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Affective disorders in five United States communities

Published online by Cambridge University Press:  09 July 2009

Myrna M. Weissman ,
Philip J. Leaf ,
Gary L. Tischler ,
Dan G. Blazer ,
Marvin Karno ,
Martha Livingston Bruce  and
Louis P. Florio
Myrna M. Weissman*
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Philip J. Leaf
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Gary L. Tischler
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Dan G. Blazer
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Marvin Karno
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Martha Livingston Bruce
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
Louis P. Florio
Affiliation:
Departments of Psychiatry, Epidemiology, Sociology, Yale University, New Haven, CT; Department of Psychiatry, Duke University, Durham, NC; Department of Psychiatry, University of California, Los Angeles, CA, USA
*
1Address for correspondence. Dr Myrna M. Weissman, College of Physicians and Surgeons of Columbia University, 722 West 168th St – Box 14, New York, NY, 10032, USA.
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Synopsis

Results on the age/sex specific prevalence of DSM-III affective disorders from the NIMH Epidemiologic Catchment Area Study (ECA), a probability sample of over 18000 adults from five United States communities, are presented. The cross-site means for bipolar disorder ranged from 0·7/100 (2 weeks) to 1–2/100 (lifetime), with a mean age of onset of 21 years and no sex difference in rates. The cross-site means for major depression ranged from 1·5/100 (2 weeks) to 4·4/ 100 (lifetime), with a mean age of onset of 27 years and higher rates in women. The cross-site means for dysthymia, a chronic condition, was 3·1/100 with a higher rate in women. There was reasonable consistency in prevalence rates among sites. The implications of these findings for understanding psychopathology are discussed.

Type
Research Article
Information
Psychological Medicine , Volume 18 , Issue 1 , February 1988 , pp. 141 - 153
Copyright
Copyright © Cambridge University Press 1988

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References

Akiskal, H. S. (1981). Subaffective disorders: dysthymic, cyclothymic and bipolar II disorders in the ‘borderline’ realm. Psychiatric Clinics of North America 4, 25–46.CrossRefGoogle ScholarPubMed
Angst, J. (1966). Zur Aetiologie und Nosologie endogener depressiver Psychosen – Eine genetische, soziologische und klinische Studie (Monograph a.d. Ges. geb. d. Neurologie und Psychiatrie Heft 112). Springer Verlag: Berlin.Google Scholar
Angst, J. & Dobler-Mikola, A. (1984). The Zurich Study: III. Diagnosis of depression. European Archives of Psychiatric Neurological Sciences 234, 30–37.CrossRefGoogle ScholarPubMed
Angst, J., Dobler-Mikola, A. & Binder, J. (1984). The Zurich Study – A prospective epidemiological study of depressive, neurotic and psychosomatic syndromes: I. Problem methodology. European Archives of Psychiatric Neurological Sciences 234, 13–20.CrossRefGoogle ScholarPubMed
Anthony, J. C, Folstein, M., Romanoski, A. J., Von Korff, M. R., Nestadt, G. R., Chahal, R., Merchant, A., Brown, C. H., Shapiro, S., Kramer, M. & Gruenberg, E. M. (1985). Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis. Archives of General Psychiatry 42, 667–675.CrossRefGoogle Scholar
Blazer, D. & Williams, C. D. (1980). Epidemiology of dysphoria and depression in an elderly population. American Journal of Psychiatry 137, 439–444.Google Scholar
Blazer, D., George, L. K., Landerman, R., Pennybacker, M., Melville, M. L., Woodbury, M., Manton, K. G., Jordan, K. & Locke, B. (1985). Psychiatric disorders: a rural urban comparison. Archives of General Psychiatry 42, 651–656.CrossRefGoogle ScholarPubMed
Boyd, J. H. & Weissman, M M (1981). Epidemiology of affective disorders' a reexamination and future directions. Archives of General Psychiatry 38, 1039–1046.CrossRefGoogle ScholarPubMed
Clayton, P. (1983). Introduction to bipolar illness. In Psychiatry Update, Vol. II (ed. Grinspoon, L.), pp. 269–271. American Psychiatric Press: Washington DC.Google Scholar
Cohen, S B. & Kalsbeek, W. D. (1981). NMCES Estimation and Sampling Vartances in the Household Survey. National Center for Health Services Research, Publication No. (PHS) 81–3281. Department of Health and Human Services, Washington DC.Google Scholar
Dean, C., Surtees, P. G., & Sashidharan, S. P. (1983). Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry 142, 247–256.CrossRefGoogle Scholar
Dunner, D. L. (1980). Unipolar and bipolar depression – recent findings from clinical and biologic studies. In The Psychobiology of Affective Disorders (ed. Mendels, J. and Amsterdam, J. D), pp. 333–340S Karger: Basel.Google Scholar
Dunner, D. L. (1983). Drug treatment of the acute manic episode. In Psychiatry Update, Vol. II (ed. Grinspoon, L.), pp. 293–303. American Psychiatric Press: Washington, DCGoogle Scholar
Dunner, D L, Fleiss, J. L. & Fieve, R R (1976). The course of development of mania in patients with recurrent depression. American Journal of Psychiatry 133, 905–908.Google ScholarPubMed
Eaton, W. W. & Kessler, L. G. (eds). (1985) Epidemiologic Field Methods in Psychiatry The NIMH Epidemiologic Catchment Area Program. Academic Press: New York.Google Scholar
Eaton, W. W., Holzer, C. E. III, VonKorff, M., Anthony, J. C., Helzer, J. E., George, L., Burnam, M. A., Boyd, J. H., Kessler, L. G. & Locke, B. Z. (1984). The design of the Epidemiologic Catchment Area surveys: the control and measurement of error. Archives of General Psychiatry 41, 942–948.CrossRefGoogle ScholarPubMed
Elliot, D., Huizinger, D. & Morse, B. J. (1985). The Dynamics of Deviant Behavior A National Survey: Progress Report. Behavioral Research Institute, 2305 Canyon Blvd., Boulder, COL, 80302.Google Scholar
Freeman, D. H., Livingston, M., Leo, L. & Leaf, P. J. (1985). A comparison of indirect variance estimation procedures. In Proceedings of the American Statistical Association, Section on Survey Research Methods, pp. 313–316. American Statistical Association: Washington DC.Google Scholar
Gershon, E. S., Hamovit, J., Guroff, J. J., Dibble, E., Leckman, J. F., Sceery, W., Targum, S. D., Nurnberger, J I., Goldin, L. R. & Bunney, W. E. Jr. (1982). A family study of schizoaffective, bipolar I, bipolar II, unipolar and normal control probands. Archives of General Psychiatry 39, 1157–1167.Google Scholar
Hansen, M. H., Horwitz, W. N. & Madow, W G. (1953). Sample Survey Methods II. Wiley: New York.Google Scholar
Helzer, J. E., Robins, L. N., McEvoy, L. T., Spitznagel, E. L., Stoltzman, R. K., Farmer, A. & Brockington, I. F. (1985). A comparison of clinical and diagnostic interview schedule diagnoses. Archives of General Psychiatry 42, 657–666.Google Scholar
Hirschfeld, R. M. A. & Cross, C. K. (1982). Epidemiology of affective disorders. Archives of.General Psychiatry 39, 35–46.CrossRefGoogle ScholarPubMed
Holt, D. & Smith, T. M. F (1979). Postratification. Journal of the Royal Statistical Society Series A, 142, 33–66.CrossRefGoogle Scholar
Holzer, C. E., Spitznagel, E., Jordan, K. B., Timbers, D. M., Kessler, L. G. & Anthony, J C. (1985). Sampling the household population. In Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program (ed. Eaton, W. W. and Kessler, L. G.), pp. 23–48. Academic Press: New YorkCrossRefGoogle Scholar
Keller, M D. & Shapiro, R. W (1982). ‘Double depression’: superimposition of acute depressive episodes on chronic depressive disorders. American Journal of Psychiatry 139, 438–442Google ScholarPubMed
Klerman, G. L. (1985) Diagnosis of psychiatric disorders in epidemiologic field studies. Archives of General Psychiatry 42, 723–724.CrossRefGoogle ScholarPubMed
Kessler, L., Folsom, R., Royall, R., Forsythe, A., McEvoy, L., Holzer, C. E., Rae, D. & Woodbury, M. (1985). Analysis: Parameter and variance estimation. In Epidemiologic Field Methods in Psychiatry The NIMH Epidemiologic Catchment Area Program (ed. Eaton, W. W. and Kessler, L. G.), pp. 327–348. Academic Press: New YorkCrossRefGoogle Scholar
Koch, G. G, Freeman, D. H. & Freeman, J. L. (1975). Strategies in the multivariate analysis of data from complex surveys. International Statistical Review 43, 59–78CrossRefGoogle Scholar
Leaf, P. J., German, P. S., Spitznagel, E., George, L. K., Landsverk, J & Windle, C. D. (1985). Sampling the institutional survey. In Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program (ed. Eaton, W. W. and Kessler, L. G.), pp. 49–66. Academic Press. New YorkCrossRefGoogle Scholar
Loranger, A. W. & Levine, T. M. (1978). Age at onset of bipolar affective illness. Archives of General Psychiatry 35, 1345–1348.Google Scholar
Murphy, J. M. (1980). Continuities in community-based psychiatric epidemiology Archives of General Psychiatry 37, 1215–1223.CrossRefGoogle ScholarPubMed
Myers, J. K., Weissman, M. M., Tischler, G. L., Holzer, C E., Leaf, P. J., Orvaschel, H, Anthony, J. C., Boyd, J. H., Burke, J. D., Kramer, M. & Stoltzman, R. (1984). Six month prevalence of psychiatric disorders in three communities: 1980 to 1982. Archives of General Psychiatry 41, 959–967.CrossRefGoogle ScholarPubMed
Prien, R. F. (1983). Long-term prophylactic pharmacologic treatment of bipolar illness. In Psychiatry Update, Vol. II (ed. Grinspoon, L.), pp 303–318. American Psychiatric Press: Washington DC.Google Scholar
Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D G., Hough, R. L., Eaton, W. W. & Locke, B. Z. (1984). The NIMH epidemiologic catchment area program. Archives of General Psychiatry 41, 934–941.CrossRefGoogle ScholarPubMed
Robins, L. N., (1985). Epidemiology: reflections on testing the validity of psychiatric interviews Archives of General psychiatry 42, 918–941.Google Scholar
Robins, L. N., Helzer, J. E, Croughan, J. L. &Ratchff, K. S. (1981). The NIMH Diagnostic Interview Schedule: its history, characteristics, and validity. Archives of General Psychiatry 38, 381–389.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, J. D. & Regier, D. A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry 41, 949–958.CrossRefGoogle ScholarPubMed
Rounsaville, B. J., Sholomskas, D. & Prusoff, B. A. (1980). Chronic mood disorders in depressed outpatients: diagnosis and response to pharmacotherapy. Journal of Affective Disorders 2, 73–88.CrossRefGoogle ScholarPubMed
Shah, B. V & LaVange, L M (1981). Software for Inference on Linear Models from Survey Data. Research Triangle Institute: Cary, North Carolina.Google Scholar
Shrout, P. E., Spitzer, R. L. & Fleiss, J. L. (1987). Quantification of agreement in psychiatric diagnosis revisited. Archives of General Psychiatry 44, 172–177.Google Scholar
Spitznagel, E. L. & Helzer, J. E. (1985). A proposed solution to the base rate problem in the Kappa Statistic. Archives of General Psychiatry 42, 725–728.Google Scholar
Surtees, P. G., Sashidharan, S. P. & Dean, C. (1986). Affective disorder amongst women in the general population: a longitudinal study. British Journal of Psychiatry 148, 176–186.CrossRefGoogle ScholarPubMed
Torgersen, S. (1986). Genetic factors in moderately severe and mild affective disorders. Archives of General Psychiatry 43, 222–227.CrossRefGoogle ScholarPubMed
Uhlenhuth, E. H., Baiter, M. B., Mellinger, G. D., Cisin, I. H. & Calinthorne, J. (1983). Symptom checklist syndromes in the general population: correlations with psychotherapeutic drug use. Archives of General Psychiatry 40, 1167–1173.CrossRefGoogle ScholarPubMed
VonKorff, M., Cottler, L., George, L., Eaton, W. W., Leaf, P. J. & Burnam, A. (1985). Nonresponse and nonresponse bias in the ECA surveys. In Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program (ed. Eaton, W. W. and Kessler, L. G.), pp. 85–98. Academic Press: New York.Google Scholar
Weissman, M. M. & Klerman, G. L. (1977). Sex differences in the epidemiology of depression. Archives of General Psychiatry 34, 98–111.Google Scholar
Weissman, M. M. & Myers, J. K. (1978). Affective disorders in a US urban community: the use of Research Diagnostic Criteria in an epidemiologic survey. Archives of General Psychiatry 35, 1304–1311.CrossRefGoogle Scholar
Weissman, M. M., Kasl, S. V. & Klerman, G. L. (1976). Follow-up of depressed women after maintenance treatment. American Journal of Psychiatry 133, 757–760.Google Scholar
Weissman, M. M., Gershon, E. S., Kidd, K. K., Prusoff, B. A., Leckman, J. F., Dibble, E., Hamovit, J., Thompson, W. D., Pauls, D. L & Guroff, J. J. (1984). Psychiatric disorders in the relatives of probands with affective disorders: the Yale–NIMH collaborative family study. Archives of General Psychiatry 41, 13–21.CrossRefGoogle Scholar
Winokur, G. (1980). Is there a common genetic factor in bipolar and unipolar affective disorder? Comprehensive Psychiatry 21, 460–468.Google Scholar
Winokur, G., Clayton, P & Reich, T. (1969). Manic-Depressive Illness. C. V Mosby: St Louis.Google Scholar
Wittchen, H. V., Semler, G. & von Zerssen, D. (1985). A comparison of two diagnostic methods: clinical ICD diagnoses v. DSM-III and Research Diagnostic Criteria using the Diagnostic Interview Schedule (Version 2). Archives of General Psychiatry 42, 677–684Google Scholar