Lifetime risk and age of onset distributions of psychiatric disorders: analysis of national sample survey in South Korea

Background

The present study represents the first attempt at examining variation across Korean cohorts with respect to lifetime risk of DSM-IV psychiatric disorders.

Aims

To present data on lifetime prevalence and projected lifetime risk, as well as age of onset (AOO) and demographic correlates of DSM-IV psychiatric disorders as assessed in the nationwide survey of a representative sample of Korean adults.

Method

The survey was based on a multistage area probability sample of non-institutionalized Koreans aged 18–64?years. The Korean version of the Composite International Diagnostic Interview 2.1 (K-CIDI 2.1) was administered by lay interviewers.

Results

Lifetime prevalence of any disorder was 24.6%. Alcohol abuse (9.2%), alcohol dependence (7.0%), major depressive disorder (5.6%), specific phobia (3.8%), and GAD (1.6%) were the most common disorders. The median AOO was earliest for anxiety disorders (age 29), latest for mood disorders (age 47), and intermediate for alcohol use disorders (age 31). Compared to observed lifetime prevalence (24.6%), 35.0% of Koreans will eventually experience one of these disorders. Further, half of the population who present with a psychiatric disorder do so by the age of 32 and younger cohorts are at greater risk for most disorders.

Conclusions

About one-third of the Korean adult population will meet the criteria for a DSM-IV psychiatric disorder at some time during their life. The median age of onset varies from disorder to disorder and younger cohorts appear to be at greater risk for most disorders.     

A Norwegian psychiatric epidemiological study.

OBJECTIVE: This study reports results of a large-scale epidemiological investigation of the prevalence of mental disorder in Oslo. METHOD: A random sample of Oslo residents age 18-65 years was drawn from the Norwegian National Population Register. A total of 2,066 subjects, 57.5% of the original sample, were interviewed with the Composite International Diagnostic Interview in 1994-1997. The mean age of the interviewed subjects was 39.3 years. RESULTS: The 12-month prevalence of all mental disorders was 32.8%, and the lifetime prevalence was 52.4%. Alcohol abuse/dependence and major depression had the highest lifetime prevalence and 12-month prevalences. All mental disorders were more prevalent in women than in men, with the exception of alcohol and drug abuse/dependence. Severe psychopathology (e.g., three or more diagnoses) was found in 14%-15% of the respondents. The lifetime and 12-month prevalences for all diagnostic categories except drug abuse/dependence were similar to those found in the United States Comorbidity Survey. CONCLUSIONS: Epidemiological data for Oslo show that the lifetime and 12-month prevalences of mental disorder are quite high, with alcohol abuse/dependence and major depression particularly frequent. The rates for women are higher than those for men for all diagnostic categories, except for alcohol and drug abuse/dependence.     

Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study

  Background: The aim of the Transitions in Alcohol Consumption and Smoking (TACOS) project is to investigate substance use and use disorders in the adult general population in a region of the under-researched north of Germany, focussing on smoking and alcohol consumption. In this study, the design and quality assurance provisions of the baseline cross-section of the longitudinal project are described. Prevalence rates of alcohol use disorders, consumption pattern, and the nature of their association are also analysed with regard to preventive strategies. Method: A random sample of 4075 participants, aged 18 to 64 and drawn from residents registration office files, was interviewed with a DSM-IV adapted version of WHO CIDI. Fieldwork resulted in a response rate of 70.2% and an unbiased database with regard to demographic characteristics. Results: Low lifetime prevalence of alcohol use disorders (4.5% abuse, 3.8% dependence) and hazardous consumption (13.2% lifetime; 6.0% 12-month) was found compared to southern regions of Germany and US American data. In contrast, we found a comparatively high percentage of moderate alcohol uses. Male subjects are more affected by lifetime alcohol use disorders (abuse OR 8.3, 95% CI 5.3–13.2; dependence OR 4.3, 95% CI 2.8–6.4). The association between alcohol use disorders and alcohol consumption pattern revealed a weaker relation for alcohol abuse compared to dependence. Conclusion: National and regional drinking habits and norms have to be considered as a significant source of variance, supporting the need for European epidemiological research on substance use in addition to US American activities, and emphasising the advantages of community-based preventive measures. An evaluation of public recommendations for safe limits of alcohol consumption and prevention targets referring to average consumption is indicated. There is also a need for a clear distinction between alcohol abuse and dependence. Accepted: 27 October 2000     

Mental illness in a rural area

Objectives Few epidemiological studies have compared less well-integrated urban areas with well-integrated rural areas with the same methods. The aim of this study was to explore the prevalence of mental disorder in a socially stable demographic western region of Norway and make comparison with previously observed prevalence figures of mental illness in Oslo, the capital of Norway. Method A random sample of the 107,738 residents of Sogn and Fjordane, a western rural region of Norway, age 18–65 years, was drawn from the Norwegian Population Register. A total of 1,080 subjects, 63% of the original sample, were interviewed with the Composite International Diagnostic Interview. Results The mean age of the subjects was 39.2 years. The 12-month prevalence of mental illness was 16.5% and the lifetime prevalence was 30.9%. Simple phobia and social phobia had the highest 12-month prevalence whereas alcohol abuse and major depression had the highest lifetime prevalence. All mental disorders were more prevalent in women than in men, with the exception of alcohol and drug abuse. Severe psychopathology was found in 2.2% (12 month prevalence) and 5.1% (lifetime prevalence). These observations show that the 12-month and the lifetime prevalence of mental illness in this western area is approximately half the rate of figures observed for Oslo. Conclusion Epidemiological figures for a western rural region of Norway showing 12-month and the lifetime prevalence of mental disorder are considerably lower than figures obtained in studies from the capital of Norway. However, the same basic pattern of mental illness can be observed in the rural as in the urban area of Oslo, with alcohol abuse/dependence and major depression being the most common disorders at both sites. The sex pattern is also the same with higher figures for women both in rural and urban areas with the exception of alcohol and drug abuse being higher in men.     

Prevalence of Mental Disorders from Adolescence Through Early Adulthood in American Indian and First Nations Communities

Indigenous communities lack representation in psychiatric epidemiology despite disproportionate exposure to risk factors. We document the cumulative and 12-month prevalence of psychiatric disorders across the early life course among a sample of Indigenous young adults and compare prospective and retrospective reporting of lifetime mental disorders. This community-based participatory research includes data from 735 Indigenous people from 8 reservations/reserves. Personal interviews were conducted between 2002–2010 and 2017–2018 totaling 9 waves; diagnostic assessments of DSM-IV-TR alcohol abuse/dependence, marijuana use/dependence, other substance abuse/dependence, generalized anxiety disorder, major depressive disorder, dysthymic disorder, and attention deficit/hyperactivity disorder occurred at waves 1 (mean age = 11.1 years), 4 (mean age = 14.3 years), 6 (mean age = 16.2 years), 8 (mean age = 18.3 years), and 9 (mean age = 26.3 years). Cumulative lifetime psychiatric disorders reached 77.3% and lifetime comorbidity 56.4% by wave 9. Past-year prevalence and comorbidity at wave 9 were 28.7% and 6.7%, respectively. Substance use disorders (SUDs) were most common with peak past-year prevalence observed when participants were on average 16.3 years old then declining thereafter. Trends in early life course psychiatric disorders in this study with Indigenous participants highlight cultural variations in psychiatric epidemiology including surprisingly low rates of internalizing disorders in the face of risk factors, disproportionately high rates of early-onset and lifetime SUD, and lower rates of past-year SUD in early adulthood compared with prior research.

     

Lifetime and 6-month prevalence of abuse and dependence of alcohol in the Munich follow-up study

Summary This paper reports lifetime and 6-month prevalence rates of alcohol abuse and dependence in West Germany. Assessment instruments are a modified German version of the Diagnostic Interview Schedule (DIS), a fully standardized interview for the assessment of selected DSM-III diagnoses and the Munich Alcoholism Test (MALT). According to the DIS/DSM-III criteria, 13.0% of the adult general population (aged 25–64 years) were found to fulfill the lifetime criteria for alcohol abuse, alcohol dependence, or both; however, only 1.3% of all men and 0.9% of the women interviewed received a current DSM-III diagnosis of alcohol abuse or dependence. There was good consensus between current DSM-III diagnoses with current clinical ICD-diagnoses, but poor concordance with lifetime diagnoses. Symptoms of alcoholism, onset and severity, comorbidity with other DIS/DSM-III disorders as well as some selected risk factors are reported. The results are primarily compared with the results of the US-Epidemiological Catchment Area Program (ECA).     

Lifetime prevalence of substance or alcohol abuse and dependence among subjects with bipolar I and II disorders in a voluntary registry

Objective: To evaluate the prevalence of substance abuse dependence and/or alcohol abuse dependence among subjects with bipolar I versus bipolar II disorder in a voluntary registry.

Method: One hundred randomly selected registrants in a voluntary case registry for bipolar disorder were interviewed, using the Structured Clinical Interview for DSM‐IV Axis I Disorders, to validate the diagnosis of this registry. Corroborative information was obtained from medical records, family members and the treating psychiatrist. Eighty‐nine adults (18–65 years) met criteria for bipolar disorder (bipolar I=71, bipolar II=18) and were included in this analysis.

Results: Forty‐one (57.8%) subjects with bipolar I disorder abused, or were dependent on one or more substances or alcohol, 28.2% abused, or were dependent on, two substances or alcohol, and 11.3% abused or were dependent on three or more substances or alcohol. Nearly 39% of bipolar II subjects abused or were dependent on one or more substances, nearly 17% were dependent on two or more substances or alcohol, and 11% were dependent on three or more substances or alcohol. Alcohol was the most commonly abused drug among either bipolar I or II subjects.

Conclusions: Consistent with other epidemiologic and hospital population studies, this voluntary bipolar disorder registry suggests a high prevalence of comorbidity with alcohol and/or substance abuse dependence. Bipolar I subjects appear to have higher rates of these comorbid conditions than bipolar II subjects; however, as the number of bipolar II subjects was rather small, this suggestion needs confirmation.     

Panic disorder and alcoholism]

Relationships between alcoholism and anxiety disorder are well known by clinicians. Studies have recently shown that the prevalence of alcohol abuse or dependence is very high in patients with panic disorder with or without agoraphobia (Thyer et al., 1986; Bibb and Chambless, 1986). The aims of this study were to determine the prevalence and comorbidity of alcohol abuse and dependence in a population of panic outpatients who were consecutive referrals for treatment of panic disorder (PD) in an anxiety clinic. Patients were interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version Modified for the study of anxiety disorders (SADS-LA) which is a standardized and semi-structured interview allowing to make diagnoses according to RDC, DSM III and DSM III-R criteria. One hundred and three panic patients (39 males and 64 females) were included in the study. Their mean age was 38.5 years (SD: 11.6). In this sample, 24.3% met the DSM III-R criteria for alcohol abuse and 8.7% those for alcohol dependence. Among these patients, 26.2%, abused of benzodiazepines and 16.5% of them of other substances. We found a high comorbidity rate. In fact, 6.8% of the patients met diagnostic criteria for PD alone, 31.0% for one more diagnosis, 29.1% for two more and 33.0% for three or more besides PD. In this study, we found an association between alcohol abuse and the presence of a lifetime diagnosis of major depressive episode and/or other addictive behaviors. Otherwise, alcohol abuse did not occur more often in patients suffering from panic disorder associated with agoraphobia and/or social phobia.     

Obsessive-compulsive syndromes and disorders

Abstract Objective To determine the prevalence and clinical characteristics of comorbid obsessive compulsive disorders and syndromes (OCD/OCS), compared with pure OCD/OCS among adults in the community. Method Data were drawn from the Zurich Study, a longitudinal cohort study of 591 adults in the canton of Zurich. Comorbid OCD/OCS was compared with pure OCD/OCS groups in terms of distress, impairment, family history, suicide behavior and treatment using multivariable logistic regression analyses. Results OCD was significantly comorbid with bipolar I/II and minor bipolar disorders, anxiety states (GAD, repeated panic attacks) and social phobia, whereas there was no clear association between OCD and major depressive disorder or phobias other than social phobia. Results suggest that comorbid OCD/OCS is common among adults in the community, with the majority of those with OCD/OCS having at least one comorbid mood or anxiety disorder with a prevalence of 7.4% compared to 4.8% of remaining OCD/OCS. Comorbidity of OCD/OCS and anxiety states was more common among women (85.6 %) and comorbidity with bipolar spectrum was more common among men (69.6%). Comorbid OCD/OCS was associated with significantly higher levels of treatment seeking, impairment,distress and suicidality compared with pure OCD/OCS. Comorbidity with bipolar disorders significantly increased the risk for alcohol abuse/dependence. Conclusion Comorbidity of OCD/OCS with bipolar disorder and bipolar spectrum disorders is common and very probably explains the association between OCD and depression found in other studies. The early recognition of bipolar/cyclothymic OCD/OCS may help to prevent the abuse of/dependence on alcohol.     

Prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder in a nationwide sample of Korean women

Purpose

We examined the prevalence, correlates, comorbidities, and suicidal tendencies of premenstrual dysphoric disorder (PMDD) according to the DSM-IV criteria in a nationwide sample of Korean women.

Methods

A total of 2,499 women aged 18–64?years participated in this study. Diagnostic assessments were based on the Korean version of the Composite International Diagnostic Interview (CIDI) 2.1 and its 12-month PMDD diagnostic module, which were administered by lay interviewers. The frequencies of DSM-IV psychiatric disorders, insomnia, and suicidal tendency were analyzed among PMDD cases and compared with non-PMDD cases, and both odds ratios and significance levels were calculated.

Results

The 12-month prevalence rate of DSM-IV-diagnosed PMDD was 2.4?%. Among subjects with PMDD, 59.3?% had at least one psychiatric illness; in comparison, the control frequency was 21.8?%. Associations between PMDD and alcohol abuse/dependence, major depressive disorder, post-traumatic stress disorder, social phobia, specific phobia, somatoform disorder, insomnia, and suicidality were overwhelmingly positive and significant (p?<?0.05), after controlling for age. Physical illness and being underweight were associated with increased risks of PMDD (p?<?0.05).

Conclusions

PMDD was prevalent in the nationwide sample of Korean women and was frequently associated with other psychiatric disorders, insomnia, and suicidality, suggesting the need to detect and treat women who experience PMDD.