Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies
Open accessAbstract
Epidemiological data on a wide range of mental disorders from community studies conducted in European countries are presented to determine the availability and consistency of prevalence, disability and treatment findings for the EU. Using a stepwise multimethod approach, 27 eligible studies with quite variable designs and methods including over 150,000 subjects from 16 European countries were identified. Prevalence: On the basis of meta-analytic techniques as well as on reanalyses of selected data sets, it is estimated that about 27% (equals 82.7 million; 95% CI: 78.5-87.1) of the adult EU population, 18-65 of age, is or has been affected by at least one mental disorder in the past 12 months. Taking into account the considerable degree of comorbidity (about one third had more than one disorder), the most frequent disorders are anxiety disorders, depressive, somatoform and substance dependence disorders. When taking into account design, sampling and other methodological differences between studies, little evidence seems to exist for considerable cultural or country variation. Disability and treatment: despite very divergent and fairly crude assessment strategies, the available data consistently demonstrate (a) an association of all mental disorders with a considerable disability burden in terms of number of work days lost (WLD) and (b) generally low utilization and treatment rates. Only 26% of all cases had any consultation with professional health care services, a finding suggesting a considerable degree of unmet need. The paper highlights considerable future research needs for coordinated EU studies across all disorders and age groups. As prevalence estimates could not simply be equated with defined treatment needs, such studies should determine the degree of met and unmet needs for services by taking into account severity, disability and comorbidity. These needs are most pronounced for the new EU member states as well as more generally for adolescent and older populations.
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Women make greater use of mental healthcare services than men.
“in line with the higher prevalence of women who make use of mental healthcare services”
From Patients <i>requesting</i> and <i>receiving</i> euthanasia for psychiatric disorders in the Netherlands (2023) · cites this paper as [12]
In Europe, only about 25% of people with mental disorders receive professional treatment.
“In Europe, only about 25% of people with mental disorders receive professional treatment (Wittchen and Jacobi, 2005).”
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Many with anxiety disorders have no diagnosis nor seek treatment.
“It is the case that many with anxiety disorders have no diagnosis nor seek treatment [29,30].”
From Low-intensity internet-delivered treatment for generalized anxiety symptoms in routine care: protocol for a randomized controlled trial (2014) · cites this paper as [30]
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Wulf Rössler, A., Salize, H. J., van Os, J., & Riecher‐Rössler, A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.009 · Cited by 746 · cited 2× · see citing works
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BackgroundResultPrevalence and burden of bipolar disorders in European countries
Pini, S., de Queiroz, V., Pagnin, D., Pezawas, L., Angst, J., Cassano, G. B., & Wïttchen, H. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.011 · Cited by 364 · cited 2× · see citing works
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“…of the six-country study ESEMeD/MHEDEA 2000 (2004c) provides, however, some benchmark data, that appear by and large consistent with several individual national and regional studies (Bijl and Ravelli, 2000b; Bijl et al., 2003; Jacobi et al., 2004a,b; ten Have et al., 2004; Wittchen, 2000).”
BackgroundResultMild Disorders Should Not Be Eliminated From the DSM-V
Kessler, R. C., Merikangas, K. R., Berglund, P., Eaton, W. W., Koretz, D. S., & Walters, E. E. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.11.1117 · Cited by 348 · cited 1× · see citing works
“Such data have not only muchdisputed major public health and policy implications (Narrow et al., 2002; Kessler et al., 2003), but are also essential for estimating the cost burden.”
BackgroundThe epidemiology of generalized anxiety disorder
Kessler, R. C., Keller, M. B., & Wittchen, H.-U. (2001) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70204-5 · Cited by 337 · see citing works
The Prevalence Of Treated And Untreated Mental Disorders In Five Countries
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“Some of these individual studies have already been critically reviewed elsewhere, for example in the context of international diagnosis-specific reviews (Andrade et al., 2000, 2003; Bijl et al., 2003; Coulter andMagee, 2003; Fryers et al., 2004; Kessler, 2004; Sartorius et al., 1993; Vega et al., 2002; Weissman et al.…”
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“…in the context of international diagnosis-specific reviews (Andrade et al., 2000, 2003; Bijl et al., 2003; Coulter andMagee, 2003; Fryers et al., 2004; Kessler, 2004; Sartorius et al., 1993; Vega et al., 2002; Weissman et al., 1992, 1994, 1996, 1997, 1999; Wittchen et al., 2003; Wittchen, 2004).”
BackgroundObsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course
Angst, J., Gamma, A., Endrass, J., Goodwin, R. D., Ajdacic‐Gross, V., Eich, D., & Wulf Rössler, A. (2004) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-004-0459-4 · Cited by 279 · see citing works
The burden of brain diseases in Europe
Olesen, J., & Leonardi, M. (2003) · European Journal of Neurology · doi:10.1046/j.1468-1331.2003.00682.x · Cited by 269 · cited 6× · see citing works
“The lack of such EU-wide information is also a core obstacle to the adequate estimation of (a) the total burden associated with these disorders (Olesen and Leonardi, 2003), (b) the degree of met and unmet needs for treatment and intervention, (c) the patterns and costs of treatment and (d) the…”
BackgroundMethodInfluentialBIJL, R. V., & RAVELLI, A. (2000) · Psychological Medicine · doi:10.1017/s0033291799001841 · Cited by 265 · cited 3× · see citing works
“…of the six-country study ESEMeD/MHEDEA 2000 (2004c) provides, however, some benchmark data, that appear by and large consistent with several individual national and regional studies (Bijl and Ravelli, 2000b; Bijl et al., 2003; Jacobi et al., 2004a,b; ten Have et al., 2004; Wittchen, 2000).”
BackgroundResultSize and burden of depressive disorders in Europe
Paykel, E. S., Brugha, T. S., & Fryers, T. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.008 · Cited by 262 · cited 2× · see citing works
“Beyond these core findings (for disorder specific details see Berr et al., 2005; Fehm et al., 2005; Goodwin et al., 2005; Lieb et al., 2005; Paykel et al., 2005; Pini et al., 2005; Rehm et al., 2005a,b; Rössler et al., 2005; Von Campenhausen et al., 2005) and our attempt to estimate the size and burden with greater pr…”
BackgroundResultHealth economics and cost implications of anxiety and other mental disorders in the United States
Rice, D. P., & Miller, L. S. (1998) · The British Journal of Psychiatry · doi:10.1192/s0007125000293458 · Cited by 261 · cited 2× · see citing works
“Consistent with numerous earlier studies for specific diagnoses (Bijl and Ravelli, 2000a; Jacobi et al., 2004b; Greenberg et al., 1996, 1999; Kessler and Frank, 1997; Rice and Miller, 1998; Spijker et al., 2004; Wittchen, 2002) and expert-based WHO projections (i.”
BackgroundResultAngst, J., Dobler-Mikola, A., & Binder, J. (1984) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/bf00432878 · Cited by 260 · see citing works
Prevalence of major depression and stress indicators in the Danish general population
Olsen, L. R., Mortensen, E. L., & Bech, P. (2004) · Acta Psychiatrica Scandinavica · doi:10.1046/j.0001-690x.2003.00231.x · Cited by 259 · see citing works
The epidemiology of panic disorder and agoraphobia in Europe
Goodwin, R. D., Faravelli, C., Rosi, S., Cosci, F., Truglia, E., de Graaf, R., & Wïttchen, H. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.006 · Cited by 243 · cited 2× · see citing works
“Beyond these core findings (for disorder specific details see Berr et al., 2005; Fehm et al., 2005; Goodwin et al., 2005; Lieb et al., 2005; Paykel et al., 2005; Pini et al., 2005; Rehm et al., 2005a,b; Rössler et al., 2005; Von Campenhausen et al., 2005) and our attempt to estimate the size and burden with greater pr…”
BackgroundResultThe prevalence of major depressive and bipolar disorders in Hungary
Szádóczky, E., Papp, Z., Vitrai, J., Rihmer, Z., & Füredi, J. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(98)00056-1 · Cited by 238 · see citing works
Prevalence of dementia in the elderly in Europe
Berr, C., Wancata, J., & Ritchie, K. A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.003 · Cited by 233 · cited 1× · see citing works
“Beyond these core findings (for disorder specific details see Berr et al., 2005; Fehm et al., 2005; Goodwin et al., 2005; Lieb et al., 2005; Paykel et al., 2005; Pini et al., 2005; Rehm et al., 2005a,b; Rössler et al., 2005; Von Campenhausen et al., 2005) and our attempt to estimate the size and…”
BackgroundThe epidemiology of generalized anxiety disorder in Europe
Lieb, R., Becker, E. S., & Altamura, C. A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.010 · Cited by 227 · cited 2× · see citing works
“Beyond these core findings (for disorder specific details see Berr et al., 2005; Fehm et al., 2005; Goodwin et al., 2005; Lieb et al., 2005; Paykel et al., 2005; Pini et al., 2005; Rehm et al., 2005a,b; Rössler et al., 2005; Von Campenhausen et al., 2005) and our attempt to estimate the size and burden with greater pr…”
BackgroundResultTylee, A. T., Gastpar, M., Lépine, J., & MENDLEWICZ, J. (1999) · International Clinical Psychopharmacology · doi:10.1097/00004850-199905002-00001 · Cited by 221 · see citing works
Vega, W. A., Aguilar‐Gaxiola, S., Andrade, L. H., Bijl, R. V., Borges, G. L. G., Caraveo-Anduaga, J. J., DeWit, D. J., Heeringa, S. G., Kessler, R. C., Kolody, B., et al. (2002) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(02)00224-7 · Cited by 221 · cited 2× · see citing works
“…in the context of international diagnosis-specific reviews (Andrade et al., 2000, 2003; Bijl et al., 2003; Coulter andMagee, 2003; Fryers et al., 2004; Kessler, 2004; Sartorius et al., 1993; Vega et al., 2002; Weissman et al., 1992, 1994, 1996, 1997, 1999; Wittchen et al., 2003; Wittchen, 2004).”
BackgroundThe European Patient Of The Future
Coulter, A., & Magee, H. (2003) · Cited by 220 · see citing works
The Early Developmental Stages of Psychopathology Study (EDSP): A Methodological Update
Lieb, R., Isensee, B., von Sydow, K., & Wïttchen, H. (2000) · European Addiction Research · doi:10.1159/000052043 · Cited by 206 · see citing works
The prevalence of psychiatric morbidity among adults living in private households
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Mental Illness in the Community
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“Service register data are problematic for our purpose because they rely only on identified patients, whereas it has long been known that people with mental or psychiatric disorders often do not seek treatment or do not present their mental health problems as the reason for consultation and are therefore not identified…”
BackgroundDIPS Diagnostisches Interview bei psychischen Störungen
Margraf, J., Schneider, S., & Ehlers, A. (1991) · Springer eBooks · doi:10.1007/978-3-662-06603-4 · Cited by 201 · see citing works
Pao, M., & Kazak, A. E. (2014) · Oxford University Press eBooks · doi:10.1093/med/9780199335114.003.0012 · Cited by 198 · see citing works
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Critical Issues in the Evaluation of Comorbidity of Psychiatric Disorders
Wïttchen, H. (1996) · The British Journal of Psychiatry · doi:10.1192/s000712500029836x · Cited by 167 · cited 2× · see citing works
“Wittchen, F. Jacobi / European Neuropsychopharmacology 15 (2005) 357–376 358”
BackgroundAlcohol use disorders in EU countries and Norway: An overview of the epidemiology
Rehm, J. T., Room, R., van den Brink, W., & Jacobi, F. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.005 · Cited by 167 · cited 3× · see citing works
“In interpreting this finding, it should be noted that this disorder is considerably more frequent (2–4 times) in adolescents and young adults (up to age 30), but rare in older persons; in addition, it remains unclear whether dependence of prescribed sedatives or other drugs has been assessed with sufficient integrity…”
BackgroundSelf-citationOECD Factbook 2005: Economic, Environmental and Social Statistics
Sorrentino, C. (2005) · Monthly labor review · Cited by 160 · see citing works
Jacobi, F., Wïttchen, H., Hölting, C., Sommer, S., Lieb, R., Höfler, M., & Pfister, H. (2002) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.118 · Cited by 159 · cited 3× · see citing works
“…in the ESEMeD project (ESEMeD/MHEDEA 2000 Investigators, 2002), the Mental Health Supplement of the German National Health Interview and Examination Survey (GHSMHS; Jacobi et al., 2002; Wittchen et al., 2000), and a study from Norway (OsLof study, unpublished data provided by I. Sandanger).”
BackgroundSelf-citationSpijker, J., de Graaf, R., Bijl, R. V., Beekman, A. T. F., Ormel, J., & Nolen, W. A. (2004) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00335.x · Cited by 158 · cited 2× · see citing works
“…for specific diagnoses (Bijl and Ravelli, 2000a; Jacobi et al., 2004b; Greenberg et al., 1996, 1999; Kessler and Frank, 1997; Rice and Miller, 1998; Spijker et al., 2004; Wittchen, 2002) and expert-based WHO projections (i.e. Murray and Lopez, 1996; Olesen and Leonardi, 2003), there is thus little…”
BackgroundResult(2000) · Cambridge University Press eBooks · doi:10.1017/cbo9780511543562 · Cited by 154 · see citing works
The National Psychiatric Morbidity Surveys of Great Britain – strategy and methods
JENKINS, R., BEBBINGTON, P., BRUGHA, T., FARRELL, M., GILL, B., LEWIS, G., MELTZER, H., & PETTICREW, M. (1997) · Psychological Medicine · doi:10.1017/s003329179700531x · Cited by 153 · see citing works
British psychiatric morbidity survey
Jenkins, R., Bebbington, P., Brugha, T. S., Farrell, M., Lewis, G., & Meltzer, H. (1998) · The British Journal of Psychiatry · doi:10.1192/bjp.173.1.4 · Cited by 152 · see citing works
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Mental Health Outcome Measures
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Alonso, J., Ferrer, M., Romera, B., Vilagut, G., Angermeyer, M. C., Bernert, S., Brugha, T. S., Taub, N. A., Mccolgen, Z., de Girolamo, G., et al. (2002) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.123 · Cited by 111 · see citing works
Outcomes of Depression International Network (ODIN): Background, methods and field trials
Dowrick, C., Casey, P., Dalgard, O., Hosman, C., Lehtinen, V., Vázquez-Barquero, J.-L., & Wilkinson, G. (1998) · British Journal of Psychiatry · doi:10.1192/bjp.172.4.359 · Cited by 106 · see citing works
Predictors of smoking cessation and maintenance
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Lifetime prevalence of specific mental disorders among people born in Iceland in 1931
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“…is considerably more frequent (2–4 times) in adolescents and young adults (up to age 30), but rare in older persons; in addition, it remains unclear whether dependence of prescribed sedatives or other drugs has been assessed with sufficient integrity in the surveys covered (Rehm et al., 2005).”
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Faravelli, C., Abrardi, L., Bartolozzi, D., Cecchi, C., Cosci, F., D’Adamo, D., Iacono, B. L., Ravaldi, C., Scarpato, M. A., Truglia, E., et al. (2004) · Psychotherapy and Psychosomatics · doi:10.1159/000077741 · Cited by 84 · see citing works
Mental Health Outcome Measures
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Prevalence of psychiatric disorder and the need for psychiatric care in Northern Ireland
Mcconnell, P., Bebbington, P., McClelland, R. J., Gillespie, K., & Houghton, S. (2002) · The British Journal of Psychiatry · doi:10.1192/bjp.181.3.214 · Cited by 71 · see citing works
Tylee, A. T., Gastpar, M., Lépine, J., & MENDLEWICZ, J. (1999) · International Clinical Psychopharmacology · doi:10.1097/00004850-199905002-00002 · Cited by 66 · see citing works
Prevalence of psychiatric disorder in Europe: the potential and reality of meta-analysis
Fryers, T., Brugha, T. S., Morgan, Z., Smith, J., Hill, T., Carta, M. G., Lehtinen, V., & Kovess–Masféty, V. (2004) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-004-0875-9 · Cited by 64 · see citing works
What depressive symptoms are associated with the use of care services?
ten Have, M., de Graaf, R., Vollebergh, W., & Beekman, A. T. F. (2003) · Journal of Affective Disorders · doi:10.1016/s0165-0327(03)00132-0 · Cited by 60 · cited 1× · see citing works
“…of the six-country study ESEMeD/MHEDEA 2000 (2004c) provides, however, some benchmark data, that appear by and large consistent with several individual national and regional studies (Bijl and Ravelli, 2000b; Bijl et al., 2003; Jacobi et al., 2004a,b; ten Have et al., 2004; Wittchen, 2000).”
ResultSelective serotonin re-uptake inhibitors : advances in basic research and clinical practice
Feighner, J. P., & Boyer, W. F. (1996) · Medical Entomology and Zoology · Cited by 59 · see citing works
Critical issues in the evaluation of comorbidity
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What is Comorbidity – Fact or Artefact?
Wïttchen, H. (1996) · The British Journal of Psychiatry · doi:10.1192/s0007125000298358 · Cited by 49 · see citing works
Durchführung und Auswertung des DIPS: Diagnostisches Interview bei psychischen Störungen
Schneider, S., Ehlers, A., & Margraf, J. (1994) · Springer eBooks · doi:10.1007/978-3-662-06753-6_5 · Cited by 42 · see citing works
What is comorbidity. Fact or artefact? (Editorial)
Wïttchen, H. (1996) · Max Planck Institute for Plasma Physics · Cited by 39 · see citing works
The prevalence of affective and anxiety disorders in primary care practice in Hungary
Szádóczky, E., Rihmer, Z., Papp, Z., & Füredi, J. (1997) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)01439-0 · Cited by 37 · see citing works
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Unmet Need in Psychiatry: Problems, Resources, Responses
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The Diagnostic Screening Procedure Writer A Tool to Develop Individualized Screening Procedures
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Continued Needs for Epidemiological Studies of Mental Disorders in the Community
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Depression in the community: results of the first Italian survey
Dubini, A., Mannheimer, R., & Pancheri, P. (2001) · International Clinical Psychopharmacology · doi:10.1097/00004850-200101000-00006 · Cited by 26 · see citing works
The Florence Psychiatric Interview
Faravelli, C., Bartolozzi, D., Cimminiello, L., Cecchi, C., Cosci, F., D’Adamo, D., Matteo, C. D., Primio, C. D., Fabbri, C., Iacono, B. L., et al. (2001) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.112 · Cited by 26 · see citing works
Met and unmet need for interventions in community cases with anxiety disorders
Wittchen, H.-U. (2000) · Unmet Need in Psychiatry · doi:10.1017/cbo9780511543562.020 · Cited by 23 · see citing works
Gender differences in major depressive disorder in a Hungarian community survey
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Entwicklung und Gütekriterien des DIPS: Diagnostisches Interview bei psychischen Störungen
Margraf, J., & Schneider, S. (1994) · Springer eBooks · doi:10.1007/978-3-662-06753-6_4 · Cited by 14 · see citing works
[Prevalence of mood and anxiety disorders in the Hungarian adult population].
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Pharmacological interventions for somatoform disorders in adults
Kleinstäuber, M., Witthöft, M., Steffanowski, A., van Marwijk, H., Hiller, W., & Lambert, M. J. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010628.pub2 · Cited by 11,361 · see citing works
The size and burden of mental disorders and other disorders of the brain in Europe 2010
Wittchen, H. U., Jacobi, F., Rehm, J., Gustavsson, A., Svensson, M., Jönsson, B., Olesen, J., Allgulander, C., Alonso, J., Faravelli, C., et al. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.07.018 · Cited by 3,754 · see citing works
“…conducted by the coordinating center with a restricted set of mental health disorders reported in Table 1, to estimate comorbidity rates, treatment rates, age and gender effects by diagnoses, and to provide an overall estimate of having any disorder (for details, see Wittchen and Jacobi, 2005).”
BackgroundMethodInfluentialSelf-citationClement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015) · Psychological Medicine · doi:10.1017/s0033291714000129 · Cited by 3,152 · see citing works
Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. (2012) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1359 · Cited by 2,947 · see citing works
The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013
Steel, Z., Marnane, C., Iranpour, C., Chey, T., Jackson, J. W., Patel, V., & Silove, D. (2014) · International Journal of Epidemiology · doi:10.1093/ije/dyu038 · Cited by 2,846 · see citing works
Epidemiology of anxiety disorders in the 21st century
Bandelow, B., & Michaelis, S. (2015) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2015.17.3/bbandelow · Cited by 2,079 · see citing works
The global burden of mental disorders: An update from the WHO World Mental Health (WMH) surveys
Kessler, R. C., Aguilar-Gaxiola, S., Alonso, J., Chatterji, S., Lee, S., Ormel, J., Üstün, T. B., & Wang, P. S. (2009) · Epidemiologia e Psichiatria Sociale · doi:10.1017/s1121189x00001421 · Cited by 1,895 · see citing works
Cost of disorders of the brain in Europe 2010
Gustavsson, A., Svensson, M., Jacobi, F., Allgulander, C., Alonso, J., Beghi, E., Dodel, R., Ekman, M., Faravelli, C., Fratiglioni, L., et al. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.08.008 · Cited by 1,723 · see citing works
“In 2005, the European Brain Council published the results of a comprehensive study estimating the cost of disorders of the brain in Europe in 2004 (Andlin-Sobocki et al., 2005; Wittchen and Jacobi, 2005), below called the EBC2005 study.”
Self-citationPrevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis
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“64,65 In interpreting the results, it is important to note that the majority of studies assessed anxiety using self-report instruments that measured anxiety symptoms rather than gold-standard diagnostic clinical interviews for various anxiety disorders.”
BackgroundA mega-analysis of genome-wide association studies for major depressive disorder
Major Depressive Disorder Working Group of the Psychiatric GWAS Consortium, Ripke, S., Wray, N. R., Lewis, C. M., Hamilton, S. P., Weissman, M. M., Breen, G., Byrne, E. M., Blackwood, D. H. R., Boomsma, D. I., et al. (2013) · Molecular Psychiatry · doi:10.1038/mp.2012.21 · Cited by 1,120 · see citing works
Long-term mental health of war-refugees: a systematic literature review
Bogic, M., Njoku, A., & Priebe, S. (2015) · BMC International Health and Human Rights · doi:10.1186/s12914-015-0064-9 · Cited by 1,166 · see citing works
“For example, compared with the general Western adult population [74–76], the review findings of higher quality studies indicate that refugees may be roughly up to 14 times more likely to have depression and 15 times more likely to have PTSD.”
ResultCost of disorders of the brain in Europe
Andlin‐Sobocki, P., Jönsson, B., Wïttchen, H., & Olesen, J. (2005) · European Journal of Neurology · doi:10.1111/j.1468-1331.2005.01202.x · Cited by 1,139 · see citing works
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Risk factors for eating disorders.
Striegel-Moore, R. H., & Bulik, C. M. (2007) · American Psychologist · doi:10.1037/0003-066x.62.3.181 · Cited by 999 · see citing works
Bandelow, B., Zohar, J., Hollander, E., Kasper, S., Möller, H., & WFSBP Task Force on Treatment Guide (2008) · The World Journal of Biological Psychiatry · doi:10.1080/15622970802465807 · Cited by 862 · see citing works
Exercise as a treatment for depression: A meta-analysis
Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.03.063 · Cited by 837 · see citing works
Scale up services for mental disorders: a call for action
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Self-citationSize of burden of schizophrenia and psychotic disorders
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“High levels of co-morbidity are seen between the anxiety disorders, and with major depression [I] (Wittchen and Jacobi, 2005), bipolar disorder [II] (Gaudiano and Miller, 2005; Henry et al.”
BackgroundInfluentialVirtual reality exposure therapy in anxiety disorders: a quantitative meta-analysis
Opriş, D., Pintea, S., García-Palacios, A., Botella, C., Szamosközi, Ş., & David, D. (2012) · Depression and Anxiety · doi:10.1002/da.20910 · Cited by 636 · see citing works
“[42] Choy et al.”
Prevalence and clinical course of depression: a review
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“A similar level of comorbid anxiety with major depression is also found in nonclinical samples (Wittchen & Jacobi, 2005).”
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Prevalence and incidence of Parkinson's disease in Europe
von Campenhausen, S., Bornschein, B., Wick, R., Bötzel, K., Sampaio, C., Poewe, W. H., Oertel, W. H., Siebert, U., Berger, K., & Dodel, R. C. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.007 · Cited by 624 · see citing works
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Unemployment and Substance Use: A Review of the Literature (1990-2010)
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“We need to consider the influence of the diverse sociodemographic structure of the aggregate unemployment in different countries, the occurrence and frequency of long-term unemployment, the general prevalence rates for substance use disorders in the population [57], the potential accessibility of illicit drugs and pre…”
BackgroundJacobi, F., Höfler, M., Siegert, J., Mack, S., Gerschler, A., Scholl, L., Busch, M. A., Hapke, U., Maske, U., Seiffert, I., et al. (2014) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1439 · Cited by 586 · see citing works
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“Depressive disorders can lower the ability to function in work and daily life [4].”
BackgroundCongenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management
Claahsen - van der Grinten, H. L., Speiser, P. W., Ahmed, S. F., Arlt, W., Auchus, R. J., Falhammar, H., Flück, C. E., Guasti, L., Huebner, A., Kortmann, B. B. M., et al. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab016 · Cited by 556 · see citing works
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Oxidative Stress and Anxiety: Relationship and Cellular Pathways
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The role of socio-economic status in depression: results from the COURAGE (aging survey in Europe)
Freeman, A., Tyrovolas, S., Koyanagi, A., Chatterji, S., Leonardi, M., Ayuso‐Mateos, J. L., Tobiasz‐Adamczyk, B., Koskinen, S. V. P., Rummel‐Kluge, C., & Haro, J. M. (2016) · BMC Public Health · doi:10.1186/s12889-016-3638-0 · Cited by 494 · see citing works
“The prevalence of depression varies considerably both within and between countries across Europe [3, 4], which may be a reflection of the role of contextual factors, such as economic, demographic and environmental factors on the development and prevalence of depression [5–9].”
BackgroundJacobi, F., Höfler, M., Strehle, J., Mack, S., Gerschler, A., Scholl, L., Busch, M. A., Maske, U., Hapke, U., Gäebel, W., et al. (2015) · Der Nervenarzt · doi:10.1007/s00115-015-4458-7 · Cited by 457 · see citing works
Self-citationStigma and discrimination limit access to mental health care
Thornicroft, G. (2008) · Epidemiologia e Psichiatria Sociale · doi:10.1017/s1121189x00002621 · Cited by 432 · see citing works
A major role for common genetic variation in anxiety disorders
Purves, K. L., Coleman, J. R. I., Meier, S. M., Rayner, C., Davis, K. A. S., Cheesman, R., Bækvad‐Hansen, M., Børglum, A. D., Cho, S. W., Deckert, J., et al. (2019) · Molecular Psychiatry · doi:10.1038/s41380-019-0559-1 · Cited by 412 · see citing works
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“M AJOR DEPRESSIVE DISORders (MDDs) are considered to be the most frequentlyencountered formofmental illness.(1) The Global Burden of Disease study(2) identified depression as having the third greatest impact intermsofdisability-adjustedlifeyears in Europe and the greatest impact of allphysicalandmentaldiseasesintheAme…”
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“Purchase of antidepressants might not yield results that are comparable to symptoms-based measurements because a substantial proportion of individuals with depression are not treated with antidepressants (4, 48) and antidepressants are also prescribed for other disorders, such as anxiety, sleep disorders, or neuropath…”
InfluentialMental health, health care utilisation of migrants in Europe
Lindert, J., Schouler-Ocak, M., Heinz, A., & Priebe, S. (2008) · European Psychiatry · doi:10.1016/s0924-9338(08)70057-9 · Cited by 373 · see citing works
Size and burden of social phobia in Europe
Fehm, L., Pélissolo, A., Furmark, T., & Wïttchen, H. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.002 · Cited by 375 · see citing works
Prevalence and burden of bipolar disorders in European countries
Pini, S., de Queiroz, V., Pagnin, D., Pezawas, L., Angst, J., Cassano, G. B., & Wïttchen, H. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.011 · Cited by 364 · see citing works
Bipolar Disorder and Violent Crime
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“In Europe 27% of people experience mental illness (all disorders) each year, but 74% receive no treatment [2].”
Boedhoe, P. S. W., Schmaal, L., Abe, Y., Ameis, S. H., Arnold, P. D., Batistuzzo, M. C., Benedetti, F., Beucke, J. C., Bollettini, I., Bose, A., et al. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2016.16020201 · Cited by 335 · see citing works
“Obsessive-compulsive disorder (OCD) is a neurodevelopmental disorder that affects 1%–3% of the population (1, 2).”
Prevalence of dental fear and phobia relative to other fear and phobia subtypes
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Prevalence and comorbidity of common mental disorders in primary care
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Determinants of anxiety in elite athletes: a systematic review and meta-analysis
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Bonabi, H., Müller, M., Ajdacic-Gross, V., Eisele, J., Rodgers, S., Seifritz, E., Rössler, W., & Rüsch, N. (2016) · Journal of Nervous & Mental Disease · doi:10.1097/nmd.0000000000000488 · Cited by 308 · see citing works
“In Europe, approximately 1 in 4 individualswithmental disorders receives appropriate treatment (Wittchen and Jacobi, 2005); in low- and middle-income countries, the number is even smaller (Wang et al., 2007).”
BackgroundBekker, M. H. J., & van Mens-Verhulst, J. (2007) · Gender Medicine · doi:10.1016/s1550-8579(07)80057-x · Cited by 362 · see citing works
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Mack, S., Jacobi, F., Gerschler, A., Strehle, J., Höfler, M., Busch, M. A., Maske, U. E., Hapke, U., Seiffert, I., Gaebel, W., et al. (2014) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1438 · Cited by 284 · see citing works
Self-citationEpidemiology of Anxiety Disorders
Kessler, R. C., Ruscio, A. M., Shear, K., & Wittchen, H.-U. (2009) · Current Topics in Behavioral Neurosciences · doi:10.1007/7854_2009_9 · Cited by 496 · see citing works
Lifetime prevalence of psychiatric disorders in South Africa
Stein, D. J., Seedat, S., HERMAN, A. A. B., Moomal, H., Heeringa, S. G., Kessler, R. C., & Williams, D. R. (2008) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.106.029280 · Cited by 287 · see citing works
Most people with mental illness are not treated
Thornicroft, G. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61392-0 · Cited by 285 · see citing works
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Glantz, M. D., Bharat, C., Degenhardt, L., Sampson, N. A., Scott, K. M., Lim, C. C. W., Al-Hamzawi, A., Alonso, J., Andrade, L. H., Cardoso, G., et al. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2019.106128 · Cited by 272 · see citing works
Geoffroy, P. A., Hoertel, N., Étain, B., Bellivier, F., Delorme, R., Limosin, F., & Peyre, H. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.032 · Cited by 284 · see citing works
“Major Depressive Disorder (MDD) is associated with considerable functional and social impairment (Ustün et al., 2004; Wittchen and Jacobi, 2005) and considered as being the most prevalent psychiatric disorder (Waraich et al., 2004).”
BackgroundSize and burden of depressive disorders in Europe
Paykel, E. S., Brugha, T. S., & Fryers, T. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.008 · Cited by 262 · see citing works
Somatization in the population: from mild bodily misperceptions to disabling symptoms
Hiller, W., Rief, W., & Brähler, E. (2006) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-006-0082-y · Cited by 261 · see citing works
Anxiety: There is an app for that. A systematic review of anxiety apps: SUCALA et al.
Sucala, M., Cuijpers, P., Muench, F., Cardoș, R., Soflau, R., Dobrean, A., Achimas-Cadariu, P., & David, D. (2017) · Depression and Anxiety · doi:10.1002/da.22654 · Cited by 232 · see citing works
“Although numerous effective treatments have been developed, only a minority of individuals suffering from anxiety disorders have access to these treatments (Alonso et al., 2004b; Collins, Westra, Dozois, & Burns, 2004; Weis-berg,Dyck,Culpepper,&Keller,2007;Wittchen&Jacobi,2005;Young, Klap, Shoai, & Wells, 2008).”
BackgroundAalto, A., Elovainio, M. J., Mika Kivimaki, B., Uutela, A. K., & Pirkola, S. P. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.09.008 · Cited by 258 · see citing works
“The prevalence of depression and other psychiatric disorders was comparable to results from other European countries (Pirkola et al., 2005; Wittchen and Jacobi, 2005).”
ResultRiedel, O., Klotsche, J., Spottke, A., Deuschl, G., Förstl, H., Henn, F., Heuser, I., Oertel, W., Reichmann, H., Riederer, P., et al. (2010) · Journal of Neurology · doi:10.1007/s00415-010-5465-z · Cited by 256 · see citing works
“Similarly, the estimated frequency of depression in our study was twice as high as reported in a review by Wittchen and Jacobi [38] in the European general population and still substantially higher than among people aged C65 years [35], though the prevalence rates are usually more heterogenous in this age-group.”
ResultAlonso, J., Burón, A., Bruffaerts, R., He, Y., Posada-Villa, J., Lépine, J. P., Angermeyer, M. C., Levinson, D., de Girolamo, G., Tachimori, H., et al. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01241.x · Cited by 244 · see citing works
The epidemiology of panic disorder and agoraphobia in Europe
Goodwin, R. D., Faravelli, C., Rosi, S., Cosci, F., Truglia, E., de Graaf, R., & Wïttchen, H. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.006 · Cited by 243 · see citing works
Sartori, S. B., & Singewald, N. (2019) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2019.107402 · Cited by 236 · see citing works
Martini, J., Knappe, S., Beesdo-Baum, K., Lieb, R., & Wittchen, H.-U. (2010) · Early Human Development · doi:10.1016/j.earlhumdev.2010.04.004 · Cited by 236 · see citing works
“During fertile age, DSM-IV anxiety disorders arewidespread (12-month prevalence inwomen aged 18–34: 17%, CI: 14%–20%) [14].”
BackgroundHarvey, A. G., & Gumport, N. B. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.02.004 · Cited by 221 · see citing works
“In the analysis of 16 European countries, only 26% of all cases had any consultation with professional health care services (Wittchen & Jacobi, 2005).”
BackgroundDomhardt, M., Geßlein, H., von Rezori, R. E., & Baumeister, H. (2019) · Depression and Anxiety · doi:10.1002/da.22860 · Cited by 218 · see citing works
Prevalence of dementia in the elderly in Europe
Berr, C., Wancata, J., & Ritchie, K. A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.003 · Cited by 233 · see citing works
Mental Disorders Following War in the Balkans
Priebe, S., Bogić, M., Ajduković, D., Frančišković, T., Galeazzi, G. M., Kučukalić, A., Lečić‐Toševski, D., Nexhmedin Morina, B., Popovski, M., Wang, D., et al. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.37 · Cited by 246 · see citing works
Mindfulness-based cognitive therapy: evaluating current evidence and informing future research
Coelho, H. F., Canter, P. H., & Ernst, E. (2007) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.75.6.1000 · Cited by 227 · see citing works
Revealing Real-Time Emotional Responses: a Personalized Assessment based on Heartbeat Dynamics
Valenza, G., Citi, L., Lanatá, A., Scilingo, E., & Barbieri, R. (2014) · Scientific Reports · doi:10.1038/srep04998 · Cited by 245 · see citing works
Escitalopram Therapy for Major Depression and Anxiety Disorders
Baldwin, D. S., Reines, E. H., Guiton, C., & Weiller, E. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k089 · Cited by 228 · see citing works
Culture and the anxiety disorders: recommendations for DSM-V
Lewis‐Fernández, R., Hinton, D. E., Laria, A. J., Patterson, E. H., Hofmann, S. G., Craske, M. G., Stein, D. J., Asnaani, A., & Liao, B. (2009) · Depression and Anxiety · doi:10.1002/da.20647 · Cited by 227 · see citing works
“2%, more similar to US surveys.([7]) In one study, not a single Mapuche Indian met lifetime DSM-III-R PD criteria, despite the fact that 1.”
InfluentialThe epidemiology of generalized anxiety disorder in Europe
Lieb, R., Becker, E. S., & Altamura, C. A. (2005) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2005.04.010 · Cited by 227 · see citing works
The epidemiology of multiple somatic symptoms
Creed, F. H., Davies, I., Jackson, J., Littlewood, A., Chew-Graham, C. A., Tomenson, B., Macfarlane, G. J., BARSKY, A. J., Katon, W. J., & McBeth, J. (2012) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.01.009 · Cited by 224 · see citing works
Donohue, J. M., & Pincus, H. A. (2007) · PharmacoEconomics · doi:10.2165/00019053-200725010-00003 · Cited by 214 · see citing works
Kindler, S., Samietz, S., Houshmand, M., Grabe, H. J., Bernhardt, O., Biffar, R., Kocher, T., Meyer, G. F., Völzke, H., Metelmann, H., et al. (2012) · Journal of Pain · doi:10.1016/j.jpain.2012.09.004 · Cited by 212 · see citing works
The size, burden and cost of disorders of the brain in the UK
Fineberg, N. A., Haddad, P. M., Carpenter, L., Gannon, B., Sharpe, R., Young, A. H., Joyce, E. M., Rowe, J. B., Wellsted, D. M., Nutt, D., et al. (2013) · Journal of Psychopharmacology · doi:10.1177/0269881113495118 · Cited by 213 · see citing works
“Mental and neurological illness data derived from 30 European countries, including the UK, were used to calculate and estimate the patterns and costs of treatment and the health economic implications in terms of total direct and indirect costs for EU nations (Andlin-Sobocki et al., 2005; Wittchen and Jacobi, 2005).”
BackgroundMethodInfluentialA pilot study of aerobic exercise as an adjunctive treatment for drug dependence
Brown, R. A., Abrantes, A. M., Read, J. P., Marcus, B. H., Jakicic, J. M., Strong, D. R., Oakley, J. R., Ramsey, S. E., Kahler, C. W., Stuart, G. L., et al. (2010) · Mental health and physical activity · doi:10.1016/j.mhpa.2010.03.001 · Cited by 213 · see citing works
“Epidemiological data from 27 community studies in European countries reveal a 12-month prevalence rate for any substance dependence of 3.4% of the adult population (Wittchen & Jacobi, 2005).”
BackgroundInfluentialRelevance of Stress and Female Sex Hormones for Emotion and Cognition
ter Horst, J. P., de Kloet, E. R., Schächinger, H., & Oitzl, M. S. (2011) · Cellular and Molecular Neurobiology · doi:10.1007/s10571-011-9774-2 · Cited by 212 · see citing works
“Epidemiological studies revealed that mood disorders are at least twice as common in women as in men (Kessler 2003; Lewinsohn et al. 1998; Steiner et al. 2003; Wittchen and Jacobi 2005).”
BackgroundVeale, D., & Roberts, A. (2014) · British medical journal · doi:10.1136/bmj.g2183 · Cited by 153 · see citing works
Animal models for depression and the mismatch hypothesis of disease
Schmidt, M. V. (2010) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2010.07.001 · Cited by 204 · see citing works
“4 million people in Europe suffer from depression, which has a life time prevalence of up to 20% (Wittchen and Jacobi, 2005).”
Background(2012) · doi:10.1787/9789264124523-en · Cited by 490 · see citing works
Stapinski, L. A., Bowes, L., Dieter Wolke, C., Pearson, R. M., Mahedy, L., Button, K. S., Lewis, G., & Araya, R. (2014) · Depression and Anxiety · doi:10.1002/da.22270 · Cited by 202 · see citing works
“[2,3] Early preventative interventions have the potential to greatly reduce the burden of these disorders at the societal level and alleviate suffering at the individual level.”
BackgroundThe effects of shift work on physical and mental health
Vogel, M., Braungardt, T., Meyer, W. T., & Schneider, W. (2012) · Journal of Neural Transmission · doi:10.1007/s00702-012-0800-4 · Cited by 198 · see citing works
“Over the last decades, the prevalence of psychiatric and psychosomatic disorders has continuously risen (Wittchen and Jacobi 2005).”
BackgroundPrevalence of mental disorders based on general population surveys
Baumeister, H., & Härter, M. C. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0204-1 · Cited by 200 · see citing works
Epidemiology of Major Depressive Disorder in Mainland China: A Systematic Review
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Is atopic disease a risk factor for attention‐deficit/hyperactivity disorder? A systematic review
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The Cost of Brain Diseases: A Burden or a Challenge?
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The erring brain: Error‐related negativity as an endophenotype for OCD—A review and meta‐analysis
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Early life stress paradigms in rodents: potential animal models of depression?
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“Life time prevalence of depression was reported to range between 15% and 20%, with a twice-ashigh risk for women than for men (Kendler et al. 2002; Wittchen and Jacobi 2005).”
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The association of air pollution and depressed mood in 70,928 individuals from four European cohorts
Zijlema, W. L., Wolf, K., Emeny, R. T., Ladwig, K., Peters, A., Kongsgård, H. W., Hveem, K., Kvaløy, K., Yli‐Tuomi, T., Partonen, T., et al. (2015) · International Journal of Hygiene and Environmental Health · doi:10.1016/j.ijheh.2015.11.006 · Cited by 172 · see citing works
Lintvedt, O. K., Griffiths, K. M., Sørensen, K., Østvik, A. R., Wang, C. E. A., Eisemann, M., & Waterloo, K. (2013) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.770 · Cited by 157 · see citing works
- Authors
- Wittchen, H.-U., & Jacobi, F.
- Affiliations
- Max Planck Institute of Psychiatry (DE)
- ORCID
- Jacobi, Frank
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2005-08
- Volume
- 15
- Issue
- 4
- Pages
- 357-376
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2107900025
- Cited by
- 1,503
- References
- 140
- Citations by year
- 2026: 14 · 2025: 31 · 2024: 43 · 2023: 64 · 2022: 48 · 2021: 46 · 2020: 57 · 2019: 58 · 2018: 64 · 2017: 75 · 2016: 83 · 2015: 84 · 2014: 103 · 2013: 110 · 2012: 121
- FWCI
- 96.18
- Type
- journal article
- Language
- en
- Open access
- green
- tud.qucosa.de
- Licence
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- mental illness, prevalence, disability burden, treatment utilization, unmet needs, comorbidities, anxiety disorders, depression, somatoform disorders, substance dependence, lost workdays, European Union, cross-national comparison, adolescent mental health, older adults
- MeSH terms
- Absenteeism, Adolescent, Adult, Age Factors, Aged, Mental Disorders, Disability Evaluation, Europe, Female, Humans, Male, Mental Health Services, Middle Aged, Quality of Life, Residence Characteristics, Review Literature as Topic, Sex Factors, Comorbidity, Prevalence, Cost of Illness, Diagnosis, Dual (Psychiatry), Quality-Adjusted Life Years
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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