Prevalence of disorders

In order to test this hypothesis it was necessary to compare populations with differing dietary practices but with similar exposure to environmental lead. The "Asian immigrant population in Britain, which is in fact derived from India and Pakistan, is known to differ in nutritional and cultural practices in comparison with the indigenous community. It is characterised by the prevalence of disorders of mineral metabolism including osteomalacia, and in the young, nutritional rickets and neonatal hypocalcaemia. A study was therefore undertaken in two towns located near London - Luton and Bedford - in which there are mutiracial populations (Strehlow and Barltrop 1978). Children from the Asian and non-Asian community aged 2-5 years were selected at random from computer-based local authority records and venous blood samples obtained for analysis. 

The 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES), based on interviews with a national probability household sample of nearly 43,000 adults age 18 years and older, showed the 1-year prevalence of DSM-IV alcohol use disorder to be 7.4% (i.e., 3.0% with alcohol abuse and 4.4% with alcohol dependence) (Grant et al. 1994). Findings from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a community-based survey of nearly 43,000 individuals conducted in 2001—2002 (Grant... 

Kahkonen S Alcohol withdrawal changes cardiovascular responses to propranolol challenge. Neuropsychobiology 47 192—197, 2003 Kessler RC, McGonagle KA, Zhao S, et al Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 51 8-19,1994... 

Ross HE, Frederick B, Glaser MD, et al The prevalence of psychiatric disorders in patients with alcohol and other drug problems. Arch Gen Psychiatry 45 1023-1031, 1988... 

Comparable findings for lifetime prevalence of psychiatric disorders were obtained in another study of 133 persons, which also found that 47% received a concurrent DSM-III diagnosis of substance abuse or dependence (Khantzian and Treece 1985). The most frequently abused substances were sedative-hypnotics (23%), alcohol (14%), and cannabis (13%). Similar rates of psychiatric disorders were found in other studies of drug abusers (Mirin et al. 1986 Woody et al. 1983). Although such diagnoses do not imply causality, and, in many cases, opioid dependence causes or exacerbates psychiatric problems, some causal link seems likely (Regier et al. 1990). 

Clinicians have more recently become more aware of elevated rates of posttraumatic stress disorder (PTSD) in both men and women with opioid dependence (Hien et al. 2000). A lifetime prevalence of PTSD of 20% in women and 11% in men was found in one sample of methadone maintenance patients (Villagomez et al. 1995). Patients often deny a PTSD history during initial assessment. They should be reassessed after they have had the opportunity to develop trust in their treating clinicians. 

Fyer AJ, Liebowitz MR, Gorman JM, et al Effects of clonidine on alprazolam discontinuation in panic patients a pilot study. J Clin Psychopharmacol 8 270—274,1988 Garvey MJ, Tollefson GD Prevalence of misuse of prescribed benzodiazepines in patients with primary anxiety disorder or major depression. Am J Psychiatry 143 1601-1603, 1986... 

Compton WM, Grant BF, Colliver JD, et al Prevalence of marijuana use disorders in the United States 1991-1992 and2001-2002. JAMA291 2114-2121,2004 Cook SA, Lowe JA, Martin BR CBl receptor antagonist precipitates withdrawal in mice exposed to delta9-tetrahydrocannabinol. J Pharmacol Exp Ther 285 1150— 1156, 1998... 

The porphyrias are a group of disorders due to abnormalities in the pathway of biosynthesis of heme they can be genetic or acquired. They are not prevalent, but it is important to consider them in certain circumstances (eg, in the differential diagnosis of abdominal... 

Further detailed analyses of the ECA data have been extrapolated to USA national costs (Rice and Miller, 1998). It was calculated that the economic costs of mental disorders in 1990 in the USA totalled US 147.8 billion. Anxiety disorders were the most cosdy, amounting to 46.6 billion, just under a third of the total. Direct costs spent on mental health care totalled 67 billion, of which anxiety disorders accounted for only 11 billion (16.5%). Drug costs were 2191 million, of which anxiety disorders accounted for 1167 million—over half Morbidity costs—the value of goods and services not produced because of mental disorders — amounted to 63.1 billion, with anxiety disorders accounting for 34.2 billion, 54.2% of the total. This reflects the high prevalence of anxiety disorders in the community and the high associated rate of lost productivity. In contrast, patients with affective disorders appeared better able to function (Rice and Miller, 1995). In summary, anxiety disorders are common, disruptive and costly to society drug treatment is a substantial element of treatment costs (11%) compared with, say, schizophrenia (2.2%). 

The lifetime prevalence of social anxiety disorder is at least 2.5% and the condition often goes unrecognized (Nutt et al, 1999). Its... 

Post-traumatic stress disorder (PTSD) is a severe condition with a lifetime prevalence of about 12.5% in women and 6.2% in men (Pigott, 1999). About one in four individuals exposed to trauma develop the syndrome. Drug treatments are still being developed, mostly using antidepressants. Few systematic data are available on the pharmacoeconomics of the condition. 

Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 8-19. 

Epilepsy is a disorder that afflicts approximately 2 million individuals in the United States, with an age-adjusted prevalence of approximately 4 to 7 cases per 1000 persons.1 The incidence of epilepsy in the United States is estimated at 35 to 75 cases per 100,000 persons per year, which is similar to that of other developed countries.2,3 In developing countries, the incidence is higher at 100 to 190 cases per 100,000 persons per year, possibly related to poor health care and prenatal care, increased risk of neurologic trauma, and increased rates of infections. About 8% of the United States population will experience a seizure during their lifetime. New-onset seizures occur most frequently in infants below 1 year of age and in adults after age 55.4 However, the largest number of patients suffering from epilepsy is between the ages of 15 and 64 years. 

The prevalence of neuropathic pain is unknown because of the lack of epidemiologic studies. Current estimates suggest that approximately 1.5% of the population in the United States may be affected by neuropathic pain.7 However, this figure is probably an underestimate and will likely increase due to the increase in disorders associated with neuropathic pain in the ever-growing older population. Approximately 25% to 50% of all pain clinic visits are related to neuropathic pain.8 Central neuropathic pain is estimated to occur in 2% to 8% of all stroke patients.9... 

Tension-type headache (TTH) is the most common primary headache disorder. It is often underrepresented in clinical practice, as many patients do not present for care.6 The term tension-type headache is used to describe all headache syndromes in which muscle contraction is the most significant factor in the pathogenesis of pain. The 1-year prevalence of TTH in the population ranges from 30% to 90%.6 It is more common in adult females. Environmental factors, as opposed to genetic predisposition, play a more central role in their development. Tension-type headaches can be further divided into episodic or chronic the mean frequency of attacks is 3 days per month in episodic disorders, and chronic TTH is defined as 15 or more attacks in a 1-month period.7 The estimated prevalence of chronic TTH is less than 5%.6 Some researchers believe that chronic TTHs represent a continuum of headache severity with migraine headache.8 When severe headaches are difficult to differentiate clinically, treatment should initially target TTH. 

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... 

With a lifetime prevalence of 28.8%, anxiety disorders collectively represent the most prevalent Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)2 class of disorders, with specific phobia (12.5%) and social anxiety disorder (12.1%) being the most common.3 Recent reports from the National Comorbidity Survey Revised (NCS-R) estimate the lifetime and 1-year prevalence of generalized anxiety disorder (GAD) for those 18 years of age and older to be 5.7% and 3.1%, respectively.3,4 Rates for panic disorder (PD) are slightly lower, with an estimated 12-month prevalence of 2.7% and lifetime prevalence of 4.7%. 

Articulate the incidence and prevalence of sleep disorders, list the sequelae of undiagnosed or untreated sleep disorders, and appreciate the importance of successful treatment of sleep disorders. 

Restless-legs syndrome occurs in 5% to 15% of the population, making it a common sleep disorder.11,12 The prevalence of RLS increases with age and in various medical conditions such as end-stage renal disease (ESRD), pregnancy, and iron deficiency.13 RLS appears to be more common in women than in men and has a genetic link. The majority of RLS patients (63% to 92%) report a positive family history.14... 

Non-REM parasomnias have variable prevalence rates depending on patient age and different diagnoses. Sleep talking, brux-ism, sleepwalking, sleep terrors, and enuresis occur more frequently in childhood than in adulthood. Nightmares appear to occur with similar frequency in adults and children. REM behavior disorder (RBD), an REM-sleep parasomnia, has a reported prevalence of 0.5% and frequently is associated with concomitant neurologic conditions.16 Chronic RBD is more common in elderly men and may have a familial disposition. 

Although ADHD generally is considered a childhood disorder, symptoms can persist into adolescence and adulthood. The prevalence of adulthood ADHD is estimated to be 4%, with 60% of adults having manifested symptoms of ADHD from childhood.8,9 Further, problems associated with ADHD (e.g., social, marital, academic, career, anxiety, depression, smoking, and substance-abuse problems) increase with the transition of patients into adulthood. 

Discuss the prevalence of thyroid disorders, including subclinical (mild) and overt (typical signs and/or symptoms present) hypothyroidism and hyperthyroidism. 

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