prevalence estimates are higher in recent cohorts than in earlier cohorts and have fairly stable intercohort differences across the life course that vary in substantively plausible ways among sociodemographic subgroups. Conclusions About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

https://www.ph.ucla.edu/epi/faculty/detels/PH150/Kessler_DSMIV_AGP2009.pdf

Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication

Background Little is known about the general population prevalence or severity of DSM-IV mental disorders. Objective To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication. Design and Setting Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Participants Nine thousand two hundred eighty-two English-speaking respondents 18 years and older. Main Outcome Measures Twelve-month DSM-IV disorders. Results Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population. Conclusion Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

/pdf/prevalence-severity-and-comorbidity-of-12-month-dsm-iv-54fahxwd1s.pdf

Prevalence, Severity, and Comorbidity of 12-Month DSM-IV Disorders in the National Comorbidity Survey Replication

世界経済・社会統計 = World development indicators

Prospective Cohort Study

Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010.

Numerous studies addressed the topic of behavioral and symptomatic changes in eating disorders. Rates of transition vary widely across studies, ranging from 0 to 70.8%, depending on the diagnoses taken into account and the study design. Evidence shows that the specific transition from restrictive-type anorexia nervosa (AN-R) to disorders involving binging and purging behaviors (BPB) is related to a worsening of the clinical picture and worse long-term outcomes. The aim of this systematic review and meta-analysis is to focus on this specific transition, review existing literature, and summarize related risk factors. Medline and PsycINFO databases were searched, including prospective and retrospective studies on individuals with AN-R. The primary outcome considered was the rate of onset of BPB. Twelve studies (N = 725 patients) were included in the qualitative and quantitative analysis. A total of 41.84% (95% CI 33.58–50.11) of patients with AN-R manifested BPB at some point during follow-up. Risk factors for the onset of BPB included potentially treatable and untreatable factors such as the family environment, unipolar depression and higher premorbid BMI. These findings highlight that patients with AN-R frequently transition to BPB over time, with a worsening of the clinical picture. Existing studies in this field are still insufficient and heterogeneous, and further research is needed. Mental health professionals should be aware of the frequent onset of BPB in AN-R and its risk factors and take this information into account in the treatment of AN-R. Evidence obtained from a systematic review and meta-analysis, Level I.

/pdf/the-transition-from-restrictive-anorexia-nervosa-to-binging-8vtm4ozt4h.pdf

The transition from restrictive anorexia nervosa to binging and purging: a systematic review and meta-analysis.

Zorggebruik voor mentale stoornissen in België. Resultaten van de European Study of the Epidemiology of Mental Disorders (ESEMeD)

Positive screens for mental disorders among healthcare professionals during the first covid19 wave in Belgium.

Objectif. Determiner la prevalence sur un an et au cours de l'existence des troubles mentaux purs et co-morbides chez les Belges adultes non institutionnalises. Methode. Entre avril 2001 et juin 2002, 2419 personnes (de 18 ans et +) issues d'un echantillon representatif de la population belge ont ete interviewees oralement. A l'aide de la version la plus recente du Composite International Diagnostic Interview (CIDI-2000, Questionnaire composite international pour le diagnostic), les chercheurs ont evalue, sur base du Diagnostic Manual of Mental Disorder, 4 e edition (DSM-IV, Manuel diagnostique statistique des troubles mentaux), la presence des troubles mentaux suivants : troubles de l'humeur (trouble depressif, dysthymie), troubles anxieux (anxiete generalisee, phobie sociale, phobie specifique, trouble lie a des facteurs de stress post-traumatique, agoraphobie, panique) et troubles lies a l'alcool (abus d'alcool, dependance alcoolique). Resultats. Pratiquement 27% des repondants affirment avoir manifeste un trouble mental au cours de leur vie; un sur dix affirme avoir developpe un trouble mental au cours de l'annee ecoulee. Les femmes rapportent nettement plus souvent des troubles mentaux que les hommes. Le trouble depressif et l'abus d'alcool sont les plus frequents au cours de l'existence entiere, tandis que le trouble depressif et une phobie specifique sont les plus frequents dans l'annee ecoulee. La co-morbidite psychiatrique est egalement souvent evoquee. Conclusion. Les resultats de cette etude sont fondes sur un echantillon representatif de la population belge. Sur base de cette donnee, on peut donc affirmer que plus de deux millions de Belges ont developpe un trouble mental au cours de leur vie. Parmi eux, 800 000 individus ont manifeste ce trouble au cours de l'annee ecoulee.

Prévalence des troubles mentaux dans la population belge : Résultats de l'European Study on Epidemiology of Mental Disorders (ESEMeD)

Objectif: Description de la consommation de medicaments psychotropes chez les adultes belges non institutionnalises. Methode: Entre avril 2001 et juin 2002, 2419 personnes (de + de 18 ans) constituant un echantillon representatif de la population belge ont ete interviewees oralement a l'aide de la World Mental Health Composite International Diagnostic Interview (WMH-CIDI). On n'evaluait pas seulement la presence d'un trouble mental durant les derniers 12 mois avant l'interview, mais egalement l'utilisation de quatre classes d'agents psychopharmaceutiques durant la meme periode: antidepresseurs, anxiolytiques, neuroleptiques et stabilisateurs de l'humeur. Resultats: Un peu plus de 19 % des participants avaient pris un medicament psychotrope au cours des 12 derniers mois; un trouble mental etait present chez 11 % des sujets. Les personnes avec un trouble de l'humeur prenaient plus souvent un psychotrope (60 %) que les sujets presentant un trouble lie a l'alcool (53 %) ou les personnes avec une trouble anxieux (39 %). Trente neuf pour cent des personnes avec un trouble de l'humeur prenaient un antidepresseur, tandis que 23 % des sujets avec un trouble anxieux utilisaient un anxiolytique. Parmi les repondants ayant consomme des antidepresseurs, la plupart ont utilise des selective serotonin reuptake inhibitors (SSRI). Conclusion: Sur la base de cette etude, on peut constater qu'en Belgique, on n'assiste pas a une surconsommation, mais plutot a une utilisation peu differenciee et aspecifique des agents psycho-pharmaceutiques, surtout des anxiolytiques.

Ronny Bruffaerts

Papers

The transition from restrictive anorexia nervosa to binging and purging: a systematic review and meta-analysis.

Zorggebruik voor mentale stoornissen in België. Resultaten van de European Study of the Epidemiology of Mental Disorders (ESEMeD)

Positive screens for mental disorders among healthcare professionals during the first covid19 wave in Belgium.

Prévalence des troubles mentaux dans la population belge : Résultats de l'European Study on Epidemiology of Mental Disorders (ESEMeD)

[Psychotropic drug use in the Belgian non-institutionalized population].