Prevalence, comorbidity, disability and service utilisation: Overview of the Australian National Mental Health Survey
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Background: Health planning should be based on data about prevalence, disability and services used. Aims: To determine the prevalence of ICD–10 disorders and associated comorbidity, disability and service utilisation. Method: We surveyed a national probability sample of Australian households using the Composite International Diagnostic Interview and other measures. Results: The sample size was 10 641 adults, response rate 78%. Close to 23% reported at least one disorder in the past 12 months and 14% a current disorder. Comorbidity was associated with disability and service use. Only 35% of people with a mental disorder in the 12 months prior to the survey had consulted for a mental problem during that year, and most had seen a general practitioner. Only half of those who were disabled or had multiple comorbidity had consulted and of those who had not, more than half said they did not need treatment. Conclusions: The high rate of not consulting among those with disability and comorbidity is an important public health problem. As Australia has a universal health insurance scheme, the barriers to effective care must be patient knowledge and physician competence.
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Social anxiety disorder is one of the early or premature anxiety disorders (Andrews et al., 2001; McEvoy et al., 2011).
“Social anxiety disorder is one of the early or premature anxiety disorders (Andrews, Henderson, & Hall, 2001; McEvoy, Grove, & Slade, 2011).”
From Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problemsand Psychological Flexibility in Female High School Students With Social Anxiety Disorder (2015) · cites this paper as Andrews, Henderson, & Hall, 2001
The Assessment section lists social phobia among the anxiety disorders studied. But neither that section nor the passages on prevalence and chronicity establish that it begins early in life; searches for age of onset and early onset did not find support for that part of the claim. (LLM, conf=0.81)
Experimental — accuracy not yet measuredSocial anxiety disorder is one of the most common disorders among chronic psychological disorders (Andrews et al., 2001; McEvoy et al., 2011).
“It is one of the most common disorders among chronic psychological disorders (Andrews, Henderson, & Hall, 2001; McEvoy, Grove, & Slade, 2011)”
From Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problemsand Psychological Flexibility in Female High School Students With Social Anxiety Disorder (2015) · cites this paper as Andrews, Henderson, & Hall, 2001
Table 1 reports social phobia in 2.7% of the surveyed population over 12 months, placing it among the more prevalent individual disorders measured. The Chronicity section reports only that anxiety disorders as a group occupy the middle ground for chronicity; it does not establish that social anxiety disorder is one of the most common chronic disorders. (LLM, conf=0.78)
Experimental — accuracy not yet measuredStudies consistently show high comorbidity between mental disorders.
“Furthermore, studies consistently show high comorbidity between mental disorders [4–6].”
From Using person-specific networks in psychotherapy: challenges, limitations, and how we could use them anyway (2020) · cites this paper as [4]
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Influentialvan Straten, A., Cuijpers, P., & Smits, N. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.954 · Cited by 297 · see citing works
“Web-based self-help may be an effective and inexpensive alternative to more traditional therapies, especially since the majority of persons in the general population with a mental health disorder (an estimated 65%) do not receive help from any professional mental health services [9,10].”
BackgroundKenny, D., Driscoll, T., & Ackermann, B. (2014) · Psychology of Music · doi:10.1177/0305735612463950 · Cited by 309 · see citing works
Te Rau Hinengaro: The New Zealand Mental Health Survey
Browne, M. A. O., Wells, J. E., Scott, K. M., Kessler, R. C., & Üstün, T. B. (2008) · Cited by 295 · see citing works
Psychiatric Morbidity Following Injury
O'Donnell, M. L., Creamer, M. C., Pattison, P. E., & Atkin, C. (2004) · American Journal of Psychiatry · doi:10.1176/appi.ajp.161.3.507 · Cited by 306 · see citing works
Population level of unmet need for mental healthcare in Europe
Alonso, J., Codony, M., Kovess, V., Angermeyer, M. C., Katz, S. J., Haro, J. M., De Girolamo, G., De Graaf, R., Demyttenaere, K., Vilagut, G., et al. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.022004 · Cited by 299 · see citing works
Wrigley, S., Jackson, H. J., Judd, F. K., & Komiti, A. (2005) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2005.01612.x · Cited by 298 · see citing works
Clinician-Assisted Internet-Based Treatment is Effective for Panic: A Randomized Controlled Trial
Wims, E., Titov, N., Andrews, G., & Choi, I. (2010) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048671003614171 · Cited by 290 · see citing works
Self-citationOrmel, J., Raven, D., van Oort, F., Hartman, C. A., Reijneveld, S. A., Veenstra, R., Vollebergh, W. A. M., Buitelaar, J., Verhulst, F. C., & Oldehinkel, A. J. (2015) · Psychological Medicine · doi:10.1017/s0033291714001469 · Cited by 276 · see citing works
“…concentration of morbidity is important because studies in adult populations suggest that in particular multimorbidity (53 lifetime disorders) is associated with high levels of disability and service use (e.g. Kessler et al. 1994; Jenkins et al. 1997; Andrews et al. 2001; Jacobi et al. 2004).”
BackgroundThe prospective course of postconcussion syndrome: The role of mild traumatic brain injury.
Meares, S., Shores, E. A., Taylor, A., Batchelor, J., Bryant, R. A., Baguley, I. J., Chapman, J., Gurka, J. A., & Marosszeky, J. E. (2011) · Neuropsychology · doi:10.1037/a0022580 · Cited by 293 · see citing works
“, 2010; O’Donnell, Creamer, Pattison, & Atkin, 2004), there was a high rate of pre-injury and post-injury psychiatric disorder in mTBI and trauma controls in comparison to Australian population controls (Andrews et al., 2001).”
ResultPsychological well-being and psychological distress: is it necessary to measure both?
Winefield, H. R., Gill, T. K., Taylor, A. W., & Pilkington, R. M. (2012) · Psychology of Well-Being Theory Research and Practice · doi:10.1186/2211-1522-2-3 · Cited by 292 · see citing works
“The national mental health survey in Australia established strong links between mental disorders such as anxiety and depression and the likelihood of being disabled in carrying out usual activities (Andrews et al. 2001; Dear et al. 2002).”
BackgroundMobile mental health: Review of the emerging field and proof of concept study
Harrison, V., Proudfoot, J., Wee, P. P., Parker, G., Pavlovic, D. H., & Manicavasagar, V. (2011) · Journal of Mental Health · doi:10.3109/09638237.2011.608746 · Cited by 267 · see citing works
“They are both highly prevalent and disabling (Andrews et al., 2001; Andrews & Titov, 2007), yet only a minority of people seek professional help for these conditions (Australian Bureau of Statistics [ABS], 2007; Wang et al., 2002).”
BackgroundDarves‐Bornoz, J., Alonso, J., de Girolamo, G., de Graaf, R., Haro, J. M., Kovess–Masféty, V., Lépine, J., Nachbaur, G., Nègre‐Pagès, L., Vilagut, G., et al. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20357 · Cited by 284 · see citing works
Prinz, U., Nutzinger, D. O., Schulz, H., Petermann, F., Braukhaus, C., & Andreas, S. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-104 · Cited by 278 · see citing works
“Empirical data from health surveys have shown that the prevalence rate of affective disorders ranges from 6.6% [13] to 11.9% [14].”
InfluentialPrevalence of parental mental illness in Australian families
Maybery, D. J., Reupert, A., Patrick, K., Goodyear, M. J., & Crase, L. (2009) · Psychiatric Bulletin · doi:10.1192/pb.bp.107.018861 · Cited by 278 · see citing works
Kay‐Lambkin, F. J., Baker, A. L., Lewin, T. J., & Carr, V. J. (2009) · Addiction · doi:10.1111/j.1360-0443.2008.02444.x · Cited by 269 · see citing works
Beals, J. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.1.99 · Cited by 276 · see citing works
Prins, M. A., Verhaak, P. F. M., Bensing, J. M., & van der Meer, K. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2008.02.009 · Cited by 271 · see citing works
Public beliefs about treatment and outcome of mental disorders: a comparison of Australia and Japan
Jorm, A. F., Nakane, Y., Christensen, H. M., Yoshioka, K., Griffiths, K. M., & Wata, Y. (2005) · BMC Medicine · doi:10.1186/1741-7015-3-12 · Cited by 264 · see citing works
“A change in such beliefs may help improve the comparatively low rate of help-seeking observed in a 1997 survey of the Australian public [ 25 ].”
BackgroundShould depression be managed as a chronic disease?
Andrews, G. (2001) · BMJ · doi:10.1136/bmj.322.7283.419 · Cited by 259 · see citing works
Self-citationComorbidity of internalizing disorders in children with oppositional defiant disorder
Boylan, K., Vaillancourt, T., Boyle, M., & Szatmári, P. (2007) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-007-0624-1 · Cited by 257 · see citing works
“The phenomenon of higher rates of ODD in clinical samples is well described in the literature and likely occurs because of characteristics of clinical samples including higher base rates of behaviour disorder and functional impairment of the child and family upon referral [3, 50].”
BackgroundThompson, A., Hunt, C., & Issakidis, C. (2004) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-004-0816-7 · Cited by 253 · see citing works
Comparison of two self-rating scales to detect depression: HADS and PHQ-9
Hansson, M., Chotai, J., Nordstöm, A., & Bodlund, O. (2009) · British Journal of General Practice · doi:10.3399/bjgp09x454070 · Cited by 246 · see citing works
Prevalence of anxiety disorders among adults seeking speech therapy for stuttering
Iverach, L., O’Brian, S., Jones, M., Block, S., Lincoln, M., Harrison, E., Hewat, S., Menzies, R. G., Packman, A., & Onslow, M. (2009) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.06.003 · Cited by 255 · see citing works
Andrews, G., Bell, C., Boyce, P., Gale, C., Lampe, L., Marwat, O., Rapee, R., & Wilkins, G. (2018) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867418799453 · Cited by 243 · see citing works
“Approximately half of these adults report that they have experienced GAD in the past year, an indication of how chronic the condition is (Andrews et al., 2001; Hunt et al., 2002; Oakley Browne et al., 2006; Slade et al., 2009a).”
BackgroundSelf-citationSuicide and mental health in rural, remote and metropolitan areas in Australia
Caldwell, T. M., Jorm, A. F., & Dear, K. B. G. (2004) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2004.tb06348.x · Cited by 241 · see citing works
Depression and violence: a Swedish population study
Fazel, S., Wolf, A., Chang, Z., Larsson, H., Goodwin, G. M., & Lichtenstein, P. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(14)00128-x · Cited by 245 · see citing works
Afterword: Against “global mental health”
Summerfield, D. A. (2012) · Transcultural Psychiatry · doi:10.1177/1363461512454701 · Cited by 246 · see citing works
Mitchison, D., & Mond, J. (2015) · Journal of Eating Disorders · doi:10.1186/s40337-015-0058-y · Cited by 243 · see citing works
“, [8-10]), or their inclusion is limited to anorexia nervosa (AN) and/or bulimia nervosa (BN; e.”
Prevalence and correlates of DSM-IV major depression in an Australian national survey
Wilhelm, K. A., Mitchell, P. B., Slade, T. N., Brownhill, S., & Andrews, G. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00040-x · Cited by 243 · see citing works
Self-citationClinician-Assisted Internet-Based Treatment is Effective for Depression: Randomized Controlled Trial
Perini, S., Titov, N., & Andrews, G. (2009) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670902873722 · Cited by 231 · see citing works
Self-citationMental Disorders in Australian Prisoners: a Comparison with a Community Sample
Butler, T. G., Andrews, G., Allnutt, S. H., Sakashita, C., Smith, N. E., & Basson, J. V. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2006.01785.x · Cited by 233 · see citing works
Self-citationMcTernan, W. P., Dollard, M. F., & LaMontagne, A. D. (2013) · Work & Stress · doi:10.1080/02678373.2013.846948 · Cited by 233 · see citing works
Functional Impact and Health Utility of Anxiety Disorders in Primary Care Outpatients
Stein, M. B., Roy‐Byrne, P., Craske, M. G., Bystritsky, A., Sullivan, G., Pyne, J. M., Katon, W. J., & Sherbourne, C. D. (2005) · Medical Care · doi:10.1097/01.mlr.0000185750.18119.fd · Cited by 235 · see citing works
“2 Whether viewed from a community 3,4 or from a clinical perspective, 5 anxiety disorders are associated with substantial disability and reduced well-being.”
Teesson, M., Hall, W., Slade, T. N., Mills, K. L., Grove, R., Mewton, L. R., Baillie, A., & Haber, P. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.03096.x · Cited by 233 · see citing works
Self-citationCulture 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
Titov, N., Andrews, G., Choi, I., Schwencke, G., & Mahoney, A. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802512107 · Cited by 221 · see citing works
“High prevalence disorders such as anxiety and depression result in considerable disability [1,2] but can be treated effectively with cognitive behavioural therapy (CBT) [3 5].”
BackgroundSelf-citationChapter 20 Psychiatric Comorbidities in Epilepsy
LaFrance, W. C., Jr., Kanner, A. M., & Hermann, B. P. (2008) · International review of neurobiology · doi:10.1016/s0074-7742(08)00020-2 · Cited by 225 · see citing works
“Because of stigmatizing attitudes, patients may avoid or delay medical care and treatment for their mental health problems (Andrews et al., 2001).”
BackgroundDissociative identity disorder: An empirical overview
Dorahy, M. J., Brand, B. L., Şar, V., Krüger, C., Stavropoulos, P., Martínez-Taboas, A., Lewis-Fernández, R., & Middleton, W. (2014) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867414527523 · Cited by 225 · see citing works
“may account for the lack of DID data from large-scale community-based epidemiological studies (Andrews et al., 2001; Bijl et al., 1998).”
BackgroundMental health and school dropout across educational levels and genders: a 4.8-year follow-up study
Hjorth, C. F., Villumsen, L. B., Frandsen, L. S., Overgaard, C., Torp-Pedersen, C. T., Nielsen, B. J., & Bøggild, H. (2016) · BMC Public Health · doi:10.1186/s12889-016-3622-8 · Cited by 220 · see citing works
“Even though evidence supports that the MCS-score is a valid measure when studying psychiatric conditions as depression [47–49], bipolar disorders [50], anxiety [47] and severe mental illness [48] across groups in the general population, only moderate evidence are found for use regarding substance abuse and personality…”
Kruijshaar, M. E., Barendregt, J. J., Vos, T., de Graaf, R., Spijker, J., & Andrews, G. (2005) · European Journal of Epidemiology · doi:10.1007/s10654-004-1009-0 · Cited by 216 · see citing works
“In this study we indirectly estimate the lifetime prevalence of MD on data from the Australian Adult Mental Health and Wellbeing Survey [9] and the Netherlands Mental Health Survey and Incidence Study (NEMESIS) [10].”
MethodSelf-citationEpidemiology of dissociative disorders: An overview
Sar, V. (2011) · Epidemiology Research International · doi:10.1155/2011/404538 · Cited by 212 · see citing works
“Thus, many large scale general psychiatric epidemiological studies using general psychiatric instruments failed to catch dissociative disorders appropriately and have led to biased reports in this context [16–18].”
BackgroundHansson, L. I., Jormfeldt, H., Svedberg, P., & Svensson, B. (2011) · International Journal of Social Psychiatry · doi:10.1177/0020764011423176 · Cited by 215 · see citing works
Wiegner, L., Hange, D., Björkelund, C., & Ahlborg, G. (2015) · BMC Family Practice · doi:10.1186/s12875-015-0252-7 · Cited by 216 · see citing works
- Authors
- Andrews, G., Henderson, S., & Hall, W.
- Affiliations
- UNSW Sydney (AU)
- Australian National University (AU)
- Corresponding author
- Andrews, Gavin
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2001-02
- Volume
- 178
- Issue
- 2
- Pages
- 145-153
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2147496214
- Cited by
- 933
- References
- 28
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 11 · 2022: 20 · 2021: 24 · 2020: 31 · 2019: 9 · 2018: 29 · 2017: 23 · 2016: 32 · 2015: 40 · 2014: 55 · 2013: 44 · 2012: 53
- FWCI
- 70.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Department of Health and Aged Care, Australian Government
- 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, comorbidities, disability, health care utilization, help-seeking, ICD-10, Composite International Diagnostic Interview, barriers to care, patient knowledge, physician competence, Australia
- MeSH terms
- Adolescent, Adult, Aged, Australia, Mental Disorders, Family Practice, Female, Health Services Needs and Demand, Health Surveys, Humans, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Severity of Illness Index, Comorbidity, Prevalence, Substance-Related Disorders, Persons with Mental Disabilities, Persons with Intellectual Disabilities
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