Cited by 1,485Mental Health Treatment and AccessTreatment of Major DepressionChild and Adolescent Psychosocial and Emotional Development

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The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey

Dan German Blazer, Ronald C. Kessler, Katherine A. McGonagle, Marvin S. Swartz·1994·American Journal of Psychiatry

DOI 10.1176/ajp.151.7.979

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Abstract

OBJECTIVE: Major depression is a frequent and disabling psychiatric disorder in the United States. This report examines the prevalence and risk factor profile of both pure and comorbid major depression according to data from the National Comorbidity Survey. METHOD: To estimate the prevalence of psychiatric comorbidity in the United States, a national sample of 8,098 persons 15-54 years of age from the 48 conterminous states was surveyed with a modified version of the Composite International Diagnostic Interview. RESULTS: From the survey data the prevalence of current (30-day) major depression was estimated to be 4.9%, with a relatively higher prevalence in females, young adults, and persons with less than a college education. The prevalence estimate for lifetime major depression was 17.1%, with a similar demographic distribution. Both 30-day and lifetime prevalence estimates were higher than estimates from the earlier Epidemiologic Catchment Area study. When pure major depression was compared with major depression co-occurring with other psychiatric disorders, the risk factor profiles exhibited clear differences. CONCLUSIONS: These findings suggest a greater burden of major depression in community-dwelling persons than has been estimated from previous community samples. The risk factor profile showed significant differences between persons with pure and combined major depression.

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BackgroundMethod
Increased symptoms of attention deficit hyperactivity disorder and major depressive disorder symptoms in nail‐patella syndrome: Potential association with LMX1B loss‐of‐function
López‐Arvizu, C., Sparrow, E. P., Strube, M., Slavin, C., DeOleo, C., James, J., Hoover-Fong, J. E., McIntosh, I., & Tierney, E. (2010) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.31138 · Cited by 26
“MDD has reported a 30-day prevalence of 4.9% (based on community surveys in the U.S.A.) [Blazer et al., 1994] and a 12-month prevalence of 6.6% [Kessler et al., 2003].”
BackgroundInfluential
Psychosomatic disorders in pregnancy
Tam, W. H., & Chung, T. K. H. (2007) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e3280825614 · Cited by 24
Race/Ethnicity and Other Social Determinants of Psychological Well-being and Functioning in Mental Health Clinics
Chang, T. E., Weiss, A. P., Marques, L. M., Baer, L., Vogeli, C., Trinh, N., Clain, A. J., Blais, M. A., D, M. F. M., & Yeung, A. (2014) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2014.0138 · Cited by 24
Sociodemographic and Health Related Factors Associated with Poor Mental Health in Midlife Australian Women
Outram, S., Mishra, G. D., & Schofield, M. J. (2004) · Women & Health · doi:10.1300/j013v39n04_06 · Cited by 24
“Lower educational levels and not being in the paid workforce (ie home duties, unemployed and looking for work) signficantly predicted poor mental health, consistent with previous research (Blazer et al, 1994; Williams, McGee et al 1997; Australian Bureau of Statistics, 1998).”
Result
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Wong, W. S., Chen, P. P., Yap, J., Mak, K. H., Tam, B. K. H., & Fielding, R. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.04.012 · Cited by 24
Translating comparative effectiveness of depression medications into practice by comparing the depression medication choice decision aid to usual care: study protocol for a randomized controlled trial
LeBlanc, A., Bodde, A. E., Branda, M. E., Yost, K. J., Herrin, J. S., Williams, M. D., Shah, N. D., Houten, H. V., Ruud, K. L., Pencille, L. J., et al. (2013) · Trials · doi:10.1186/1745-6215-14-127 · Cited by 24
“Despite a lifetime prevalence of 17%, depression is often undetected and suboptimally managed, particularly in primary care where 80% of patients with depression receive care and 75% of antidepressant prescriptions are provided [2,3].”
Background
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Mittendorfer‐Rutz, E. (2006) · The Journal of Men s Health and Gender · doi:10.1016/j.jmhg.2006.02.006 · Cited by 24
Primary care options to prevent mental illness
Kendrick, T. (1999) · Annals of Medicine · doi:10.3109/07853899908998792 · Cited by 23
Regulation of Inositol Biosynthesis: Balancing Health and Pathophysiology
Case, K. C., Salsaa, M., Yu, W., & Greenberg, M. L. (2018) · Handbook of experimental pharmacology · doi:10.1007/164_2018_181 · Cited by 22
Characteristics of Poststroke Depression in Japanese Patients
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Rueda-Jaimes, G. E., Camacho, P. A., Latorre, J. F., Navarro-Mancilla, Á. A., Escobar, M., & Franco, J. A. (2009) · Biomédica · doi:10.7705/biomedica.v29i2.28 · Cited by 23
Comparisons of prevalence and related factors of depression in middle-aged adults between urban and rural populations in Japan
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Epidemiology of mood disorders
Joyce, P. R. (2012) · doi:10.1093/med/9780199696758.003.0086 · Cited by 23
Age-related associations between psychological characteristics and pain intensity among Japanese patients with temporomandibular disorder
Komiyama, O., Obara, R., Iida, T., Nishimura, H., Okubo, M., Uchida, T., Shimosaka, M., Narita, N., Niwa, H., Kubo, H., et al. (2014) · Journal of Oral Science · doi:10.2334/josnusd.56.221 · Cited by 23
“For the purpose of comparison, the patients were classified into six age groups: 15 to 24, 25 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 to 85 years (Groups A through F, respectively), as in a previous study (9,10).”
Method
Illicit Drug Use From Adolescence to Young Adulthood Among Child Welfare-Involved Youths
Casanueva, C. E., Stambaugh, L. F., Urato, M. P., Fraser, J. G., & Williams, J. G. (2013) · Journal of Child & Adolescent Substance Abuse · doi:10.1080/1067828x.2012.735514 · Cited by 22
Is inflammation a new risk factor of depression in haemodialysis patients?
Nowak, Ł. R., Adamczak, M., & Więcek, A. (2012) · International Urology and Nephrology · doi:10.1007/s11255-012-0269-y · Cited by 23
“and reported prevalence of depression in ESRD patients is much higher than in general population [2], did not change over time [3–9] and is the most common psychiatric disorder in this group of patients [10].”
Background
Maternal depressive symptoms as a predictor of alcohol use onset and heavy episodic drinking in youths.
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Gender and Depression: Explaining the Different Rates of Depression Between Men and Women
Murakumi, J. (2002) · Cited by 22
Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6) in a nationally representative sample of US adults
Tomitaka, S., Kawasaki, Y., Ide, K., Akutagawa, M., Yamada, H., Ono, Y., & Furukawa, T. A. (2017) · PeerJ · doi:10.7717/peerj.2987 · Cited by 22
“Because depressive symptomology (number and chronicity) form the basis of a diagnosis of clinical depression, there is considerable interest in understanding the distribution of depressive symptoms in the general population (Blazer & Kessler, 1994; Kroenke et al., 2009).”
Background
Course and Predictors of Major Depressive Disorder in the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey: Cours et Prédicteurs du Trouble de Dépression Majeure Dans l’Enquête de Suivi Sur la Santé Mentale Auprès Des Membres des Forces Armées Canadiennes et des ex-Militaires
Enns, M. W., Mota, N. P., Afifi, T. O., Bolton, J. M., Richardson, J. A., Patten, S. B., & Sareen, J. (2021) · The Canadian Journal of Psychiatry · doi:10.1177/0706743720984677 · Cited by 22
Introduction
Dobson, K. S., & Dozois, D. J. A. (2008) · Elsevier eBooks · doi:10.1016/b978-0-08-045078-0.00001-0 · Cited by 23
The History and Timing of Depression Onset as Predictors of Young Adult Self-Esteem
Gayman, M. D., Lloyd, D. A., & Ueno, K. (2010) · Journal of Research on Adolescence · doi:10.1111/j.1532-7795.2010.00702.x · Cited by 22
The serotonin transporter 5‐HTTPR polymorphism is associated with current and lifetime depression in persons with chronic psychotic disorders
Contreras, J., Hare, L., Camarena, B., Glahn, D. C., Dassori, A. M., Medina, R., Contreras, S. A., Ramirez, M., Armas, R., MUNOZ, R. A., et al. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01273.x · Cited by 22
“In terms of current depression, the rates are still above most epidemiologic reports culled from the general population (48).”
White Matter Changes in Depression and Alzheimer's Disease: A Review of Magnetic Resonance Imaging Studies
O'Brien, J. T., Ames, D. J., & SCHWIETZER, I. (1996) · International Journal of Geriatric Psychiatry · doi:10.1002/(sici)1099-1166(199608)11:8 · Cited by 73
Depression in Female Adolescents: An IPA Analysis
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Youth depression alleviation: the Fish Oil Youth Depression Study ( YoDA ‐F): A randomized, double‐blind, placebo‐controlled treatment trial
Rice, S., Hickie, I. B., Yung, A. R., Mackinnon, A. J., Berk, M., Davey, C. G., Hermens, D. F., Hetrick, S. E., Parker, A. G., Schäfer, M. R., et al. (2014) · Early Intervention in Psychiatry · doi:10.1111/eip.12166 · Cited by 24
Depression and Health-related Quality of Life for Low-income African-American Women in the U.S.
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“In one study of poor, ethnically diverse women (44% Latina and 30% AfricanAmerican) who were uninsured or receiving public medical benefits, 22% of the womenmet criteria for current Major Depression [4].”
Background
Urban-Rural Differences in Major Mental Health Conditions
Solmi, F., Dykxhoorn, J. L., & Kirkbride, J. B. (2016) · Mental health and illness worldwide · doi:10.1007/978-981-10-0752-1_7-1 · Cited by 21
“…difference in the distribution of anxiety & mood disorders between urban & non- urban areas Age, sex, ethnicity, education, marital status, region Blazer et al (1994) USA 132 Major depression DSM-III-R (1-month prevalence) CIDI N = 8.098 Age 15-54 Degree of urbanisation At time of survey No…”
BackgroundInfluential
Autonomic control of bone formation
Ji-ye, H., Xin-Feng, Z., & Jiang, L. (2013) · Handbook of clinical neurology · doi:10.1016/b978-0-444-53491-0.00014-6 · Cited by 21
Perception of Health, Suicidal Ideation, and Suicide Attempt Among Adults in the Community
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The profile and familiality of personality traits in mood disorder families
Wu, P.-J., Chang, S., Lu, M.-K., Chen, W. J., Yang, Y. K., Tzung-LiehYeh, Liao, S.-C., Lu, R., & Kuo, P. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.01.015 · Cited by 21

Authors: Blazer, D. G., Kessler, R. C., McGonagle, K. A., & Swartz, M. S.
Affiliations: Duke Medical Center (US)
ORCID: Dan German Blazer
Ronald C. Kessler
Marvin S. Swartz
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 1994-07-01
Volume: 151
Issue: 7
Pages: 979-986
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/ajp.151.7.979
OpenAlex: W2181560023
Cited by: 1,485
References: 24
Citations by year: 2026: 7 · 2025: 11 · 2024: 20 · 2023: 17 · 2022: 20 · 2021: 16 · 2020: 26 · 2019: 33 · 2018: 38 · 2017: 42 · 2016: 50 · 2015: 49 · 2014: 57 · 2013: 71 · 2012: 57
FWCI: 39.36
Type: journal article
Language: en
Open access: closed
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Mental Health (R01MH046376, NIMH MH-00507, MH 46376)
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 › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: major depressive disorder, prevalence, psychiatric comorbidity, risk factors, lifetime prevalence, community-dwelling adults, sex differences, young adults, educational attainment, National Comorbidity Survey
MeSH terms: Adolescent, Adult, Age Factors, Mental Disorders, Depressive Disorder, Educational Status, Female, Health Surveys, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Sex Factors, United States, Comorbidity, Prevalence

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The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey

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