The DOI matches its Crossref record; 106 of the 113 references it cites were found in a registry or an index; 24 of the 68 sources its claims cite were checked for support.
Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States
Open accessAbstract
Importance: No US national data are available on the prevalence and correlates of DSM-5-defined major depressive disorder (MDD) or on MDD specifiers as defined in DSM-5. Objective: To present current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 MDD and initial information on the prevalence, severity, and treatment of DSM-5 MDD severity, anxious/distressed specifier, and mixed-features specifier, as well as cases that would have been characterized as bereavement in DSM-IV. Design, Setting, and Participants: In-person interviews with a representative sample of US noninstitutionalized civilian adults (≥18 years) (n = 36 309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 to June 2013 and were analyzed in 2016-2017. Main Outcomes and Measures: Prevalence of DSM-5 MDD and the DSM-5 specifiers. Odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders. Results: Of the 36 309 adult participants in NESARC-III, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Odds of 12-month MDD were significantly lower in men (OR, 0.5; 95% CI, 0.46-0.55) and in African American (OR, 0.6; 95% CI, 0.54-0.68), Asian/Pacific Islander (OR, 0.6; 95% CI, 0.45-0.67), and Hispanic (OR, 0.7; 95% CI, 0.62-0.78) adults than in white adults and were higher in younger adults (age range, 18-29 years; OR, 3.0; 95% CI, 2.48-3.55) and those with low incomes ($19 999 or less; OR, 1.7; 95% CI, 1.49-2.04). Associations of MDD with psychiatric disorders ranged from an aOR of 2.1 (95% CI, 1.84-2.35) for specific phobia to an aOR of 5.7 (95% CI, 4.98-6.50) for generalized anxiety disorder. Associations of MDD with substance use disorders ranged from an aOR of 1.8 (95% CI, 1.63-2.01) for alcohol to an aOR of 3.0 (95% CI, 2.57-3.55) for any drug. Most lifetime MDD cases were moderate (39.7%) or severe (49.5%). Almost 70% with lifetime MDD had some type of treatment. Functioning among those with severe MDD was approximately 1 SD below the national mean. Among 12.9% of those with lifetime MDD, all episodes occurred just after the death of someone close and lasted less than 2 months. The anxious/distressed specifier characterized 74.6% of MDD cases, and the mixed-features specifier characterized 15.5%. Controlling for severity, both specifiers were associated with early onset, poor course and functioning, and suicidality. Conclusions and Relevance: Among US adults, DSM-5 MDD is highly prevalent, comorbid, and disabling. While most cases received some treatment, a substantial minority did not. Much remains to be learned about the DSM-5 MDD specifiers in the general population.
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Claims the paper makes
24 of 68 cited sources checked · 5 supported · 1 flagged · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Demographic correlates were consistent with previous surveys.2,5”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Partly supportedcites [2] 2. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016; 138(6):pii:e20161878. sourceExperimental — accuracy not yet measured
The Results (page not available in our copy) identify sociodemographic correlates of major depressive episodes in adolescents and young adults. The Discussion says the larger increase among girls than boys aligns with past studies, but it does not establish that the demographic correlates overall were consistent with previous surveys. The paper reports major depressive episodes, rather than MDD diagnoses. (LLM, conf=0.82)
- Not checked — no full text of the sourcecites [5] 5. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097-1106. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not matchedcites [40] 40. Grant BF, Saha TD, Ruan WJ, et al. Epidemiology of DSM-5 drug use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. JAMA Psychiatry. 2016;73(1): 39-47.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [62] 62. Martins SS, Fenton MC, Keyes KM, Blanco C, Zhu H, Storr CL. Mood/anxiety disorders and their association with non-medical prescription opioid use and prescription opioid use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions. Psychol Med. 2012;42(6):1261-1272. source
This source is cited for the nonmedical prescription opioid example, not for every substance use disorder in the sentence. The Results (‘The self-medication pathway,’ Table 3) report that baseline MDD was associated with incident opioid disorder due to nonmedical prescription opioid use after adjustment for other disorders and substance use. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [5] 5. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097-1106. source
- Not checked — no full text of the sourcecites [57] 57. Mehta K, Kramer H, Durazo-Arvizu R, Cao G, Tong L, Rao M. Depression in the US population during the time periods surrounding the Great Recession. J Clin Psychiatry. 2015;76(4):e499-e504. source
- Not checked — no full text of the sourcecites [63] 63. Compton WM, Han B, Jones CM, Blanco C, Hughes A. Marijuana use and use disorders in adults in the USA, 2002-14. Lancet Psychiatry. 2016;3(10): 954-964. source
- Partly supportedcites [41] 41. Saha TD, Kerridge BT, Goldstein RB, et al. Nonmedical prescription opioid use and DSM-5 nonmedical prescription opioid use disorder in the United States. J Clin Psychiatry. 2016;77(6):772-780. sourceExperimental — accuracy not yet measured
The Results > Comorbidity section (page unavailable) reports an association between nonmedical prescription opioid use and major depressive disorder, limited to 12-month MDD. It does not report that MDD was associated with nonmedical prescription opioid use disorder, or establish that the association was particularly strong for drug disorders. (LLM, conf=0.86)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“the increases in depression and suicide that have accompanied growing income inequality suggest that the relationship of low income to MDD is due to stress from inadequate financial resources for life necessities or pessimism about improved future prospects.1”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Partly supportedcites [1] 1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112 (49):15078-15083. sourceExperimental — accuracy not yet measured
The Discussion (page unavailable) suggests that economic insecurity may be tied to rising suicide and describes concern about not being better off than one’s parents. It does not establish that low income causes MDD, identify inadequate resources for necessities as the mechanism, or show that depression rose with income inequality. (LLM, conf=0.82)
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“With increasingly positive attitudes toward substance use [64][65][66] and increasing rates of adult SUDs and associated problems, 24,41,42,[67][68][69] MDD comorbidity with SUDs remains a substantial public health 24,70 and economic 16 burden.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not matchedcites [24] 24. Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 alcohol use disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015; 72(8):757-766.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [70] 70. Bonn-Miller MO, Boden MT, Bucossi MM, Babson KA. Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. Am J Drug Alcohol Abuse. 2014;40(1):23-30. source
- Partly supportedcites [16] 16. Greenberg PE, Fournier AA, Sisitsky T, Pike CT, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiatry. 2015;76(2): 155-162. sourceExperimental — accuracy not yet measured
The Discussion reports a substantial economic burden among people with MDD and attributes a large share to comorbid conditions. The Demographics section identifies alcohol and drug abuse as comorbidities, but the paper does not isolate the economic burden of MDD comorbid with substance use disorders. In the citing sentence, this source is attached to the economic-burden claim; the public-health claim has separate citations. (LLM, conf=0.83)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“O ver the past 25 years, the US prevalence of adolescent and adult depression indicators has increased.1,2”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
What the sources say
- Partly supportedcites [1] 1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112 (49):15078-15083. sourceExperimental — accuracy not yet measured
The Midlife Morbidity section reports that serious psychological distress increased among white non-Hispanic adults aged 45–54 between 1997–1999 and 2011–2013. It does not establish an increase in depression indicators among adolescents or the broader US adult population, nor does that comparison span 25 years. (LLM, conf=0.88)
- Partly supportedcites [2] 2. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016; 138(6):pii:e20161878. sourceExperimental — accuracy not yet measured
The Abstract and Results report increased 12-month major depressive episode prevalence among US adolescents and young adults from 2005 to 2014. The study does not establish a 25-year trend or an increase among adults generally; the Discussion says the increase was limited to ages 12–20, with no change at ages 21–25. (LLM, conf=0.91)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Test-retest reliability of AUDADIS-5 DSM-5 MDD was fair 29 (κ = 0.40) 26”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Key Points
What the sources say
- Not matchedcites [26] 26. National Institute on Alcohol Abuse and Alcoholism. National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). https://niaaa.nih.gov/research/nesarc-III. Accessed October 5, 2017.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites [29] 29. Hasin DS, Shmulewitz D, Stohl M, et al. Procedural validity of the AUDADIS-5 depression, anxiety and post-traumatic stress disorder modules. Drug Alcohol Depend. 2015;152:246-256. sourceExperimental — accuracy not yet measured
The Introduction says AUDADIS-5 mood and anxiety disorders had test–retest reliability comparable to AUDADIS-IV, but gives no κ = 0.40 for DSM-5 MDD. Its κ = 0.40–0.65 range refers to AUDADIS-IV diagnoses. The Results (§3.2) instead report AUDADIS-5/PRISM-5 concordance, a different comparison. (LLM, conf=0.86)
Strength:plain· not yet calibratedn = 1,006Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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]”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097-1106. source
- Not checked — no full text of the sourcecites [46] 46. Yoshimatsu K, Palmer B. Depression in patients with borderline personality disorder. Harv Rev Psychiatry. 2014;22(5):266-273. source
- Not checked — no full text of the sourcecites [47] 47. Richman MJ, Unoka Z. Mental state decoding impairment in major depression and borderline personality disorder. Br J Psychiatry. 2015;207(6): 483-489. source
- Partly supportedcites [48] 48. Skodol AE, Grilo CM, Keyes KM, Geier T, Grant BF, Hasin DS. Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample. Am J Psychiatry. 2011;168(3):257-264. sourceExperimental — accuracy not yet measured
The Introduction describes major depressive disorder as comorbid with other mental disorders, and the Results and Discussion identify borderline personality disorder and anxiety disorders as relevant to its persistence. The paper does not single out generalized anxiety disorder as an especially strong association; the Results instead name specific phobia and panic disorder as predictors of persistence. Its main finding concerns the course of MDD, not a ranking of disorders associated with MDD generally. (LLM, conf=0.85)
- Could not verifycites [49] 49. Platt J, Prins S, Bates L, Keyes K. Unequal depression for equal work? how the wage gap explains gendered disparities in mood disorders. Soc Sci Med. 2016;149:1-8. sourceExperimental — accuracy not yet measured
The Methods > Measures section identifies MDD and GAD as separate study outcomes, and the Results relate each to the gender wage gap; neither reports an association between MDD and GAD. Searches for MDD–GAD comorbidity and borderline personality disorder found no passage addressing the claimed associations. Page numbers were not available in our copy. (LLM, conf=0.76)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Data were adjusted for oversampling and nonresponse and weighted to represent the US civilian population based on the 2012 American Community Survey.25”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Sample and Procedures
What the sources say
- Partly supportedcites [25] 25. Grant BF, Goldstein RB, Smith SM, et al. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 (AUDADIS-5): reliability of substance use and psychiatric disorder modules in a general population sample. Drug Alcohol Depend. 2015;148:27-33. sourceExperimental — accuracy not yet measured
The Methods (Section 2.1 Sample; page unavailable) identify the target as the US non-institutionalized civilian adult population and describe higher selection probabilities for minority respondents. The paper reports response rates, but our copy does not say that the data were adjusted for oversampling or nonresponse, or weighted using the 2012 American Community Survey. (LLM, conf=0.82)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The likelihood that NESARC-III indicates valid increases in prevalence is supported by the coherence of its results with 6 other reports showing national increases in depression indicators 1,2 (also Katherine M. Keyes, PhD, written communication, January 2, 2018) and suicidality.1,86,91,92”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
What the sources say
- Partly supportedcites [1] 1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112 (49):15078-15083. sourceExperimental — accuracy not yet measured
The Significance section reports rising suicide mortality from 1999 to 2013 across all four US census regions, but specifically among white non-Hispanics aged 45–54. This supports the cited paper as one report of an increase in a suicidality-related outcome; it does not establish a population-wide increase in suicidality or validate NESARC-III prevalence estimates. No page number is available in our copy. (LLM, conf=0.86)
- Supportedcites [2] 2. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016; 138(6):pii:e20161878. source
The Results report a national increase in 12-month major depressive episodes among US adolescents and young adults from 2005 to 2014. The Discussion also notes recent US suicide-trend data, though suicidality was not measured in this study. The source supports its role as one of the reports cited; the inference about NESARC-III’s validity is the citing authors’ own. (LLM, conf=0.87)
- Not checked — no full text of the sourcecites [86] 86. Fahimi M, Link M, Mokdad A, Schwartz DA, Levy P. Tracking chronic disease and risk behavior prevalence as survey participation declines. Prev Chronic Dis. 2008;5(3):A80.
- Not checked — no full text of the sourcecites [91] 91. Olfson M, Wang S, Blanco C. National trends in hospital-treated self-harm events among middle-aged adults. Gen Hosp Psychiatry. 2015; 37(6):613-619. source
- Not matchedcites [92]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“The likelihood of treatment for depression is reduced in those with SUDs.79”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Could not verifycites [79] 79. Olfson M, Blanco C, Marcus SC. Treatment of adult depression in the United States. JAMA Intern Med. 2016;176(10):1482-1491. sourceExperimental — accuracy not yet measured
The Statistical Analyses section examines depression treatment by sociodemographic characteristics and psychological distress, not substance use disorder. The Discussion identifies low treatment likelihood among racial and ethnic minorities but does not address whether substance use disorders reduce the likelihood of depression treatment. Searches for substance use disorders, SUDs, and alcohol or drug dependence found no passage establishing the claimed association. (LLM, conf=0.74)
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Could not verify
- It may state two separate claims as one. 25
- Probably not a substantial claim. 15
- The quote only partly states this claim. 15
Some cited sources support this claim and some don’t — read each source’s verdict below.
In the paper
“Major depressive disorder was more prevalent among women, possibly related to gender discrimination, 50 differential exposure to childhood or adult adversities 51 such as sexual abuse, 52 differential exposure to a complex host of different developmentally organized risk factors, 53 or biologically different stress responses.54”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Disputedcites [50] 50. McLaughlin KA, Conron KJ, Koenen KC, Gilman SE. Childhood adversity, adult stressful life events, and risk of past-year psychiatric disorder. Psychol Med. 2010;40(10):1647-1658. sourceExperimental — accuracy not yet measured
Citation 51 is attached to differential exposure to childhood or adult adversities as a possible explanation for higher depression prevalence among women. The Results section, “Prevalence of Childhood Adversities and Stressful Life Events” (page unavailable), says childhood-adversity exposure was similar among men and women and found no gender differences in the prevalence of minor or major life events. The Discussion considers differences in event severity, but does not offer differential exposure as an explanation for higher depression prevalence among women. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
- Not checked — no full text of the sourcecites [51] 51. Weiss EL, Longhurst JG, Mazure CM. Childhood sexual abuse as a risk factor for depression in women: psychosocial and neurobiological correlates. Am J Psychiatry. 1999;156(6):816-828. source
- Partly supportedcites [52] 52. Kendler KS, Gardner CO. Sex differences in the pathways to major depression: a study of opposite-sex twin pairs. Am J Psychiatry. 2014; 171(4):426-435. sourceExperimental — accuracy not yet measured
Citation 53 attaches to the proposed role of developmentally organized risk factors. The Discussion reports sex differences across developmental tiers of the model, supporting that part of the claim. It describes differences in the factors’ effects on depression risk, however, rather than showing that differential exposure to those factors explains the higher prevalence of depression among women. (LLM, conf=0.84)
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“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]”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
What the sources say
- Partly supportedcites [3] 3. Spijker J, Graaf R, Bijl RV, Beekman AT, Ormel J, Nolen WA. Functional disability and depression in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Acta Psychiatr Scand. 2004; 110(3):208-214. sourceExperimental — accuracy not yet measured
The Discussion reports worse functioning during depression and improvement after recovery, supporting the impairment portion of the sentence. However, the Diagnostic instrument section specifies DSM-III-R diagnoses, not the DSM-IV diagnosis named in the claim. The other outcomes are attached to different citations in the citing sentence and are not assessed here. (LLM, conf=0.86)
- Not matchedcites [4] 4. Kessler RC, Bromet EJ. The epidemiology of depression across cultures. Annu Rev Public Health. 2013;34:119-138.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [5] 5. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097-1106. source
- Not checked — no full text of the sourcecites [6] 6. Regier DA, Farmer ME, Rae DS, et al. Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiologic Catchment Area (ECA) Study. JAMA. 1990;264(19): 2511-2518. source
- Not matchedcites [7] 7. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51(1):8-19.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [8] 8. Grant BF, Harford TC. Comorbidity between DSM-IV alcohol use disorders and major depression. Drug Alcohol Depend. 1995;39(3):197-206. source
- Not checked — no full text of the sourcecites [9] 9. Kessler RC, Berglund P, Demler O, et al; National Comorbidity Survey Replication. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289(23):3095-3105. source
- Not checked — no full text of the sourcecites [10] 10. Goldstein BI, Carnethon MR, Matthews KA, et al; American Heart Association Atherosclerosis; Hypertension and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Major depressive disorder and bipolar disorder predispose youth to accelerated atherosclerosis and early cardiovascular disease. Circulation. 2015; 132(10):965-986. source
- Not checked — no full text of the sourcecites [11] 11. Vancampfort D, Mitchell AJ, De Hert M, et al. Type 2 diabetes in patients with major depressive disorder. Depress Anxiety. 2015;32(10):763-773. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Impaired functioning was assessed with version 2 of the 12-Item Short Form Health Survey (SF-12v2), a reliable, valid, widely used measure of impairment in the prior 30 days.39”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Impairment
What the sources say
- Partly supportedcites [39] 39. Hasin DS, Kerridge BT, Saha TD, et al. Prevalence and correlates of DSM-5 cannabis use disorder, 2012-2013: findings from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Am J Psychiatry. 2016;173(6):588-599. sourceExperimental — accuracy not yet measured
The Method > Disability/Impairment passage describes the SF-12v2 as a widely used measure of current disability and says the study used it to assess functioning. It does not specify a prior-30-day period or state that the SF-12v2 is reliable and valid; the reliability and validity statements in Method > Assessments concern a different interview. (LLM, conf=0.87)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“This study found association between low income and 12-month MDD, consistent with other studies conducted within the last 3 years.1,57,58”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Could not verifycites [1] 1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proc Natl Acad Sci U S A. 2015;112 (49):15078-15083. sourceExperimental — accuracy not yet measured
The Midlife Morbidity section reports trends in psychological distress among white non-Hispanic adults aged 45–54. The Discussion considers possible ties between economic insecurity and worsening health, but neither passage reports an association between low income and 12-month major depressive disorder. Searches for MDD, low income, and depression did not locate that finding in our copy. (LLM, conf=0.76)
- Not checked — no full text of the sourcecites [57] 57. Mehta K, Kramer H, Durazo-Arvizu R, Cao G, Tong L, Rao M. Depression in the US population during the time periods surrounding the Great Recession. J Clin Psychiatry. 2015;76(4):e499-e504. source
- Not checked — no full text of the sourcecites [58] 58. Galea S, Annas GJ. Aspirations and strategies for public health. JAMA. 2016;315(7):655-656. source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Evidence suggests that efforts to selfmanage depression with cannabis are increasing [71][72][73][74][75] (also Aaron L. Sarvet, MPH, written communication, January 2, 2018) despite lack of evidence that cannabinoids are effective for this purpose 76,77 ; prospectively, cannabis worsens the course of depressive disorders.78”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Partly supportedcites [71] 71. Corroon JM Jr, Mischley LK, Sexton M. Cannabis as a substitute for prescription drugs. J Pain Res. 2017;10:989-998. sourceExperimental — accuracy not yet measured
The Results (Comorbidities) report that respondents used cannabis to manage depression, supporting the self-management part of the cited clause. This cross-sectional study does not establish that such efforts are increasing over time. The statements about effectiveness and the prospective course of depression have separate citations and are not attributed to this source. (LLM, conf=0.85)
- Partly supportedcites [72] 72. Nunberg H, Kilmer B, Pacula RL, Burgdorf J. An analysis of applicants presenting to a medical marijuana specialty practice in California. J Drug Policy Anal. 2011;4(1):pii:1. sourceExperimental — accuracy not yet measured
The Results section, “Applicants’ Self Reports of the Therapeutic Benefits of Marijuana” (page unavailable), reports that 26.1% of applicants said they used marijuana for relief of depression. That supports the self-management portion of the clause to which this source is cited, but the paper does not establish that such efforts are increasing. The separate claims about efficacy and the prospective course of depression carry different citations in the citing sentence and are not attributed to this source. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites [73] 73. Bradford AC, Bradford WD. Medical marijuana laws may be associated with a decline in the number of prescriptions for Medicaid enrollees. Health Aff (Millwood). 2017;36(5):945-951. source
- Not checked — no full text of the sourcecites [74] 74. Bradford AC, Bradford WD. Medical marijuana laws reduce prescription medication use in Medicare Part D. Health Aff (Millwood). 2016;35(7): 1230-1236. source
- Supportedcites [75] 75. Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456-2473. source
The citation to this review supports the clause about lack of evidence that cannabinoids treat depression. The Depression section reports that no treatment studies met the inclusion criteria and that three studies assessing depression as an outcome found no difference from placebo. The separate claims about increasing self-management and the prospective course of depressive disorders have other citations. (LLM, conf=0.93)
- Not matchedcites [76] 76. National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: National Academies Press; 2017.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites [77] 77. Bahorik AL, Leibowitz A, Sterling SA, Travis A, Weisner C, Satre DD. Patterns of marijuana use among psychiatry patients with depression and its impact on recovery. J Affect Disord. 2017;213:168-171. source
Citation 78 supports the final clause of the citing sentence, not its separate claims about self-management or cannabinoid efficacy. The Results report that marijuana use worsened depression symptoms over six months, and the Discussion describes poorer recovery among psychiatry outpatients with depression. (LLM, conf=0.90)
- Not checked — no full text of the sourcecites [78] 78. Han B, Olfson M, Mojtabai R. Depression care among depressed adults with and without comorbid substance use disorders in the United States. Depress Anxiety. 2017;34(3):291-300. source
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The NESARC-III treatment rates are plausible given the extent of direct-toconsumer advertising of antidepressants 83 and widespread distribution through primary care.79”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [83] 83. Qaseem A, Barry MJ, Kansagara D; Clinical Guidelines Committee of the American College of Physicians. Nonpharmacologic versus pharmacologic treatment of adult patients with major depressive disorder: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;164(5):350-359. source
- Supportedcites [79] 79. Olfson M, Blanco C, Marcus SC. Treatment of adult depression in the United States. JAMA Intern Med. 2016;176(10):1482-1491. source
Citation 79 is attached to the primary-care part of the sentence, not the advertising part. The Health Care Professionals section reports that 73.3% of patients treated for depression were treated exclusively by general medical professionals and that most patients treated by that group received antidepressants. This supports the claim of widespread provision through primary care; the paper does not need to establish the separate advertising claim attributed to citation 83. (LLM, conf=0.91)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Major depressive disorder was associated with anxiety disorders, particularly panic disorder and generalized anxiety disorder, as well as with PTSD.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Further adjusting for psychiatric comorbidity reduced asso-ciations by a factor of approximately 50%, although ORs remained statistically significant.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Few were mild; most were moderate or severe.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additional adjustment for other psychiatric disorders decreased all aORs (some substantially), but most remained significant.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Associations With Other Psychiatric Disorders
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“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”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [5] 5. Hasin DS, Goodwin RD, Stinson FS, Grant BF. Epidemiology of major depressive disorder: results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry. 2005;62(10):1097-1106. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“were higher in younger adults (age range, 18-29 years; OR, 3.0; 95% CI, 2.48-3.55)”
- Also stated in: § DSM-5 MDD Prevalence and Sociodemographic Correlates · plain
“Compared with respondents 65 years or older, odds of 12month MDD were greater for younger age groups.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
- Also stated in: § DSM-5 MDD Prevalence and Sociodemographic Correlates · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“those with low incomes ($19 999 or less; OR, 1.7; 95% CI, 1.49-2.04)”
- Also stated in: § DSM-5 MDD Prevalence and Sociodemographic Correlates · plain
“Compared with the highest income category ($70 000 or higher), odds of 12-month MDD were greater in each successively lower household income category”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
- Also stated in: § DSM-5 MDD Prevalence and Sociodemographic Correlates · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Greater prevalence was found among younger adults and among white adults and Native American adults than among African American, Asian American, and Hispanic adults.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the mixed-features specifier characterized 15.5%.”
- Also stated in: § DSM-5 Specifiers and Bereavement · plain
“the mixed-features specifier characterized 15.5% of those with lifetime MDD”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
- Also stated in: § DSM-5 Specifiers and Bereavement · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Controlling for severity, both specifiers were associated with early onset, poor course and functioning, and suicidality.”
- Also stated in: § DSM-5 Specifiers and Bereavement · plain
“Both specifiers were significantly associated with earlier onset, number of episodes, longest duration, severity, MDD treatment overall and by type, suicidality, and poorer SF-12v2 scores.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § DSM-5 Specifiers and Bereavement · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While many with MDD receive treatment, others remain untreated.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Talk therapy with a professional | 62.49 (0.79) | 44.01 (2.95)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any MDD (n = 448) | 42.29 (0.71) | <.001 | 43.85 (0.80) | <.001 | 42.94 (0.70) | <.001 | 42.10 (0.76) | <.001”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Wanted to die | 46.74 (0.91) | 32.05 (2.45)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mixed-Features Specifier c | No Yes | (n = 6235) (n = 1197) | 29.60 (0.22) 26.11 (0.47) | 3.69 (0.12) 4.81 (0.36) | 25.70 (0.12) 51.41 (0.39)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mixed-Features Specifier c | No Yes | (n = 6235) (n = 1197) | 29.60 (0.22) 26.11 (0.47) | 3.69 (0.12) 4.81 (0.36) | 25.70 (0.12) 51.41 (0.39)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any MDD (n = 448) | 42.29 (0.71) | <.001 | 43.85 (0.80) | <.001 | 42.94 (0.70) | <.001 | 42.10 (0.76) | <.001”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mixed-Features Specifier c | No Yes | (n = 6235) (n = 1197) | 29.60 (0.22) 26.11 (0.47) | 3.69 (0.12) 4.81 (0.36) | 25.70 (0.12) 51.41 (0.39)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thought a lot about one's own death | 34.78 (0.72) | 28.79 (2.69)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any MDD (n = 448) | 42.29 (0.71) | <.001 | 43.85 (0.80) | <.001 | 42.94 (0.70) | <.001 | 42.10 (0.76) | <.001”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Any MDD (n = 448) | 42.29 (0.71) | <.001 | 43.85 (0.80) | <.001 | 42.94 (0.70) | <.001 | 42.10 (0.76) | <.001”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thought a lot about suicide | 39.31 (0.80) | 22.75 (2.19)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Attempted suicide | 13.62 (0.58) | 4.77 (1.09)”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among US adults, DSM-5 MDD is highly prevalent, comorbid, and disabling.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Comparing participants with the total eligible sample (including nonrespondents), no significant differences were found in percentages of African American, Asian, or Hispanic individuals or in population density, vacancy rate, or proportion in group quarters or renters.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Sample and Procedures
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“While most cases received some treatment, a substantial minority did not.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Therefore, MDD remains a widespread, serious US health problem.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The total response rate was 60.1%.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Sample and Procedures
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The high prevalence of MDD among US adults is a substantial concern given the personal, public health, and economic burdens that the disorder imposes.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Conclusions
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“AUDADIS-5 used a slightly different algorithm for PTSD than the final DSM-5 definition, caused by a last-minute DSM-5 change that occurred too late to implement in NESARC-III.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“However, NESARC-III response rates compare favorably with other recent national health surveys.[86][87][88]”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
What the sources say
- Not matchedcites [86] 86. Fahimi M, Link M, Mokdad A, Schwartz DA, Levy P. Tracking chronic disease and risk behavior prevalence as survey participation declines. Prev Chronic Dis. 2008;5(3):A80.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites [87] 87. Center for Behavioral Health Statistics and Quality. 2015 National Survey on Drug Use and Health: Methodological Summary and Definitions. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [88] 88. Simon NM, Shear KM, Thompson EH, et al. The prevalence and correlates of psychiatric comorbidity in individuals with complicated grief. Compr Psychiatry. 2007;48(5):395-399. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“This result is higher than the treatment rate in one recent study 80 that used less specific measures to identify depression but is consistent with rates from other studies published in the last 4 years.81,82”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [80] 80. Olfson M, Kroenke K, Wang S, Blanco C. Trends in office-based mental health care provided by psychiatrists and primary care physicians. J Clin Psychiatry. 2014;75(3):247-253. source
- Not matchedcites [81] 81. Han B, Hedden S, Lipari R, Copello E, Kroutil L. Receipt of Services for Behavioral Health Problems: Results From the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2015.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [82] 82. Avery RJ, Eisenberg MD, Simon KI. The impact of direct-to-consumer television and magazine advertising on antidepressant use. J Health Econ. 2012;31(5):705-718. source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This approach enabled us to examine the association between these severity levels and SF-12v2 impairment scores.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“However, dual-focused treatment is more effective when 2 disorders are present.70”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Discussion
What the sources say
- Not checked — no full text of the sourcecites [70] 70. Bonn-Miller MO, Boden MT, Bucossi MM, Babson KA. Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. Am J Drug Alcohol Abuse. 2014;40(1):23-30. source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Removing the bereavement exclusion in DSM-5 could have accounted for a small amount of the prevalence increase in NESARC-III, but not for all of it by any means.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study was cross-sectional; associations do not necessarily indicate causal relationships.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our definition of the anxious/ distressed specifier used a lower threshold than DSM-5, which may have somewhat inflated the rates, an issue meriting future study using different data.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Also, as noted, 85 DSM-5 left differentiating MDD from normal bereavement to clinical judgment.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
What the sources say
- Not matchedcites [85] 85. Curtin SC, Warner M, Hedegaard H. Increase in suicide in the United States, 1999-2014. NCHS Data Brief. 2016;(241):1-8.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These limitations are offset by the large sample, reliable and valid measures of psychiatric and substance disorders, and rigorous study methods.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Lifetime associations of MDD with other psychiatric disorders may be influenced by recall bias, although this possibility is less likely for 12-month findings, which were similar.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Some groups were not included (eg, homeless and prisoners), so NESARC-III may underestimate MDD prevalence.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, we defined the DSM-5 severity specifier by MDD symptom counts, which are straightforward, transparent, and replicable.”
§ Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States > Limitations
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
The paper relies on this without support.
National epidemiologic information on major depressive disorder is limited to pre-DSM-5 studies conducted more than 15 years ago.
“However, national epidemiologic information on major depressive disorder (MDD) is limited to pre-DSM-5 studies conducted more than 15 years ago.”
The paper relies on this without support.
The proportion of MDD cases diagnosed as positive after bereavement has not been studied.
“the proportion of MDD cases diagnosed as positive after bereavement has also not been studied.”
The paper relies on this without support.
DSM-IV and DSM-5 include a severity specifier (mild, moderate, or severe) that had not previously been examined in national data.
“The DSM-IV and DSM-5 include a severity specifier (mild, moderate, or severe) not previously examined in national data.”
The paper relies on this without support.
The DSM-5 does not state the number of MDD symptoms required for each severity level.
“The DSM-5 does not state the number of MDD symptoms required for each severity level, so these levels were defined as follows: mild is 5 symptoms (minimum for a diagnosis), moderate is 6 to 7 symptoms, and severe is 8 to 9 symptoms.”
The paper relies on this without support.
The DSM-5 states that distress and impairment should increase across severity levels but without clear definitions.
“The DSM-5 also states that distress and impairment should increase across levels but without clear definitions.”
The paper relies on this without support.
The DSM-5 suggests incorporation of distress and impairment levels into the severity classifications but defines these vaguely.
“The DSM-5 also suggests incorporation of distress and impairment levels into the severity classifications but defines these vaguely.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Half of the women with infertility in LMICs experience lifetime abuse that culminates in anxiety and depressive episodes [6,14,15].”
From Psychosocial interventions for improving marital intimacy, sexual satisfaction, and quality of life of women and couples with infertility problems in low and middle-income countries: Systematic review protocol (2025) · cites this paper as [14]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although MDD is present in individuals of various social situations, it seems to increase considerably in poor populations and low socioeconomic status, suggesting that this condition is a significant risk factor for the disorder [7],[16],[17].”
From Stress and serum cortisol levels in major depressive disorder: a cross-sectional study (2020) · cites this paper as [7]
Experimental — accuracy not yet measuredIn the citing paper
“Given that MDD is highly comorbid with other mental and physical health conditions [7,43]”
From The Economic Burden of Adults with Major Depressive Disorder in the United States (2019) (2023) · cites this paper as [7]
In the citing paper
“A multi-site fully remote e-clinical validation study that enrolled participants with MDD to evaluate the sensitivity and specificity of Kintsugi's technology's prediction has recently been completed.”
From Digital health technologies and major depressive disorder (2023) · cites this paper as [115]
In the citing paper
“Kintsugi is a passive vocal biomarker instrument that uses short clips of free-form speech for depression screening.”
From Digital health technologies and major depressive disorder (2023) · cites this paper as [115]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Reported median falls below its implied duration category
MinorFor participants whose MDD began in the past 12 months, 38.35% had a longest episode of 8 weeks or less, and 53.07% had one of 12 weeks or less. The median must therefore be in the 9-12-week category, not 8.81 weeks.
“| Duration of longest or only lifetime | 25.90 (1.47) | 8.81 (0.69) |”
“| 2-3 | 8.59 (0.38) | 18.34 (1.96) | | 4-8 | 12.26 (0.47) | 20.01 (2.48) | | 9-12 | 9.24 (0.42) | 14.72 (2.20) |”
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“For example, both countries have a higher prevalence of depression for women than for men, and experience stigma primarily from the perceived controllability of MDD (Hasin et al., 2018; Huang et al., 2019; Krendl & Freeman, 2019).”
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“Women face a higher lifetime risk, with prevalence rates of 40% and 26% for anxiety and depression, respectively, compared to 20% and 15% in men (Gregory et al. 2020; Hasin et al. 2018).”
Mixed features and suicide attempts in youth depression: a six-month follow-up study
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“Among adults aged 18 years and older with MDD, epidemiological evidence from the United States further shows that about 15.5% experience mixed features during depressive episodes [10].”
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Group Psychotherapy for Depression
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“It is estimated to afflict one in five people in the United States in their lifetimes and one in 10 people in a 12-month period (Hasin et al., 2018).”
BackgroundPerceived helpfulness of depression treatments among young adults with autism
Zheng, S., Taylor, J. L., Adams, R. E., Pezzimenti, F., & Bishop, S. L. (2021) · Autism Research · doi:10.1002/aur.2515 · Cited by 2
“Depression is significantly more common in adults with autism spectrum disorders (ASD) than in the general population (Hasin et al., 2018; Hollocks et al., 2019; Joshi et al., 2013).”
BackgroundPreventative Interventions for Childhood and Adolescent Disorders
Werner‐Seidler, A., Beames, J. R., & Torok, M. H. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-818697-8.00049-2 · Cited by 2
O’Shields, J., & Mowbray, O. P. (2021) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2021.100316 · Cited by 1
Acculturation and Depressive Symptoms Among Dominicans in New York City
Hagen, D., Goldmann, E., Parikh, N. S., Goodman, M. S., & Boden-Albala, B. M. (2021) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-021-01316-2 · Cited by 1
“[41, 42]; however, a meta-analysis of 31 studies found no statistically significant difference in terms of lifetime prevalence, and a slightly elevated point prevalence among Hispanic as compared to non-Hispanic White individuals [43].”
ResultPerskin, C. R., Maseda, M., Konda, S. R., et al. (2021) · The Knee · doi:10.1016/j.knee.2021.11.014 · Cited by 1
Girardi, P., Fiaschè, F., Zocchi, C., et al. (2022) · Minerva Psychiatry · doi:10.23736/s2724-6612.21.02219-3 · Cited by 1
VIVEMOS UM COLETIVO DE TRANSTORNO DE PERSONALIDADE DRAMÁTICA
Rodrigues, F. D. A. A., & da Silveira, F. M. (2022) · RECISATEC - REVISTA CIENTÍFICA SAÚDE E TECNOLOGIA · doi:10.53612/recisatec.v2i2.92 · Cited by 1
Bringing Lived Lives to Swift’s Asylum: a psychiatric hospital perspective
Malone, K. M., Cleary, E., Kelleher, C., Jefferies, J. K., Lane, A., Lucey, J. V., & McGuiness, S. (2021) · Wellcome Open Research · doi:10.12688/wellcomeopenres.15588.2 · Cited by 1
Deep Brain Stimulation for Treatment-Resistant Depression
Díaz, A. P., Fernandes, B. S., Cuellar, V. A., Quevedo, J., Fenoy, A. J., Sanches, M., & Soares, J. C. (2022) · Neuromethods · doi:10.1007/978-1-0716-2083-0_17 · Cited by 1
The brief obsessive-compulsive scale: Development and validation of a self-report (BOCS-SR)
Patel, S. R., Basaraba, C. N., Rose, S. V., Meter, P. E. V., Wall, M. M., & Simpson, H. B. (2022) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2022.100730 · Cited by 1
Weaver, A., Landry, C., Zhang, A., McQuown, L., Hahn, J., Harrington, M. M., Tucker, K. M., Holzworth, J., Buys, T., Smith, F. N., et al. (2022) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2022.100952 · Cited by 2
Musker, M. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-89843-0.00031-3 · Cited by 1
Duncan, G. E., Avery, A. R., Tsang, S., Watson, N. F., Williams, B. D., & Turkheimer, E. N. (2022) · BMC Public Health · doi:10.1186/s12889-022-13901-7 · Cited by 1
“Further, undesirable health outcomes related to these health behaviors, such as obesity [13] and depression [14], are prevalent in the US.”
BackgroundWang, J., Yuan, M., & Zhang, W. (2022) · PubMed Central · doi:10.12182/20220960509 · Cited by 1
Silaule, O., Adams, F., & Nkosi, N. G. (2023) · JMIR Research Protocols · doi:10.2196/44268 · Cited by 1
“For example, depressive disorder is characterized by prolonged feelings of sadness and guilt and reduced energy levels, which hinder participation in activities of daily living and work-related activities [4-7].”
Jiang, X., Ma, Z., Li, Z., Ou, Y., Luo, Z., & Li, Z. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1209354 · Cited by 1
Ibrahim, H. M., & Jha, M. K. (2023) · Psychiatric Annals · doi:10.3928/00485713-20230820-01 · Cited by 1
Voineskos, D. (2019) · TSpace (University of Toronto) · Cited by 1
Suicide: An Immunological Disorder?Preprint
O'Connor, K. (2021) · SSRN Electronic Journal · doi:10.2139/ssrn.3783063 · Cited by 1
Multi-scale neural signatures of major depressive, anxiety, and stress-related disordersPreprint
Zhukovsky, P., Wainberg, M., Milic, M. S., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-711822/v1 · Cited by 1
Eggenberger, L., Komlenac, N., Ehlert, U., Grub, J., & Walther, A. (2021) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/7pcfw · Cited by 2
Impact of psychiatric disorders
Pogach, M. S. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-822963-7.00278-4 · Cited by 1
Walther, A., Kräter, M., Kirschbaum, C., Gao, W., Wekenborg, M., Penz, M. S., Rothe, N., Guck, J. R., Wittwer, L. D., & Eder, J. (2022) · medRxiv · doi:10.1101/2022.09.23.22280275 · Cited by 1
“Nevertheless, both conditions cause severe functional impairment and there are major difficulties in reducing the high prevalence rates (Hasin et al., 2018; Vos et al., 2017) and improving DD treatment (Munder et al., 2019; Munkholm et al., 2019), with 33% of patients not achieving remission…”
BackgroundDuque, M., Chen, A., Hsu, E. T., Narayan, S., Rymbek, A., Begum, S., Saher, G., Cohen, A. E., Olson, D. E., Prober, D. A., et al. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.12.29.522099 · Cited by 1
Peiper, N. C., Pettitt, A., Shah, B., Atwood, O., & Pfeffer, J. (2023) · doi:10.31234/osf.io/8adpu · Cited by 1
Huang, Y., Cen, H., Hu, X., Ma, C., Yu, B., Hao, J., Wang, M., & Zhang, J. (2023) · Research Square · doi:10.21203/rs.3.rs-3045327/v1 · Cited by 1
Remote monitoring of depression severity: A machine learning approachPreprint
Holstein, V., Rahimi-Eichi, H., Emden, D., Gutfleisch, L., Refisch, A., Goltermann, J., Leenings, R., Winter, N. R., Kircher, T. T. J., Nenadić, I., et al. (2023) · medRxiv · doi:10.1101/2023.08.22.23294431 · Cited by 2
“Depression is a widespread psychiatric illness that affects millions of individuals worldwide, with a lifetime prevalence of 20% [1], projected to be the lead contributor to global disease burden by the year 2030 [2].”
BackgroundLutz, P.-É., Mokhtari, A., Ibrahim, E. C., Gloaguen, A., Barrot, C.-C., Cohen, D., Derouin, M., Vachon, H., Charbonnier, G., Loriod, B., et al. (2024) · Research Square · doi:10.21203/rs.3.rs-3978037/v1 · Cited by 1
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“Half of the women with infertility in LMICs experience lifetime abuse that culminates in anxiety and depressive episodes [6,14,15].”
Prävalenz, Verlauf und Komorbidität
Broocks, A. (2018) · InFo Neurologie + Psychiatrie · doi:10.1007/s15005-018-2784-6
The Search for Rapid Acting Antidepressants: Research Synthesis and Perspectives
Sanacora, G., Kitay, B. M., & Wilkinson, S. T. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813333-0.00035-4
Bolla, P. R. (2019) · EngagedScholarship @ Cleveland State University (Cleveland State University)
Metadata
- Authors
- Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F.
- Affiliations
- Columbia University Irving Medical Center (US)
- SUNY Downstate Health Sciences University (US)
- National Institutes of Health (US)
- New York State Psychiatric Institute (US)
- Fedpoint Systems, LLC, Arlington, Virginia
- Corresponding author
- Hasin, Deborah S.
- Venue
- JAMA Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2018-04-01
- Volume
- 75
- Issue
- 4
- Pages
- 336
- ISSN
- 2168-622X (ISSN-L)
- PMC
- PMC5875313
- OpenAlex
- W2789034326
- Cited by
- 1,737
- References
- 113
- Citations by year
- 2026: 166 · 2025: 217 · 2024: 268 · 2023: 269 · 2022: 256 · 2021: 263 · 2020: 166 · 2019: 102 · 2018: 28
- FWCI
- 189.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Drug Abuse (K01DA037914)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, DSM-5, prevalence, psychiatric comorbidity, bereavement, depressive symptoms, functional disability, antidepressant treatment, sex differences, racial and ethnic disparities, income, NESARC-III, United States adults, substance use disorders, anxiety disorders, mood disorders
- MeSH terms
- Correlation of Data, Adolescent, Adult, Age Factors, Anxiety Disorders, Cross-Sectional Studies, Major Depressive Disorder, Ethnicity, Female, Humans, Male, Sex Factors, Social Class, United States, Comorbidity, Diagnostic and Statistical Manual of Mental Disorders
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