Epidemiology of Major Depressive Disorder: Results From the National Epidemiologic Survey on Alcoholism and Related Conditions
Abstract
OBJECTIVE: To present nationally representative data on 12-month and lifetime prevalence, correlates, and comorbidity of DSM-IV major depressive disorder (MDD) among adults in the United States. DESIGN/SETTING/ PARTICIPANTS: Face-to-face survey of more than 43 000 adults aged 18 years and older residing in households and group quarters in the United States. MAIN OUTCOME MEASURES: Prevalence and associations of MDD with sociodemographic correlates and Axis I and II disorders. RESULTS: The prevalence of 12-month and lifetime DSM-IV MDD was 5.28% (95% confidence interval, 4.98-5.57) and 13.23% (95% confidence interval, 12.64-13.81), respectively. Being female; Native American; middle-aged; widowed, separated, or divorced; and low income increased risk, and being Asian, Hispanic, or black decreased risk (P<.05). Women were significantly more likely to receive treatment than men. Both current and lifetime MDD were significantly associated with other specific psychiatric disorders, notably substance dependence, panic and generalized anxiety disorder, and several personality disorders. CONCLUSIONS: This large survey suggests a higher prevalence of MDD in the US population than large-sample estimates from the 1980s and 1990s. The shift in highest lifetime risk from young to middle-aged adults is an important transformation in the distribution of MDD in the United States and specificity in risk for an age-period cohort. Associations between MDD and Axis I and II disorders were strong and significant, with variation within broad categories by specific diagnoses signaling the need for attention to the genetic and environmental reasons for such variation, as well as the implications for treatment response.
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In NCS-R and NESARC, median age-of-onset for major depression and mood disorders was about 30 years, compared to about 14 years in the WMH-ICS sample.
“in both NCS-R and NESEARC, median age-of-onset for major depression (Hasin et al., 2005) and mood disorders (Kessler et al., 2005) was ~30 years compared to ~14 years within the WMH-ICS sample.”
From WHO World Mental Health Surveys International College Student Project: Prevalence and distribution of mental disorders. (2018) · cites this paper as Hasin et al., 2005
Individuals living with MDD have reported a significant increase in other mental health disorders including anxiety, alcohol and drug use, and suicidal ideation/attempts.
“Individuals living with MDD have reported a significant increase in other mental health disorders including anxiety [59], alcohol and drug use [60], and suicidal ideation/attempts [61].”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [60]
MDD was associated with substance use disorders, particularly drug disorders.
“Major depressive disorder was assoc iated w ith SUDs, particularly drug disorders, as found previously for cannabis, 40,62 nonmedical prescription opioids, 5,57,63 and drug use disorders.41”
From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [5]
Of participants with lifetime DSM-5 MDD, 69.4% received any treatment for their disorder, slightly higher than the 60.6% in the 2001-2002 NESARC.
“Of participants with lifetime DSM-5 MDD, 69.4% received any treatment for their disorder, slightly higher than in the 2001-2002 NESARC (60.6%).5”
From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [5]
The DSM-IV diagnosis of MDD was associated with impairment, psychiatric and substance use disorders, poor health, mortality, disease and economic burden, and disability-years.
“The DSM-IV diagnosis of MDD was associated with impairment, 3,4 psychiatric and substance use disorders (SUDs), [5][6][7][8][9] poor health, 10,11 mortality, 12 disease and economic burden, 12 and disability-years.[13][14][15][16]”
From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [5]
Demographic correlates of MDD were consistent with previous surveys.
“Demographic correlates were consistent with previous surveys.2,5”
From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [5]
MDD was associated with other psychiatric disorders, especially generalized anxiety disorder and borderline personality disorder.
“Major depressive disorder was associated with other psychiatric disorders, especially generalized anxiety disorder and borderline personality disorder, associations found in previous studies.5,[46][47][48][49]”
From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [5]
Few people with depression receive treatment, so treatment probably did not greatly affect the symptom scores in this sample.
“Further, a minority of individuals with depression receive treatment [40], suggesting that treatment is unlikely to have a large impact on the symptom scores in our sample.”
From Social Media Use and Depressive Symptoms Among United States Adolescents (2021) · cites this paper as [40]
The study's prevalence estimate was in line with epidemiological studies from the same periods.
“The prevalence of adult major depression estimated in our study was between 6.1 and 10.4% from 1996 to 2015, which was in line with the epidemiological studies from the same periods (20–23).”
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Screening for Depression in African-American Churches
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Trivedi, M., Jha, M., Kahalnik, F., Pipes, R., Levinson, S., Lawson, T., Rush, A., Trombello, J., Grannemann, B., Tovian, C., et al. (2019) · Pharmaceuticals · doi:10.3390/ph12020071 · Cited by 49 · see citing works
- Authors
- Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F.
- Affiliations
- Columbia University (US)
- National Institute on Alcohol Abuse and Alcoholism (US)
- ORCID
- Hasin, Deborah S.
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2005-10-01
- Volume
- 62
- Issue
- 10
- Pages
- 1097
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2124216937
- Cited by
- 1,645
- References
- 90
- Citations by year
- 2026: 18 · 2025: 28 · 2024: 48 · 2023: 34 · 2022: 59 · 2021: 66 · 2020: 75 · 2019: 77 · 2018: 98 · 2017: 100 · 2016: 96 · 2015: 106 · 2014: 129 · 2013: 122 · 2012: 127
- FWCI
- 76.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA008159, R01-AA08159, K05 AA00161)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, prevalence, lifetime prevalence, sociodemographic risk factors, comorbidities, substance dependence, anxiety disorders, personality disorders, sex differences, treatment utilization, DSM-IV, United States adults
- MeSH terms
- Adolescent, Adult, Aged, Major Depressive Disorder, Depressive Disorder, Major, Female, Health Surveys, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, United States, Cohort Studies, Comorbidity, Prevalence, Proportional Hazards Models, Age of Onset, Diagnosis, Dual (Psychiatry), Alcohol-Related Disorders, Diagnostic and Statistical Manual of Mental Disorders
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