The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R)
- PMID: 12813115
- DOI: 10.1001/jama.289.23.3095
The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R)
Abstract
Context: Uncertainties exist about prevalence and correlates of major depressive disorder (MDD).
Objective: To present nationally representative data on prevalence and correlates of MDD by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria, and on study patterns and correlates of treatment and treatment adequacy from the recently completed National Comorbidity Survey Replication (NCS-R).
Design: Face-to-face household survey conducted from February 2001 to December 2002.
Setting: The 48 contiguous United States.
Participants: Household residents ages 18 years or older (N = 9090) who responded to the NCS-R survey.
Main outcome measures: Prevalence and correlates of MDD using the World Health Organization's (WHO) Composite International Diagnostic Interview (CIDI), 12-month severity with the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR), the Sheehan Disability Scale (SDS), and the WHO disability assessment scale (WHO-DAS). Clinical reinterviews used the Structured Clinical Interview for DSM-IV.
Results: The prevalence of CIDI MDD for lifetime was 16.2% (95% confidence interval [CI], 15.1-17.3) (32.6-35.1 million US adults) and for 12-month was 6.6% (95% CI, 5.9-7.3) (13.1-14.2 million US adults). Virtually all CIDI 12-month cases were independently classified as clinically significant using the QIDS-SR, with 10.4% mild, 38.6% moderate, 38.0% severe, and 12.9% very severe. Mean episode duration was 16 weeks (95% CI, 15.1-17.3). Role impairment as measured by SDS was substantial as indicated by 59.3% of 12-month cases with severe or very severe role impairment. Most lifetime (72.1%) and 12-month (78.5%) cases had comorbid CIDI/DSM-IV disorders, with MDD only rarely primary. Although 51.6% (95% CI, 46.1-57.2) of 12-month cases received health care treatment for MDD, treatment was adequate in only 41.9% (95% CI, 35.9-47.9) of these cases, resulting in 21.7% (95% CI, 18.1-25.2) of 12-month MDD being adequately treated. Sociodemographic correlates of treatment were far less numerous than those of prevalence.
Conclusions: Major depressive disorder is a common disorder, widely distributed in the population, and usually associated with substantial symptom severity and role impairment. While the recent increase in treatment is encouraging, inadequate treatment is a serious concern. Emphasis on screening and expansion of treatment needs to be accompanied by a parallel emphasis on treatment quality improvement.
Comment in
-
Treatment of depression by mental health specialists and primary care physicians.JAMA. 2003 Oct 15;290(15):1991-2; author reply 1992-3. doi: 10.1001/jama.290.15.1991-b. JAMA. 2003. PMID: 14559944 No abstract available.
-
Treatment of depression by mental health specialists and primary care physicians.JAMA. 2003 Oct 15;290(15):1991; author reply 1992-3. doi: 10.1001/jama.290.15.1991-a. JAMA. 2003. PMID: 14559945 No abstract available.
-
Treatment of depression by mental health specialists and primary care physicians.JAMA. 2003 Oct 15;290(15):1992; author reply 1992-3. doi: 10.1001/jama.290.15.1992-a. JAMA. 2003. PMID: 14559946 No abstract available.
Similar articles
-
The importance of irritability as a symptom of major depressive disorder: results from the National Comorbidity Survey Replication.Mol Psychiatry. 2010 Aug;15(8):856-67. doi: 10.1038/mp.2009.20. Epub 2009 Mar 10. Mol Psychiatry. 2010. PMID: 19274052 Free PMC article.
-
Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States.JAMA Psychiatry. 2018 Apr 1;75(4):336-346. doi: 10.1001/jamapsychiatry.2017.4602. JAMA Psychiatry. 2018. PMID: 29450462 Free PMC article.
-
Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment.J Am Acad Child Adolesc Psychiatry. 2015 Jan;54(1):37-44.e2. doi: 10.1016/j.jaac.2014.10.010. Epub 2014 Oct 29. J Am Acad Child Adolesc Psychiatry. 2015. PMID: 25524788 Free PMC article.
-
Epidemiology of major depressive disorder in mainland china: a systematic review.PLoS One. 2013 Jun 13;8(6):e65356. doi: 10.1371/journal.pone.0065356. Print 2013. PLoS One. 2013. PMID: 23785419 Free PMC article. Review.
-
Depression in primary care: current and future challenges.Can J Psychiatry. 2013 Aug;58(8):442-8. doi: 10.1177/070674371305800802. Can J Psychiatry. 2013. PMID: 23972105 Review.
Cited by
-
Cognitive Vulnerability to Mood Deterioration in an Exercise Cessation Paradigm.J Clin Sport Psychol. 2024 Jun;18(2):215-233. doi: 10.1123/jcsp.2021-0088. Epub 2022 Oct 17. J Clin Sport Psychol. 2024. PMID: 38817824
-
Temporal and spatial trend analysis of all-cause depression burden based on Global Burden of Disease (GBD) 2019 study.Sci Rep. 2024 May 29;14(1):12346. doi: 10.1038/s41598-024-62381-9. Sci Rep. 2024. PMID: 38811645 Free PMC article.
-
The efficacy and safety of Zuranolone for treatment of depression: A systematic review and meta-analysis.Psychopharmacology (Berl). 2024 Jul;241(7):1299-1317. doi: 10.1007/s00213-024-06611-y. Epub 2024 May 28. Psychopharmacology (Berl). 2024. PMID: 38802705 Free PMC article. Review.
-
From Connectivity to Controllability: Unraveling the Brain Biomarkers of Major Depressive Disorder.Brain Sci. 2024 May 17;14(5):509. doi: 10.3390/brainsci14050509. Brain Sci. 2024. PMID: 38790487 Free PMC article.
-
Astrocytic ALKBH5 in stress response contributes to depressive-like behaviors in mice.Nat Commun. 2024 May 21;15(1):4347. doi: 10.1038/s41467-024-48730-2. Nat Commun. 2024. PMID: 38773146 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials