Prevalence and treatment of mental disorders, 1990 to 2003.
- Authors
- Kessler, Ronald C; Demler, Olga; Frank, Richard G; Olfson, Mark; Pincus, Harold Alan; Walters, Ellen E; Wang, Philip; Wells, Kenneth B; Zaslavsky, Alan M
- Year
- 2005
- Journal
- The New England journal of medicine
- PMID
- 15958807
- DOI
- 10.1056/NEJMsa043266
- PMCID
- PMC2847367
BACKGROUND: Although the 1990s saw enormous change in the mental health care system in the United States, little is known about changes in the prevalence or rate of treatment of mental disorders. METHODS: We examined trends in the prevalence and rate of treatment of mental disorders among people 18 to 54 years of age during roughly the past decade. Data from the National Comorbidity Survey (NCS) were obtained in 5388 face-to-face household interviews conducted between 1990 and 1992, and data from the NCS Replication were obtained in 4319 interviews conducted between 2001 and 2003. Anxiety disorders, mood disorders, and substance-abuse disorders that were present during the 12 months before the interview were diagnosed with the use of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Treatment for emotional disorders was categorized according to the sector of mental health services: psychiatry services, other mental health services, general medical services, human services, and complementary-alternative medical services. RESULTS: The prevalence of mental disorders did not change during the decade (29.4 percent between 1990 and 1992 and 30.5 percent between 2001 and 2003, P=0.52), but the rate of treatment increased. Among patients with a disorder, 20.3 percent received treatment between 1990 and 1992 and 32.9 percent received treatment between 2001 and 2003 (P<0.001). Overall, 12.2 percent of the population 18 to 54 years of age received treatment for emotional disorders between 1990 and 1992 and 20.1 percent between 2001 and 2003 (P<0.001). Only about half those who received treatment had disorders that met diagnostic criteria for a mental disorder. Significant increases in the rate of treatment (49.0 percent between 1990 and 1992 and 49.9 percent between 2001 and 2003) were limited to the sectors of general medical services (2.59 times as high in 2001 to 2003 as in 1990 to 1992), psychiatry services (2.17 times as high), and other mental health services (1.59 times as high) and were independent of the severity of the disorder and of the sociodemographic characteristics of the respondents. CONCLUSIONS: Despite an increase in the rate of treatment, most patients with a mental disorder did not receive treatment. Continued efforts are needed to obtain data on the effectiveness of treatment in order to increase the use of effective treatments.
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| Why is natural recovery so common for addictive disorders? | Slutske WS | — | 2010 | → |
| Abbreviated brief symptom inventory for use as an anxiety and depression screening instrument in primary care. | Lang AJ et al. | — | 2009 | → |
| Adults with congenital heart disease: psychological needs and treatment preferences. | Kovacs AH et al. | — | 2009 | → |
| Americans' attitudes toward psychiatric medications: 1998-2006. | Mojtabai R | — | 2009 | → |
| Analysis of the psychiatric-mental health nurse workforce in the United States. | Hanrahan NP | — | 2009 | → |
| Anti-depressants and suicide. | Ludwig J et al. | — | 2009 | → |
| Anxiety disorders moderate the association between externalizing problems and substance use disorders: data from the National Comorbidity Survey-Revised. | Hofmann SG et al. | — | 2009 | → |
| Better but not best: recent trends in the well-being of the mentally ill. | Glied SA et al. | — | 2009 | → |
| Beyond parity: primary care physicians' perspectives on access to mental health care. | Cunningham PJ | — | 2009 | → |
| Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. I. Classification, burden and principles of management. | Patten SB et al. | — | 2009 | → |
| Changes in formal help seeking for psychological distress: the OsLof study. | Svensson E et al. | — | 2009 | → |
| Changing perceptions of depression: ten-year trends from the general social survey. | Blumner KH et al. | — | 2009 | → |
| Childhood onset major depressive disorder: course of illness and psychiatric comorbidity in a community sample. | Korczak DJ et al. | — | 2009 | → |
| Clinical evaluation of the Daily Assessment of Symptoms-Anxiety (DAS-A): a new instrument to assess the onset of symptomatic improvement in generalized anxiety disorder. | Feltner DE et al. | — | 2009 | → |
| Comorbid chronic illness and the diagnosis and treatment of depression in safety net primary care settings. | Ani C et al. | — | 2009 | → |
| Competition and the mental health system. | Cuellar AE et al. | — | 2009 | → |
| Correlates of help-seeking behavior among at-risk adolescents. | Husky MM et al. | — | 2009 | → |
| Cross-national associations between gender and mental disorders in the World Health Organization World Mental Health Surveys. | Seedat S et al. | — | 2009 | → |
| Epidemiological trends in psychosis-related Emergency Department visits in the United States, 1992-2001. | Pandya A et al. | — | 2009 | → |
| Epidemiologic heterogeneity of common mood and anxiety disorders over the lifecourse in the general population: a systematic review. | Nandi A et al. | — | 2009 | → |
| Examining racial/ethnic minority treatment experiences with specialty behavioral health service providers. | Redmond ML et al. | — | 2009 | → |
| From childhood to adult age: 18-year longitudinal results and prediction of the course of mental disorders in the community. | Fichter MM et al. | — | 2009 | → |
| Gender differences in veterans health administration mental health service use: effects of age and psychiatric diagnosis. | Chatterjee S et al. | — | 2009 | → |
| General practice and mental health care: determinants of outpatient service use. | Vasiliadis HM et al. | — | 2009 | → |
| Help seeking and perceived need for mental health care among individuals in Canada with suicidal behaviors. | Pagura J et al. | — | 2009 | → |
| Heterogeneity in comorbidity between major depressive disorder and generalized anxiety disorder and its clinical consequences. | Unick GJ et al. | — | 2009 | → |
| Hospitalization patterns for psychiatric disorders across the lifespan in Australia from July 1998 to June 2005. | Low LF et al. | — | 2009 | → |
| Increased depressive symptoms in menopausal age women with bipolar disorder: age and gender comparison. | Marsh WK et al. | — | 2009 | → |
| Influence of gender, sexual orientation, and need on treatment utilization for substance use and mental disorders: findings from the California Quality of Life Survey. | Grella CE et al. | — | 2009 | → |
| Long-acting risperidone: a review of its role in the treatment of bipolar disorder. | Kemp DE et al. | — | 2009 | → |
| Long-term effects of adolescent marijuana use prevention on adult mental health services utilization: the midwestern prevention project. | Riggs NR et al. | — | 2009 | → |
| Mental disorders in young adulthood. | Suvisaari J et al. | — | 2009 | → |
| Mental health in senior housing: racial/ethnic patterns and correlates of major depressive disorder. | Robison J et al. | — | 2009 | → |
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| Negative attitudes toward help seeking for mental illness in 2 population-based surveys from the United States and Canada. | Jagdeo A et al. | — | 2009 | → |
| Obesity and its relationship to addictions: is overeating a form of addictive behavior? | Barry D et al. | — | 2009 | → |
| Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. | Gum AM et al. | — | 2009 | → |
| Prevalence, risk factors, and use of health care in depression: a survey in a large region of France between 1991 and 2005. | Kovess-Masfety V et al. | — | 2009 | → |
| Providing a treatment rationale for PTSD: does what we say matter? | Feeny NC et al. | — | 2009 | → |
| Psychiatrists for medically complex patients: bringing value at the physical health and mental health/substance-use disorder interface. | Kathol RG et al. | — | 2009 | → |
| Recent trends in the incidence of recorded depression in primary care. | Rait G et al. | — | 2009 | → |
| Risk of depression and other mental health disorders in women with polycystic ovary syndrome: a longitudinal study. | Kerchner A et al. | — | 2009 | → |
| Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. | Bolton JM et al. | — | 2009 | → |
| Social phobia and perceived friendship quality. | Rodebaugh TL | — | 2009 | → |
| Sociodemographic, perceived and objective need indicators of mental health treatment use and treatment-seeking intentions among primary care medical patients. | Elhai JD et al. | — | 2009 | → |
| Stemming the tide of suicide in older white men: a call to action. | Schmutte T et al. | — | 2009 | → |
| Success of mental health referral among pregnant and postpartum women with psychiatric distress. | Smith MV et al. | — | 2009 | → |
| Surgical management of colorectal cancer in patients with psychiatric disorders. | Hashimoto N et al. | — | 2009 | → |
| The inextricable nature of mental and physical health: implications for integrative care. | Weiss SJ et al. | — | 2009 | → |
| The STAR*D trial: revealing the need for better treatments. | Insel TR et al. | — | 2009 | → |
| Treatment of major depressive disorder in the Finnish general population. | Hämäläinen J et al. | — | 2009 | → |
| Trends in mental health cost growth: an expanded role for management? | Frank RG et al. | — | 2009 | → |
| Unmet need for mental health care in schizophrenia: an overview of literature and new data from a first-admission study. | Mojtabai R et al. | — | 2009 | → |
| Unmet need for treatment of major depression in the United States. | Mojtabai R | — | 2009 | → |
| What you believe is what you want: modeling PTSD-related treatment preferences for sertraline or prolonged exposure. | Zoellner LA et al. | — | 2009 | → |
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| A glimmer of light for neuropsychiatric disorders. | Hyman SE | — | 2008 | → |
| Alcohol induces DNA damage and the Fanconi anemia D2 protein implicating FANCD2 in the DNA damage response pathways in brain. | Rulten SL et al. | — | 2008 | → |
| Antidepressant use in black and white populations in the United States. | González HM et al. | — | 2008 | → |
| An uncertain revolution: why the rise of a genetic model of mental illness has not increased tolerance. | Schnittker J | — | 2008 | → |
| A pilot study of Rhodiola rosea (Rhodax) for generalized anxiety disorder (GAD). | Bystritsky A et al. | — | 2008 | → |
| Applying the institute of medicine quality chasm framework to improving health care for mental and substance use conditions. | Keyser DJ et al. | — | 2008 | → |
| A spatial needs assessment of indigent acute psychiatric discharges in California. | Banta JE et al. | — | 2008 | → |
| Association between trauma exposure and smoking in a population-based sample of young adults. | Roberts ME et al. | — | 2008 | → |
| Associations between psychiatric disorders and menstrual cycle characteristics. | Barron ML et al. | — | 2008 | → |
| Binge drinking among California adults: results from the 2005 California Health Interview Survey. | Banta JE et al. | — | 2008 | → |
| Clinician burden and depression treatment: disentangling patient- and clinician-level effects of medical comorbidity. | Dickinson LM et al. | — | 2008 | → |
| Current Status and Future Prospects of Clinical Psychology: Toward a Scientifically Principled Approach to Mental and Behavioral Health Care. | Baker TB et al. | — | 2008 | → |
| Depressive symptoms and physical activity in adolescent girls. | Johnson CC et al. | — | 2008 | → |
| Emergency psychiatry in the 21st century: critical issues for the future. | Bruffaerts R et al. | — | 2008 | → |
| Employment of advanced-practice psychiatric nurses to stem rural mental health workforce shortages. | Hanrahan NP et al. | — | 2008 | → |
| Estimation of psycholeptic and psychoanaleptic medicine use in an adult general population sample using the Anatomical Therapeutic Chemical classification. | John U et al. | — | 2008 | → |
| Evidence-based treatments for anxiety and depression: lost in translation? | Unützer J | — | 2008 | → |
| Excessive Drinking in Young Women: Reducing harm through quality improvement. | Reiss-Brennan B et al. | — | 2008 | → |
| Financing mental health and substance use disorder care within physical health: a look to the future. | Kathol RG et al. | — | 2008 | → |
| Gain and loss of gastrointestinal symptoms in diabetes mellitus: associations with psychiatric disease, glycemic control, and autonomic neuropathy over 2 years of follow-up. | Quan C et al. | — | 2008 | → |
| Gender differences in generalized anxiety disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). | Vesga-López O et al. | — | 2008 | → |
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| Increase in antidepressant medication in the US adult population between 1990 and 2003. | Mojtabai R | — | 2008 | → |
| "I need to talk about it": a qualitative analysis of trauma-exposed women's reasons for treatment choice. | Angelo FN et al. | — | 2008 | → |
| Insurance parity and the use of outpatient mental health care following a psychiatric hospitalization. | Trivedi AN et al. | — | 2008 | → |
| Longitudinal population-based studies of affective disorders: where to from here? | Beard JR et al. | — | 2008 | → |
| Medicare inpatient treatment for elderly non-dementia psychiatric illnesses 1992--2002; length of stay and expenditures by facility type. | Hoover DR et al. | — | 2008 | → |
| Mental disorder and threats made by noninstitutionalized people with weapons in the national comorbidity survey replication. | Casiano H et al. | — | 2008 | → |
| New evidence regarding racial and ethnic disparities in mental health: policy implications. | McGuire TG et al. | — | 2008 | → |
| Older adults' help-seeking attitudes and treatment beliefs concerning mental health problems. | Mackenzie CS et al. | — | 2008 | → |
| Patient-physician communication in the primary care visits of African Americans and whites with depression. | Ghods BK et al. | — | 2008 | → |
| Persistent depression and anxiety in the United States: prevalence and quality of care. | Young AS et al. | — | 2008 | → |
| Persistent genital arousal disorder in women: case reports of association with anti-depressant usage and withdrawal. | Leiblum SR et al. | — | 2008 | → |
| Postmodernity and mental health. | Whitley R | — | 2008 | → |
| Prevalence and risk factors of threshold and sub-threshold psychiatric disorders in primary care. | Cwikel J et al. | — | 2008 | → |
| Primary care management of patients with co-occurring disorders. | Culpepper L | — | 2008 | → |
| Primary care physicians' evaluation and treatment of depression: Results of an experimental study using video vignettes. | Epstein SA et al. | — | 2008 | → |
| Psychiatric nurse reports on the quality of psychiatric care in general hospitals. | Hanrahan NP et al. | — | 2008 | → |
| Racial and ethnic disparities in detection and treatment of depression and anxiety among psychiatric and primary health care visits, 1995-2005. | Stockdale SE et al. | — | 2008 | → |
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| Re-evaluation of the efficacy and tolerability of venlafaxine vs SSRI: meta-analysis. | Weinmann S et al. | — | 2008 | → |
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| Social comparison of distress and mental health help-seeking in the US general population. | Mojtabai R | — | 2008 | → |
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| The descriptive epidemiology of commonly occurring mental disorders in the United States. | Kessler RC et al. | — | 2008 | → |
| The impact of symptoms and impairments on overall health in US national health data. | Stewart ST et al. | — | 2008 | → |
| The Upper Bavarian longitudinal community study 1975-2004. 2. Long-term course and outcome of depression. A controlled study. | Fichter MM et al. | — | 2008 | → |
| Toward a Hippocratic psychopharmacology. | Ghaemi SN | — | 2008 | → |
| Trajectory and socioeconomic predictors of depression in a prospective study of residents of New York City. | Beard JR et al. | — | 2008 | → |
| Trends in mental health and substance abuse services at the nation's community health centers: 1998-2003. | Druss BG et al. | — | 2008 | → |
| Use of health services for major depressive and anxiety disorders in Finland. | Hämäläinen J et al. | — | 2008 | → |
| US patterns of mental health service utilization for transition-age youth and young adults. | Pottick KJ et al. | — | 2008 | → |
| Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. | Löwe B et al. | — | 2008 | → |
| Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil. | de Azevedo Marques JM et al. | — | 2008 | → |
| Verifiability of diagnostic categories and work ability in the context of disability pension award: a survey on "gatekeeping" among general practitioners in Norway. | Overland R et al. | — | 2008 | → |
| World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders - first revision. | Bandelow B et al. | — | 2008 | → |
| 250 labels used to stigmatise people with mental illness. | Rose D et al. | — | 2007 | → |
| Analysis of U.S. trends in discharges from general hospitals for episodes of serious mental illness, 1995-2002. | Watanabe-Galloway S et al. | — | 2007 | → |
| Anxiety disorders in a public mental health system: clinical characteristics and service use patterns. | Wetherell JL et al. | — | 2007 | → |
| A randomized, controlled trial of disease management modules, including telepsychiatric care, for depression in rural primary care. | Hilty DM et al. | — | 2007 | → |
| Blood brain barrier: the role of pyridoxine. | Yarlagadda A et al. | — | 2007 | → |
| Can psychiatry cross the quality chasm? Improving the quality of health care for mental and substance use conditions. | Pincus HA et al. | — | 2007 | → |
| Childhood onset bipolar disorder: a role for early recognition and treatment. | Scheffer RE | — | 2007 | → |
| Comorbid medical illnesses and perceived general health among adult recipients of Medicaid Mental Health Services. | Howard PB et al. | — | 2007 | → |
| Conceptual and design essentials for evaluating mechanisms of change. | Nock MK | — | 2007 | → |
| Correlates of mental health service use intensity in the National Comorbidity Survey and National Comorbidity Survey Replication. | Elhai JD et al. | — | 2007 | → |
| Current practices in depression care. | Yeung A et al. | — | 2007 | → |
| Differences in lifetime use of services for mental health problems in six European countries. | Kovess-Masfety V et al. | — | 2007 | → |
| Discrimination in health care against people with mental illness. | Thornicroft G et al. | — | 2007 | → |
| Don't throw out the baby with the bathwater (PTSD is not overdiagnosed). | Brunet A et al. | — | 2007 | → |
| Effectiveness of adjunctive antidepressant treatment for bipolar depression. | Sachs GS et al. | — | 2007 | → |
| Effects of perceived discrimination on mental health and mental health services utilization among gay, lesbian, bisexual and transgender persons. | Burgess D et al. | — | 2007 | → |
| Effects of traditionally used anxiolytic botanicals on enzymes of the gamma-aminobutyric acid (GABA) system. | Awad R et al. | — | 2007 | → |
| Further evidence for co-segregation between pediatric obsessive compulsive disorder and attention deficit hyperactivity disorder: a familial risk analysis. | Geller D et al. | — | 2007 | → |
| Help-seeking and access to mental health care in a university student population. | Eisenberg D et al. | — | 2007 | → |
| Improving quality of care for mental illness in an uninsured, low-income primary care population. | Mauksch LB et al. | — | 2007 | → |
| Intermittent psychotherapy: an alternative to continuous long-term treatment for patients with personality disorders. | Paris J | — | 2007 | → |
| Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study. | Ballerini A et al. | — | 2007 | → |
| Mental disorders in patients with obesity in comparison with healthy probands. | Baumeister H et al. | — | 2007 | → |
| Mental health treatment dropout and its correlates in a general population sample. | Wang J | — | 2007 | → |
| Mental health treatment expenditure trends, 1986-2003. | Mark TL et al. | — | 2007 | → |
| Most people with mental illness are not treated. | Thornicroft G | — | 2007 | → |
| Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. | Sareen J et al. | — | 2007 | → |
| Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. | Sareen J et al. | — | 2007 | → |
| Population level of unmet need for mental healthcare in Europe. | Alonso J et al. | — | 2007 | → |
| Prevalence and incidence of depressive disorder: the Baltimore ECA follow-up, 1981-2004. | Eaton WW et al. | — | 2007 | → |
| Prevalence of mental disorders based on general population surveys. | Baumeister H et al. | — | 2007 | → |
| Race and ethnicity differences in reporting of depressive symptoms. | Probst JC et al. | — | 2007 | → |
| Resources for mental health: scarcity, inequity, and inefficiency. | Saxena S et al. | — | 2007 | → |
| Scale up services for mental disorders: a call for action. | Lancet Global Mental Health Group et al. | — | 2007 | → |
| Sex differences in the prevalence of psychiatric disorders and psychological distress in patients with COPD. | Laurin C et al. | — | 2007 | → |
| The poor prognosis of childhood-onset bipolar disorder. | Leverich GS et al. | — | 2007 | → |
| Transforming normality into pathology: the DSM and the outcomes of stressful social arrangements. | Horwitz AV | — | 2007 | → |
| Traumatic events and suicidal behavior: results from a national mental health survey. | Belik SL et al. | — | 2007 | → |
| [Treatment-resistant anxiety disorders: social phobia, generalized anxiety disorder and panic disorder]. | Menezes GB et al. | — | 2007 | → |
| Understanding mental health treatment in persons without mental diagnoses: results from the National Comorbidity Survey Replication. | Druss BG et al. | — | 2007 | → |
| Who is treated, and how, for depression? An analysis of statutory health insurance data in Germany. | Bramesfeld A et al. | — | 2007 | → |