Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
Int J Methods Psychiatr Res. 2012 Sep;21(3):169-84. doi: 10.1002/mpr.1359. Epub 2012 Aug 1.
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.
根据美国针对 13 岁及以上人群开展的流行病学调查，本研究报告了《精神障碍诊断与统计手册》第四版修订版（DSM-IV-TR）焦虑和心境障碍的 12 个月和终生患病率以及终生患病风险（LMR）的估计值。本报告旨在为即将发布的 DSM-5 手册提供更一致的估计值，这是常规方法无法实现的。本报告根据 DSM-5 工作组提出的最适合政策规划目的的年龄组，报告了患病率估计值。按照出现频率对 LMR/12 个月患病率估计值进行了排名，结果如下：重性抑郁发作：29.9%/8.6%；特定恐惧症：18.4%/12.1%；社交恐惧症：13.0%/7.4%；创伤后应激障碍：10.1%/3.7%；广泛性焦虑障碍：9.0%/2.0%；分离焦虑障碍：8.7%/1.2%；惊恐障碍：6.8%/2.4%；双相障碍：4.1%/1.8%；广场恐惧症：3.7%/1.7%；强迫症：2.7%/1.2%。结果有四个显著特点：首先，美国最常见的终生焦虑-心境障碍（终生患病率/患病风险）是重性抑郁（16.6/29.9%）、特定恐惧症（15.6/18.4%）和社交恐惧症（10.7/13.0%），最不常见的是广场恐惧症（2.5/3.7%）和强迫症（2.3/2.7%）；其次，发病年龄较早的焦虑-心境障碍是恐惧症和分离焦虑障碍（15-17 岁），发病年龄较晚的是惊恐障碍、重性抑郁和广泛性焦虑障碍（23-30 岁）；再次，LMR 明显高于大多数焦虑-心境障碍的终生患病率，但这种差异在发病年龄较晚的障碍中更为显著；最后，12 个月与终生患病率的比值大致反映了持续性，这种比值的差异方式与这些障碍的不同持续性的独立证据一致。
