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Prevalence of mental disorders in the Zurich Cohort Study: a twenty year prospective study

Published online by Cambridge University Press:  11 October 2011

Jules Angst*
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Alex Gamma
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Martin Neuenschwander
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Vladeta Ajdacic-Gross
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Dominique Eich
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Wulf Rössler
Affiliation:
Zurich University Psychiatric Hospital, Zurich, Switzerland
Kathleen R. Merikangas
Affiliation:
National Institute of Mental Health, Intramural Research Program, Mood and Anxiety Disorders Program, Bethesda, USA
*
Address for correspondence: Dr. J. Angst, Zurich University Psychiatric Hospital, Lenggstr. 31, Mail Box 68, CH-8029 Zurich(Switzerland). Fax: +41-1-38424.46 E-mail: [email protected]

Summary

Background — In order to minimise retrospective recall in developing estimates of the prevalence of mental dis-orders in the general population, we conducted a prospective study of a cohort of youth from Zurich, Switzerland. Method — A 20 year prospective study of a community-based cohort aged 19-20 from Zurich Switzerland. The sample was enriched by subjects scoring high on the Symptom Checklist 90 R (Derogatis, 1977). A semi-structured diagnostic interview was administered by clinically experienced psychologists and psychiatrists. The six interviews from 1979 to 1999 assessed diagnoses and sub-threshold manifestations of major diagnostic categories (with the exception of schizophrenia) for the past twelve months, depending on the current DSM versions (DSM-IH, DSM-HI R, DSM-IV). Additional information on symptoms and treatment were collected for the years between the interviews. The reported prevalence rates are weighted for stratified sampling and cumulate the one-year rates of the six interviews. Results — The cumulative weighted prevalence rates for any psychiatric disorder were 48.6% excluding, and 57.7% including tobacco dependence. In addition 29.2% and 21.8%, respectively manifested sub-diagnostic syndromes. Overall there were no significant gender differences. The corresponding treatment prevalence rates were 22.4% and 31.1%, respectively for the diagnostic subjects and 6.9% and 6.1 %, respectively for the sub-diagnostic groups. The total treatment prevalence rate was 37.2% of the population (males 30.0%, females 44.1%). Conclusions — Our findings reveal that psychiatric disorders are quite common in the general population. When the spectra of mental disorders are considered, nearly three quarters of the general population will have manifested at least one of the mental disorders across their lifetime. Limitations — The data are based on a relatively small sample; a single age cohort, and the study was conducted in Zurich, Switzerland. These study features may diminish the generalisability of the findings.

Declaration of Interest: this work was supported by Grant 3200-050881.97/1 of the Swiss National Science Foundation, and Research Scientist Development Awards (MH 46376 and DA00293) from the US National Institutes of Health (Dr. Merikangas).

Type
Invited Paper
Copyright
Copyright © Cambridge University Press 2005

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References

REFERENCES

Angst, F., Stassen, H.H., Clayton, P. J. & Angst, J. (2002). Mortality of patients with mood disorders: follow-up over 34-38 years. Journal of Affective Disorders 68, 167181.CrossRefGoogle ScholarPubMed
Angst, J. (1998). The emerging epidemiology of hypomania and bipolar II disorder. Journal of Affective Disorders 50, 143151.CrossRefGoogle ScholarPubMed
Angst, J. & Dobler-Mikola, A. (1985). The Zurich Study - A prospective epidemiological study of depressive, neurotic, and psychosomatic syndromes. IV. Recurrent and nonrecurrent brief depression. European Archives of Psychiatry and Neurological Sciences 234, 408416.CrossRefGoogle ScholarPubMed
Angst, J. & Merikangas, K.R. (1997). The depressive spectrum: diagnostic classification and course. Journal of Affective Disorders 45, 3140.CrossRefGoogle ScholarPubMed
Angst, J. & Merikangas, K. R. (2001). Multi-dimensional criteria for the diagnosis of depression. Journal of Affective Disorders 62, 715.CrossRefGoogle ScholarPubMed
Angst, J. & Wicki, W. (1992). The Zurich Study: XIII. Recurrent brief anxiety. European Archives of Psychiatry and Neurological Sciences 241, 296300.Google 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 Psychiatry and Neurological Sciences 234, 1320.CrossRefGoogle ScholarPubMed
Angst, J., Merikangas, K.R. & Preisig, M. (1997). Subthreshold syndromes of depression and anxiety in the community. Journal of Clinical Psychiatry 58, 610.Google ScholarPubMed
Angst, J., Gamma, A., Benazzi, F., Ajdacic, V., Eich, D. & Rossler, W. (2003). Toward a re-definition of subthreshold bipolarity: epidemiology and proposed criteria for bipolar-II, minor bipolar disorders and hypomania. Journal of Affective Disorders 73, 133146.CrossRefGoogle Scholar
Bijl, R.V., van Zessen, G., Ravelli, A., de Rijk, C. & Langendoen, Y. (1998). The Netherlands Mental Health Survey and Incidence Study (NEMESIS): objectives and design. Social Psychiatry and Psychiatric Epidemiology 33, 581586.CrossRefGoogle ScholarPubMed
Busslinger, M. (1984). Validierung des PsychiatrischEpidemiologischen Fragebogens SPIKE. Medical Thesis, University of Zurich: Zurich.Google Scholar
Degonda, M., Wyss, M. & Angst, J. (1993). The Zurich Study. XVIII. Obsessive-compulsive disorders and syndromes in the general population. European Archives of Psychiatry and Neurological Sciences 243, 1622.Google ScholarPubMed
Derogatis, R.L. (1977). Symptoms Checklist 90, R-Version Manual I: Scoring, Administration and Procedures for the SCL-90. Johns Hopkins Press: Baltimore.Google Scholar
Derogatis, L.R., Lipman, R.S., Rickels, K., Uhlenhuth, E.H. & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A measure of primary symptom dimensions. In Psychological Measurements in Psychopharmacology (ed. Pichot, P.). Karger: Basel.Google Scholar
Eich, D., Ajdacic-Gross, V., Condrau, M, Huber, H., Gamma, A., Angst, J. & Ossler, W. (2003). The Zurich study: participation patterns and symptom checklist 90-R scores in six interviews, 1979-99. Acta Psychiatrica Scandinavica 108, 1114.CrossRefGoogle Scholar
Goldberg, D.P. & Williams, P. (1988). A User's Guide to the General Health Questionnaire. NFER/Nelson: Windsor.Google Scholar
Hochstrasser, B. & Angst, J. (1996). The Zurich Study: XXII. Epidemiology of gastrointestinal complaints and comorbidity with anxiety and depression. European Archives of Psychiatry and Neurological Sciences 246, 261272.Google ScholarPubMed
Illes, P. (1981). Validierung des Fragebogens “SPIKE” an Diagnosen der Krankengeschichten des Sozialpsychiatrischen Dienstes Oerlikon (Klinik Hard). Medical Thesis, University of Zurich: Zurich.Google Scholar
Jacobi, F., Wittchen, H.-U., Halting, C, Hofler, M., Pfister, H., Miiller, N. & Lieb, R. (2004). Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Inverview and Examination Survey (GHS). Psychological Medicine 34, 597611.CrossRefGoogle Scholar
Kaeser, D. (1979). Psychiatrische Katamnese von ehemaligen schulpsychiatrischen Fallen. Medical Thesis, University of Zurich: Zurich.Google Scholar
Kessler, R.C. (2002). The categorical versus dimensional assessment controversy in the sociology of mental illness. Journal of Health and Social Behavior 43, 171188.CrossRefGoogle ScholarPubMed
Kessler, R.C, McGonagle, K.A., Zhao, S., Nelson, C.B., Hughes, M., Eshleman, S., Wittchen, H.-U. & Kendler, K.S. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 819.CrossRefGoogle ScholarPubMed
Kruskal, W.H. & Wallis, W.A. (1952). Use of ranks in one-criterion variance analysis. Journal of the American Statistical Association 47, 583621.CrossRefGoogle Scholar
Meier, R. (1985). Katamnese von 40 jugendlichen Patienten nach einem Suizidversuch bei verschiedenen Behandlungsmöglichkeiten im Anschluss an eine somatische Klinik. Medical Thesis, University of Zurich: Zurich.Google Scholar
Merikangas, K.R. & Angst, J. (1994). Validity sub-threshold anxiety and depression: results of the Zurich cohort study. Neuropsychopharmacology 10, 543S.Google Scholar
Merikangas, K.R., Stevens, D.E., Fenton, B., Stolar, M., O'Malley, S., Woods, S. W. & Risch, N. (1998). Co-morbidity and familial aggregation of alcoholism and anxiety disorders. Psychological Medicine 28, 773788.CrossRefGoogle ScholarPubMed
Pfortmüller, J. (1983). Beitrag zur Validierung des Depressionsratings im Fragebogen SPIKE IV an psychiatrisch hospitalisierten Patienten. Medical Thesis, University of Zurich: Zurich.Google Scholar
Robins, L.N., Helzer, J.E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. Archives of General Psychiatry 38, 381389.CrossRefGoogle ScholarPubMed
Vollrath, M., Koch, R. & Angst, J. (1992). Binge eating and weight concerns among young adults. Results from the Zurich cohort study. British Journal of Psychiatry 160, 498503.CrossRefGoogle ScholarPubMed
Weber, M. (1979). Zuverlassigkeit der Beantwortung eines anamnetis-chen Fragebogens bei zwanzigjahrigen Ziirchern. Medical Thesis, University of Zurich: Zurich.Google Scholar
Wittchen, H.-U. (1994). Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 5784.CrossRefGoogle ScholarPubMed
Wittchen, H.-U., Nelson, C.B. & Lachner, G. (1998). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine 28, 109126.CrossRefGoogle ScholarPubMed