Depressive disorders epidemiology

Kessler, R. C., P. Berglund, O. Dernier, R. Jin, D. Koretz, K. R. Merikangas, A. J. Rush, E. E. Walters, and P. S. Wang. The Epidemiology of Major Depressive Disorder Results From the National Comorbidity Survey Replication (NCS-R) Journal of the American Medical Association 289(23) (2003) 3095-3105. 

Culturally determined health beliefs and practices can also profoundly influence psychiatric assessment and psychopharmacotherapy. Cultural influences on symptoms manifested by Asian patients may mislead clinicians who are unfamiliar with Asian culture and health beliefs (Lin et al. 1995). For example, Asians are likely to express their problems in behavioral or somatic terms rather than in emotional ones. Also, Asian patients often present with somatic rather than psychological complaints and seek help from primary care physicians. However, findings from a recent epidemiological study of depressive disorders suggest that Chinese Americans are not adverse to expressing problems in emotional idioms (Takeuchi et al. 1998). 

Kessler RC, Berglund R Dernier O. The epidemiology of major depressive disorders Results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003 289 3095-3105. 

Anxiety disorders and insomnia represent relatively common medical problems within the general population. These problems typically recur over a person s lifetime (3,4). Epidemiological studies in the United States indicate that the lifetime prevalence for significant anxiety disorders is about 15%. Anxiety disorders are serious medical problems affecting not only quaUty of life, but additionally may indirecdy result in considerable morbidity owing to association with depression, cardiovascular disease, suicidal behavior, and substance-related disorders. 

Bipolar disorders have been categorized into bipolar I disorder, bipolar II disorder, and bipolar disorder, not otherwise specified (NOS). Bipolar I disorder is characterized by one or more manic or mixed mood episodes. Bipolar II disorder is characterized by one or more major depressive episodes and at least one hypomanic episode. Hypomania is an abnormally and persistently elevated, expansive, or irritable mood, but not of sufficient severity to cause significant impairment in social or occupational function and does not require hospitalization. Most epidemiologic studies have looked at bipolar disorder of all types (bipolar I and bipolar II), or the bipolar spectrum, which includes all clinical conditions thought to be closely related to bipolar disorder. The lifetime prevalence of bipolar I disorder is estimated to be between 0.3% and 2.4%. The lifetime prevalence of bipolar II disorder ranges from 0.2% to 5%. When including the bipolar spectrum, the lifetime prevalence is between 3% and 6.5%.1... 

Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG et al. Cross-national epidemiology of major depression and bipolar disorder. JAMA 1996 276 293-299. 

Believed historically to be a relatively rare disorder, large-scale epidemiological research undertaken during the last 20 years indicates that OCD is in fact quite common. The lifetime prevalence of OCD is 2-3%, making it more common, in fact, than bipolar disorder, schizophrenia, and most psychiatric illnesses other than depression and the substance use disorders. 

A number of epidemiological studies [including several reviewed in May and Lichterman 1993] have shown that panic disorder and unipolar depression occur more commonly together than could be explained by chance. Some 50%-70% of patients with panic disorder also have major depression [J. Johnson et al. 1990 Volrath and Angst 1989]. The association also holds true for seasonal depression [Halle and Dilsaver 1993] and to some extent for bipolar disorders [Savino et al. 1993]. 

Panic disorder is emerging from decades of comparative neglect as an apparently intractable and poorly understood condition to become the focus of intensive interest in epidemiological, pharmacological, and clinical research. Panic disorder is a chronic and distressing condition with a profound effect on the quality of life, similar to or even worse than the effect of major depression [Markowitz et al. 1989 Weissman 1991). Effective and well-tolerated treatment that can be used safely in the long term is badly needed. 

Soldatos CR Computerized sleep EEG (CSEEG) in psychiatry and psychopharmacology, in Biological Psychiatry Today. Edited by Obiolo J, Ballus C, Monclus EG, et al. Amsterdam, Elsevier, 1979 Soldatos CR Insomnia in relation to depression and anxiety epidemiologic considerations. J Psychosom Res 38 [suppl l 3-8, 1994 Soldatos CR, Paparrigopoulos TJ Sleep patterns in depression, in WPA Teaching Bulletin on Depression. November [issue 11), 1995 Soldatos CR, Vela-Bueno A, Kales A Sleep in psychiatric disorders. Psychiatric Medicine 4[2) 119-132, 1987... 

Weissman MM Epidemiology of major depression in women. Paper presented at the annual meeting of the American Psychiatric Association, New York, May 4, 1996 Weissman MM, Leckman JF, Merikangas KR, et al Depression and anxiety disorders in parents and children results from the Yale Family Study. Arch Gen Psychiatry 41 845-852, 1984... 

Johnson and co-workers (41) found that the lifetime rate of suicide attempts with uncomplicated panic disorder was about 7%, which is consistently higher than that of the general population without a psychiatric disorder (i.e., about 1%). The researchers concluded that panic disorder, either uncomplicated or as a co-morbid illness, led to a risk of suicide attempts comparable with those of major depression ( co-morbid or uncomplicated). Their data were derived from the Epidemiologic Catchment Area Study, with a probability sample of more than 18,000 adults living in five United States communities. 

To underscore the importance of adequate treatment for bipolar disorder, we note that it is estimated that one of every four or five untreated or inadequately treated patients commits suicide during the course of the illness, particularly during depressed or mixed episodes. Further, an increase in deaths secondary to accidents or intercurrent illnesses contributes to the greater mortality rate seen in this disorder in comparison with the general population. Unfortunately, recent epidemiological studies have indicated that only one third of bipolar patients are in active treatment despite the availability of effective therapies. 

In the 1990s, diagnostic criteria for depression began to be applied increasingly to describing the epidemiology and natural history of mood disorders so that the effects... 

---