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Ronald C. Kessler, PhD; Wai Tat Chiu, AM; Olga Demler, MA, MS; Ellen E. Walters, MS

Arch Gen Psychiatry. 2005;62:617-627.

Background  Little is known about the general population prevalence or severity of DSM-IV mental disorders.

Objective  To estimate 12-month prevalence, severity, and comorbidity of DSM-IV anxiety, mood, impulse control, and substance disorders in the recently completed US National Comorbidity Survey Replication.

Design and Setting  Nationally representative face-to-face household survey conducted between February 2001 and April 2003 using a fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview.

Participants  Nine thousand two hundred eighty-two English-speaking respondents 18 years and older.

Main Outcome Measures  Twelve-month DSM-IV disorders.

Results  Twelve-month prevalence estimates were anxiety, 18.1%; mood, 9.5%; impulse control, 8.9%; substance, 3.8%; and any disorder, 26.2%. Of 12-month cases, 22.3% were classified as serious; 37.3%, moderate; and 40.4%, mild. Fifty-five percent carried only a single diagnosis; 22%, 2 diagnoses; and 23%, 3 or more diagnoses. Latent class analysis detected 7 multivariate disorder classes, including 3 highly comorbid classes representing 7% of the population.

Conclusion  Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

Author Affiliations: Department of Health Care Policy, Harvard Medical School, Boston, Mass.

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