Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States

Abstract

Estimates of 12-month and lifetime prevalence and of lifetime morbid risk (LMR) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) anxiety and mood disorders are presented based on US epidemiological surveys among people aged 13+. The presentation is designed for use in the upcoming DSM-5 manual to provide more coherent estimates than would otherwise be available. Prevalence estimates are presented for the age groups proposed by DSM-5 workgroups as the most useful to consider for policy planning purposes. The LMR/12-month prevalence estimates ranked by frequency are as follows: major depressive episode: 29.9%/8.6%; specific phobia: 18.4/12.1%; social phobia: 13.0/7.4%; post-traumatic stress disorder: 10.1/3.7%; generalized anxiety disorder: 9.0/2.0%; separation anxiety disorder: 8.7/1.2%; panic disorder: 6.8%/2.4%; bipolar disorder: 4.1/1.8%; agoraphobia: 3.7/1.7%; obsessive-compulsive disorder: 2.7/1.2. Four broad patterns of results are most noteworthy: first, that the most common (lifetime prevalence/morbid risk) lifetime anxiety-mood disorders in the United States are major depression (16.6/29.9%), specific phobia (15.6/18.4%), and social phobia (10.7/13.0%) and the least common are agoraphobia (2.5/3.7%) and obsessive-compulsive disorder (2.3/2.7%); second, that the anxiety-mood disorders with the earlier median ages-of-onset are phobias and separation anxiety disorder (ages 15-17) and those with the latest are panic disorder, major depression, and generalized anxiety disorder (ages 23-30); third, that LMR is considerably higher than lifetime prevalence for most anxiety-mood disorders, although the magnitude of this difference is much higher for disorders with later than earlier ages-of-onset; and fourth, that the ratio of 12-month to lifetime prevalence, roughly characterizing persistence, varies meaningfully in ways consistent with independent evidence about differential persistence of these disorders.

Figure 1

Standardized age‐of‐onset distributions of DSM‐IV‐TR/CIDI anxiety disorders with the earliest ages‐of‐onset (agoraphobia, social phobia, specific phobia and separation anxiety) by age in the National Comorbidity Survey Replication (NCS‐R) and Adolescent Supplement (NCS‐A) (n = 12,175).

Figure 2

Standardized age‐of‐onset distributions of DSM‐IV‐TR/CIDI anxiety disorders with later ages‐of‐onset (PD, GAD, OCD and PTSD) by age in the National Comorbidity Survey Replication (NCS‐R) and Adolescent Supplement (NCS‐A) (n = 12,175)

Figure 3

Standardized age‐of‐onset distributions of DSM‐IV‐TR/CIDI mood disorders (MDE, BPD I and BPD II) by age in the National Comorbidity Survey Replication (NCS‐R) and Adolescent Supplement (NCS‐A) (n = 12,175)