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

Background

Little is known about the general population prevalence or severity ofDSM-IVmental disorders.

Objective

To estimate 12-month prevalence, severity, and comorbidity ofDSM-IVanxiety, 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-monthDSM-IVdisorders.

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.