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美国焦虑和心境障碍的 12 个月和终生患病率以及终生患病风险。

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

机构信息

Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.

出版信息

Int J Methods Psychiatr Res. 2012 Sep;21(3):169-84. doi: 10.1002/mpr.1359. Epub 2012 Aug 1.

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.

摘要

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。

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