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Lifetime Prevalence of Mental Disorders


 Major Categories of Psychiatric Disorders
Personality Disorders
 Anxiety Disorders
 Comorbidity Among Axis II Disorders
 Mood Disorders
 Sexual and Gender Identity Disorders
 Substance-Related Disorders
 Eating Disorders
 Alcoholism
Somatoform Disorders
 Childhood Disorders 
Comorbidity Among Major Depression,  Dysthymia and other DSMIII-R Anxiety and Substance Rekated Disorders
 Comorbidity between Personality Disorders and Anxiety Disorders
 Comorbidity between Personality Disorders and Depressive Disorders

Major Categories of Psychiatric Disorders

Disorder
Male
Female
Total
Source
Any Mood Disorder
14.7
23.9
19.3
NCS¹
Any Anxiety Disorder
19.2
30.5
24.9 
(14.6)
NCS 
(ECA)
Any Substance Disorder
35.4
17.9
26.6
(16.7)
NCS
(ECA)
Schizophrenia
 1.2
1.7
 1.5
 ECA²
Any Disorder
48.7
47.3
48.0 
(32.7)
NCS
(ECA)
¹The National Comorbidity Survey (NCS) utilized the Composite International Diagnostic Interview (CIDI) containing DSM-III-R nomenclature to assess the prevalence of mental disorders in the non institutionalized United State Population aged 15-54.  Lay interviewers administered the CIDI to a total of 8,098 respondents in the 48 coterminous states (Kessler, et al., 1994a).

²The Epidemiological Catchment Area (ECA) utilized the Diagnostic Interview Schedule (DIS) containing DSM-III nomenclature to assess the prevalence of mental disorders in five metropolitan areas.  A total of 19,182 individuals participated in the study from various households, nursing homes, prisons, and psychiatric hospitals.  The metropolitan areas chosen for this study were New Haven, CT, Baltimore, MD, St. Louis, Missouri, Durham, NC, and Los Angeles, CA (Robins & Regier, 1991).

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 Anxiety Disorders

Disorder
Males
Females
Total
Source
Any Anxiety Disorder
19.2
30.5
24.9
(14.6)
NCS 
(ECA)
Panic Disorder
2.0
(1.0)
5.0
(2.1)
3.5
(1.6) 
1.0-2.0
NCS
(ECA)
APA, 2000
Agoraphobia w/o Panic Disorder
3.5
(3.2)
7.0
(7.9)
5.3
(5.6)
NCS
(ECA)
Social Phobia
11.1
(2.5)
15.5
(2.9)
13.3
(2.7) 
3.0-13.0
NCS
(ECA) 
APA, 2000
Specific Phobias
6.7
(7.8)
15.7
(14.5)
11.3
(11.2) 
7.2-11.3
NCS
(ECA)
APA, 2000
Generalized Anxiety Disorder (GAD)
3.6
6.6
5.1
5.0
 NCS
APA, 2000
Post Traumatic Stress Disorder (PTSD)
5.0
10.4
7.8 
8.0
 NCS
APA, 2000
Obsessive-Compulsive Disorder (OCD)
(2.0)
(3.0)
(2.5) 
2.5
(ECA)
APA, 2000
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Mood Disorders

Disorder
Male
Female
Total
Source
Any Mood Disorder
14.7
23.9
19.3
NCS
Major Depressive Disorder
12.7
5.0-12.0
21.3
10.0-25.0
17.1
(4.9)
NCS
(ECA)
APA, 2000
Dysthymia
4.8 
(2.2)
8.0 
(4.1)
6.4
(3.2)
NCS
(ECA)
Bipolar I Disorder
(0.7)
(0.9)
(0.8) 
(0.4-1.6)
(ECA)
APA, 2000
Bipolar II Disorder
(0.4)
(0.5)
(0.5) 
0.5
(ECA)
APA, 2000
Cyclothymic Disorder
not available
not available
0.4-1.0
APA, 2000
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Substance-Related Disorders

 Disorder
Total
Source
Any Substance Use Disorder
16.7
Regier et al., 1990
Any Alcohol Disorder
13.5
Regier et al., 1990
Marijuana Dependence-Abuse
4.3
5.0
Regier et al., 1990
APA, 2000
Cocaine Dependence-Abuse
0.2
2.0
Regier et al., 1990
APA, 2000
Opiates Dependence-Abuse
0.7
Regier et al., 1990
Amphetamines Dependence-Abuse
1.7
1.5
Regier et al., 1990
APA, 2000
Hallucinogens Dependence-Abuse
0.3
0.6
Regier et al., 1990
APA, 2000
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Alcoholism

Disorder
Male
Female
Total
Source
Abuse & Dependence
32.6
(23.8)
14.6
(4.5)
23.5
(13.8)
NCS
(ECA)
Abuse Only
12.5
(10.3)
6.4
(1.8)
9.4
NCS
(ECA)
Dependency with or w/o Abuse
20.1
(13.5)
8.2
(2.8)
14.1
NCS
(ECA)
Abuse is defined as a pattern of pathological (excessive or uncontrolled) alcohol use plus impairment in social or occupational functioning (Robins & Regier, 1991).

Dependence is defined as either a pattern of pathological use or social/occupational impairment plus evidence of tolerance or withdrawal (Robins & Regier, 1991).

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Somatoform Disorders

Disorder
Total Prevalence
Source
Somatization Disorder
Male (0.02)
Female (0.23) 
Total (0.13)
(ECA)
Conversion Disorder
0.3
Stefansson et al., 1976
Hypochondriasis
1.0-5.0
APA, 2000
Pain Disorder
Lack of Sufficient Data
  
Body Dysmorphic Disorder
unknown, most likely less than 1%
APA, 2000
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Eating Disorders

Disorder
Males
Females
Total
Source
Anorexia Nervosa
 Less than 10% of cases are males
0.5-3.7
--
APAWG, 2000
APA, 2000
Bulimia Nervosa
Less than 10% of cases are males
1.1-4.2
--
APAWG, 2000
APA, 2000
Binge Eating Disorder
--
--
(2.0-5.0)
(Bruce & Agras, 1992)

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Sexual and Gender Identity Disorders

Disorder
Male
Female
Source
Female Orgasmic Disorder
-- 
5.0-20.0 
(22.0-26.0)
 Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Male Orgasmic Disorder
1.0-10.0
(7.0-9.0)
 --
  Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Male Erectile Difficulty
3.0-9.0
(7.0-18.0)
 --
  Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Premature Ejaculation
36.0-38.0
(28.0-32.0)
 --
  Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Hypoactive Sexual Desire
16.0
(13.0-17.0)
34.0 
(30.0-32.0)
  Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Dyspareunia
 --
8.0-23.0
(8.0-21.0)
  Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 
Female Sexual Arousal Disorder
 --
11.0-48.0
(18.0-27.0)
 Spector & Carey, 1990
(Laumann, Paik, & Rosen, 1999) 

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Personality Disorders

Personality Disorder
Gender Differences
Total Lifetime Prevalence
Sources
Paranoid
More common in males
0.4
0.5-2.5
Zimmerman & Coryell, 1990
APA, 2000
Schizoid
More common in males
0.7
uncommon in clinical settings
Zimmerman & Coryell, 1990
APA, 2000
Schizotypal
More common in males 
3.0
3.0
 Zimmerman & Coryell, 1990
APA, 2000
Antisocial
5.8 in males; 1.2 females
(4.5 in males; .8 in females)
3.5
(2.6) 
 NCS
(ECA)
Borderline
Females make up 75% of cases
1.7
2.0
 Zimmerman & Coryell, 1990
APA, 2000
Histrionic
Equal prevalence in males and females
3.0
2.0-3.0
 Zimmerman & Coryell, 1990
APA, 2000
Narcissistic
More prevalent among men
less than 1.0
less than 1.0
 Zimmerman & Coryell, 1990
APA, 2000
Avoidant
Equal prevalence in males and females 
1.3
0.5-1.0
 Zimmerman & Coryell, 1990
APA, 2000
Dependent
Equal prevalence in males and females
1.7
Zimmerman & Coryell, 1990
APA, 2000
Obsessive-Compulsive
More common in males
1.7
1.0
Zimmerman & Coryell, 1990
APA, 2000
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Comorbidity Among Axis II Disorders³

 
Paranoid
Schizoid
Schizotypal
Antisocial
Borderline
Histrionic
Narcissistic
Avoidant
Dependent
Obsessive- 
Compulsive
Paranoid
--
23.4%
25.0%
7.8%
 48.4%
28.1% 
35.9%
48.4%
29.7%
7.8%
Schizoid
46.9%
--
37.5%
3.1%
18.8% 
9.4% 
28.1%
53.1%
18.8%
15.6% 
Schizotypal
59.3%
44.4%
--
3.7%
33.3%
18.5% 
33.3%
59.3%
29.6%
11.1% 
Antisocial
27.8%
5.6%
5.6%
--
44.4%
33.3%
55.6%
16.7%
11.1%
0.0% 
Borderline
32.0%
6.2%
9.3%
8.2%
--
36.1%
30.9%
36.1%
34.0%
2.1%
Histrionic
28.6%
4.8%
7.9%
9.5%
55.6%
--
54.0%
31.7%
30.2%
4.8%
Narcissistic
35.9%
14.1%
14.1%
15.6%
46.9%
53.1%
--
35.9%
26.6%
10.9%
Avoidant
39.2%
21.5%
20.3%
3.8%
44.3%
 25.3%
29.1%
--
40.5%
16.5%
Dependent
29.2%
9.2%
12.3%
3.1%
 50.8%
 29.2%
26.2%
49.2%
--
 9.2%
Obsessive- 
Compulsive
21.7%
21.7%
13.0%
0.0%
8.7%
13.0%
30.4%
56.5%
26.1%
--
³From:
Morey, L.C.  (1988). Personality disorders in DSM-III and DSM-III-R: Convergence, coverage, and internal consistency. American Journal of Psychiatry, 145,573-577.
Sample Size  = 291
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Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence

Disorder
Male: Female
Prevalence
Source
Mental Retardation
1.5:1
1.0-3.0
1.0
 Mash & Wolfe, 2002
APA, 2000
Learning Disorder
--
 (10.0-15.0) 
2.0-10.0
(Wenar, 1994) 
APA, 2000
Stuttering
3:1
0.8-1.0
APA, 2000
Autistic Disorder
4-5:1
(3.6-13.6/10,000) 
2-20/10,000; 
(Wenar, 1994) 
APA, 2000
ADHD
3:1
(5.0) 
3.0-7.0 
Mash & Wolfe, 2002
 (Wenar, 1994)
APA, 2000
Conduct Disorder
Higher prevalence in males
2.0-6.0
(4.0-10.0) 
1.0-10.0
Hinshaw & Anderson, 1996
(Wenar, 1994)
APA, 2000
Oppositional Defiant Disorder
More prevalent in males before puberty; equal prevalence after puberty
12.0
2.0-16.0 
Hinshaw & Anderson, 1996
APA, 2000
Encopresis
5-6x more likely in males
1.0 of 5-year-olds 
1.5-3.0
Sprague-McRae, Lamb, & Homer, 1993
Schroeder & Gordon, 1991
APA, 2000
Enuresis (Unspecified Nocturnal/Diurnal)
3.0%:2.0%  10 y.o.
1.0%:1.0% adolescence
(5.0-10.0) 5 y.o 
  (3.0-5.0) 10 y.o. 
        (1.0)  15 + y.o.
Mash & Wolfe, 2002
APA, 2000
Enuresis  (Nocturnal)
--
(20.0) 5 y.o. 
(5.0) 12-14 y.o.
Wenar, 1994
Enuresis  (Diurnal)
--
(3.0) 6 y.o. 
(1.0) 7-17 y.o.
Wenar, 1994
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Comorbidity between Major Depression, Dysthymia and Other DSM III-R Anxiety and Substance Related Disorders*

Major Depressive Disorder
Dysthymic Disorder
Source
Generalized Anxiety Disorder
18.0
27.9
NCS
Panic Disorder
11.1
10.4
NCS
Social Phobia
28.5
27.6
NCS
Specific Phobia
25.9
24.3
NCS
Agoraphobia
17.2
15.2
NCS
Post Traumatic Stress Disorder
20.1
20.1
NCS
Alcohol Abuse
9.6
8.7
NCS
Alcohol Dependence
24.4
29.0
NCS 
 Drug Abuse
 6.8
5.9
NCS
Drug Dependence
14.4
16.9
NCS 
Conduct Disorder
 17.7
20.9
NCS 

*Kessler, R.C., 1994b
 
 

Comorbidity Between Anxiety and Personality Disorders*

 
Any Anxiety Disorder
Panic Disorder
Generalized Anxiety Disorder
Panic Disorder without Agoraphobia
Social Phobia
Specific Phobia
Obsessive Compulsive Disorder
Anxiety Disorder NOS
 Any Personality Disorder
 35
30 
49 
24 
61 
12 
24 
26 
 Two Personality Disorders
 11
 4
18 
11 
16 
0 
5 
6
 Any Cluster A
 1
-- 
4
-- 
2
-- 
-- 
-- 
 Paranoid
 1
-- 
4 
-- 
2 
-- 
-- 
-- 
 Schizoid
-- 
-- 
-- 
-- 
-- 
-- 
-- 
-- 
 Schizotypal
-- 
-- 
-- 
-- 
-- 
-- 
-- 
-- 
 Any Cluster B
 6
 7
10 
 5
4 
6 
10 
3 
 Antisocial
 --
--
-- 
-- 
-- 
-- 
-- 
-- 
 Borderline
 2
2
4
1
-- 
5
-- 
-- 
 Histrionic
 3
2
4
3
2
--
5
 --
 Narcissistic
 3
2
4
1
4
6
--
3
 Any Cluster C
 27
17
38
19
51
6
 14
23
 Avoidant
 13
7
13
9
37
6
5
6
 Dependent
 8
4
5
8
 18
--
5
9
 Obsessive-Compulsive
 11
 9
23
8
4
--
 5
14
Passive Aggressive
3
2
5
3
2
--
--
3
Personality Disorder NOS
4
7
5
2
8
--
5
--
*Sanderson, S.C., Wetzler, S., Beck, A., & Betz, F. (1993)Sample Size = 347 outpatients
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Comorbidity Between Personality Disorders and Depressive Disorders*

 
Major Depression
Dysthymia
Double Depression
Any Depressive Disorder
No Personality Disorder
50
48
31
47
Any Personality Disorder
50
52
69
53
Two Personality Disorders
13
24
13
15
Any Cluster A
2
5
3
3
Paranoid
2
3
0
2
Schizoid
0
0
0
0
Schizotypal
<1
2
3
1
Any Cluster B
10
16
22
13
Antisocial
2
2
3
2
Borderline
4
8
16
6
Histrionic
4
2
0
3
Narcissistic
3
6
3
4
Any Cluster C
36
32
44
36
Avoidant
12
22
16
15
Dependent
15
8
19
14
Obsessive Compulsive
9
13
9
10
Passive Aggressive
7
3
3
5
Personality Disorder NOS
6
6
9
8
*Sanderson, Wetzler, Beck, & Betz (1992) Sample Size = 260 outpatients
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REFERENCES

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth
    Edition, Text Revision. Washington, DC: American Psychiatric Association.

American Psychiatric Association Work Group on Eating Disorders (2000). Practice guideline for
        the treatment of patients with eating disorders (revision). American Journal of Psychiatry, 157 (1
        Suppl), 1-39.

Bruce, B.  & Agras, W.S. (1992). Binge eating in females: a population-based investigation. International
        Journal of Eating Disorders, 12, 365-373.

Hinshaw, S.P. & Anderson, C.A. (1996). Conduct disorder and oppositional defiant disorder. In E.J. Mash & R.A.
        Barkley (Eds.), Child psychopathology (pp. 113-149). New York: Guilford Press.

Kessler, R.C., (1997).  The Prevalence of Psychiatric Comorbidity.  In S. Wetzler& S.C. Sanderson (Eds.),
        Treatment Strategies for Patients with Psychiatric Comorbidity, (pp. 23-48).  New York: John Wiley
        & Sons, Inc.

Kessler, R. C., et al. (1994a). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the
        United States. Archives of General Psychiatry, 51, 8-19.

Kessler, R.C., (1994b).  The US National Comorbidity Survey: Onset, Chronicity and Comorbidity Patterns of Mood
        Disorders in the General Population.  In S.Z. Langer, N. Brunello, G Racagni & J. Mendlewicz (Eds.)
        Critical Issues in the Treatment of Affective Disorders, (pp. 154-157).  Paris: Karger.

Laumann, E.O., Paik, A., & Rosen, R.C. (1999). Sexual dysfunction in the United States: Prevalence and
        predictors. Journal of the American Medical Association, 281, 537-544.

Mash, E.J., & Wolfe,  D.A. (2002). Abnormal child psychology (2nd ed.). Canada: Wadsworth/Thompson Learning.

Morey, L.C. (1998).  Personality disorders in DSM-III and DSM-III-R: Convergence, coverage, and internal
        consistency.  American Journal of Psychiatry, 145, 573-577.

Regier, D.A., Farmer, M.E., Rae, D.S., Locke, B.Z., Keith, S.J., Judd, L.L., & Goodwin, F.K. (1990).
        Comorbidity of mental disorders with alcohol and other drug abuse. Journal of the American Medical
        Association, 264, 2511-2518.

Robins, L. N. & Regier, D.A. (Eds.). (1991). Psychiatric Disorders in America: The epidemiological catchment
        area study. New York: The Free Press.

Sanderson, W.C., Wetzler, S., Beck, A. & Betz, F. (1992).  Prevalence of personality disorders in patients with major depression and
        dysthymia.  Psychiatry Research, 42, 93-99.

Sanderson, W.C., Wetzler, s., Beck, A. & Betz, F. (1993).  Prevalence of personality disorders among patients with anxiety disorders.
        Psychiatry Research, 51, 167-174.

Schroeder, C.S. & Gordon, B.N. (1991). Assessment and treatment of childhood problems: A clinician's guide. New
        York: Guilford Press.

Spector, I.P., & Carey, M.P. (1990). Incidence and prevalence of the sexual dysfunctions: A critical review of
        the empirical literature, Archives of Sexual Behavior, 19, 389-408.

Sprague-McRae, J.M., Lamb, W., and Homer, D., (1993). Encopresis: A study of treatment alternatives
        and historical and behavioral characteristics.  Nurse Practitioner, 18, 52-53; 56-63.

Stefansson, J.D., Messina, J.A., & Meyerowitz, S. (1976). Hysterical neurosis, conversion type: Clinical and
        epidemiological considerations. Acta Psychiatrica Scandinavica, 53, 119-138.

Warner, L.A., Kessler, R.C., Hughes, M., Anthony, J.C., & Nelson, C.B. (1995). Prevalence and correlates of
        drug use and dependence in the United States: Results from the National Comorbidity Study. Archives of
        General Psychiatry, 52, 219-229.

Wenar, C. (1994). Developmental psychopathology (3rd ed.). New York: McGraw-Hill, Inc.

Zimmereman, M., & Coryell, W. (1990).  Diagnosing personality disorder in the community: A comparison
        of self-report and interview measures.  Archives of General Psychiatry, 47, 527-531.
The Surgeon General's web site provides estimated 1-year prevalence data for some mental disorders.

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