The key objective of this study is to collect the first nationally representative data on prevalence and correlates of DSM-IV MDD from the recently completed National Comorbidity Survey Replication (NCS-R).The study design is a direct interview household survey of a probability household survey of adults ages 18 and over from the 48 contiguous United States. The total number of subjects in the study is 9090, representing a 79% response rate. The diagnostic interview was the WHO Composite International Diagnostic Interview (CIDI), developed to collect diagnostic criteria for the DSM-IV. Clinical re-interviews were carried out with the Structured Clinical Interview for DSM-IV (SCID) to validate CIDI diagnoses. The initial results of this study were published in July, 2003. We found that CIDI MDD prevalence estimates are 16.2% lifetime (32.6-35.1 million U.S. adults) and 6.6% 12-month (13.1-14.2 million U.S. adults). Sociodemographic correlates are female, younger than 60, unmarried, not black, unemployed, and disabled. Nearly three-fourths of MDD cases have comorbid anxiety, substance, or impulse control disorders. MDD is temporally primary in only a minority of these cases. Respondents with serious-severe 12-month MDD (38% of all 12-month MDD) averaged 83.5 days out of role, while mild-moderate cases averaged 9.6 days. Although a high proportion (72.4%) of serious-severe 12-month cases receive treatment, only a minority (36.9%) of treatment is adequate. Treatment adequacy is related to sector, but not severity. Sociodemographic correlates of severity, treatment, and treatment adequacy are far less numerous than the correlates of prevalence. In summary, we found that MDD is a common, seriously impairing, disorder that is widely distributed in the population. Early treatment of temporally primary disorders might be useful to prevent MDD. While the recent dramatic increase in treatment is encouraging, low treatment adequacy is a source of concern. The emphasis on screening, detection, and expansion of the number of MDD cases in treatment needs to be accompanied by a parallel emphasis on quality improvement.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Intramural Research (Z01)
Project #
Application #
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
U.S. National Institute of Mental Health
United States
Zip Code
Merikangas, Kathleen R; McClair, Vetisha L (2012) Epidemiology of substance use disorders. Hum Genet 131:779-89
Dierker, Lisa; He, Jianping; Kalaydjian, Amanda et al. (2008) The importance of timing of transitions for risk of regular smoking and nicotine dependence. Ann Behav Med 36:87-92
Swendsen, Joel; Anthony, James C; Conway, Kevin P et al. (2008) Improving targets for the prevention of drug use disorders: sociodemographic predictors of transitions across drug use stages in the national comorbidity survey replication. Prev Med 47:629-34
Saunders, K; Merikangas, K; Low, N C P et al. (2008) Impact of comorbidity on headache-related disability. Neurology 70:538-47
Merikangas, Kathleen R; Akiskal, Hagop S; Angst, Jules et al. (2007) Lifetime and 12-month prevalence of bipolar spectrum disorder in the National Comorbidity Survey replication. Arch Gen Psychiatry 64:543-52
Kessler, Ronald C; Merikangas, Kathleen R; Wang, Philip S (2007) Prevalence, comorbidity, and service utilization for mood disorders in the United States at the beginning of the twenty-first century. Annu Rev Clin Psychol 3:137-58
Kessler, Ronald C; Berglund, Patricia A; Borges, Guilherme et al. (2007) Smoking and suicidal behaviors in the National Comorbidity Survey: Replication. J Nerv Ment Dis 195:369-77
Merikangas, Kathleen R; Ames, Minnie; Cui, Lihong et al. (2007) The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch Gen Psychiatry 64:1180-8
Szatmari, Peter; White, Julie; Merikangas, Kathleen R (2007) The use of genetic epidemiology to guide classification in child and adult psychopathology. Int Rev Psychiatry 19:483-96
Kessler, Ronald C; Akiskal, Hagop S; Angst, Jules et al. (2006) Validity of the assessment of bipolar spectrum disorders in the WHO CIDI 3.0. J Affect Disord 96:259-69

Showing the most recent 10 out of 16 publications