Wittchen H U, Nelson C B, Lachner G
Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology Unit, Munich, Germany.
Psychol Med. 1998 Jan;28(1):109-26. doi: 10.1017/s0033291797005928.
As part of a longitudinal study, prevalence findings of DSM-IV disorders are presented for a random sample of 3021 respondents aged 14 to 24, with response rate 71%.
Assessment included various subtypes of disorders, subthreshold conditions and disorders that have only rarely been studied in other epidemiological surveys. The computer-assisted Munich-Composite International Diagnostic Interview (M-CIDI) was used to derive DSM-IV diagnoses.
Substance disorders were the most frequent (lifetime 17.7%; 12-month 11.4%), with abuse being considerably more frequent than dependence. Other mental disorders had a lifetime prevalence of 27.5% (12-month, 17.5%) with depressive disorders (16.8%) being more frequent than anxiety disorders (14.4%). Eating disorders (3.0%) and threshold somatoform disorders (1.2%) were rare disorders. Subthreshold anxiety and somatoform disorders, however, were more frequent than threshold disorders. Prevalence of disorders was equally high for males and females, although specific disorder prevalence varied significantly by gender. The co-occurrence of disorders (co-morbidity) was substantial and was significantly related to greater reductions in work productivity and increased rates of professional helpseeking behaviour.
Findings underline that mental disorders in young adults are frequent and impairing, limiting work and education ability and social interaction. Given the fact that adolescents and young adults are in a key phase of socialization in terms of professional career and interpersonal relationships, our findings indicate a considerable risk potential for an accumulation of complicating factors and future chronicity. This paper is the first report of this ongoing longitudinal study about early developmental conditions of mental disorders.
作为一项纵向研究的一部分,本文呈现了对3021名年龄在14至24岁的随机受访者进行DSM-IV障碍患病率调查的结果,应答率为71%。
评估包括各种障碍亚型、阈下状况以及在其他流行病学调查中很少被研究的障碍。采用计算机辅助的慕尼黑综合国际诊断访谈(M-CIDI)得出DSM-IV诊断结果。
物质使用障碍最为常见(终生患病率17.7%;12个月患病率11.4%),滥用比依赖更为常见。其他精神障碍的终生患病率为27.5%(12个月患病率为17.5%),其中抑郁症(16.8%)比焦虑症(14.4%)更为常见。进食障碍(3.0%)和阈上躯体形式障碍(1.2%)较为罕见。然而,阈下焦虑和躯体形式障碍比阈上障碍更为常见。尽管特定障碍的患病率因性别存在显著差异,但男性和女性的障碍患病率同样较高。障碍的共病情况很普遍,并且与工作效率的更大降低以及寻求专业帮助行为的增加率显著相关。
研究结果强调,年轻人中的精神障碍很常见且具有损害性,会限制工作、教育能力以及社会交往。鉴于青少年和年轻人正处于职业生涯和人际关系的关键社会化阶段,我们的研究结果表明存在相当大的风险,可能会积累复杂因素并导致未来的慢性疾病。本文是这项关于精神障碍早期发展状况的正在进行的纵向研究的首份报告。