[Paleopsych] SW: On Mental Disorders in the US 1990-2003

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Public Health: On Mental Disorders in the US 1990-2003
http://scienceweek.com/2005/sw050715-6.htm

    The following points are made by R.C. Kessler et al (New Engl. J. Med.
    2005 352:2515):
    1) In the 1980s, the Epidemiologic Catchment Area (ECA) Study found
    that 29.4 percent of the adults interviewed had had a mental disorder
    at some time in the 12 months before the interview (referred to as a
    "12-month mental disorder"), according to the criteria of the American
    Psychiatric Association's Diagnostic and Statistical Manual of Mental
    Disorders, third edition (DSM-III).[3] A fifth of those with a
    12-month disorder received treatment. Half of all who received
    treatment did not meet the criteria for a 12-month disorder according
    to the ECA Study or the DSM-III. A decade later, the National
    Comorbidity Survey (NCS) found that 30.5 percent of people 15 to 54
    years of age had conditions that met the criteria for a 12-month
    mental disorder according to the criteria of the DSM-III, revised
    (DSM-III-R).[4] A fourth of these patients received treatment. Roughly
    half of all who received treatment did not meet the criteria for a
    12-month mental disorder according to the NCS or the DSM-III-R.
    2) The results of the ECA study and the NCS are no longer valid owing
    to changes in the delivery of mental health care. The Substance Abuse
    and Mental Health Services Administration found that annual visits to
    mental health specialists (i.e., psychiatrists and psychologists)
    increased by 50 percent between 1992 and 2000.[5] The National
    Ambulatory Medical Care Survey found that the number of people
    receiving treatment for depression tripled between 1987 and 1997. The
    Robert Wood Johnson Foundation Community Tracking Survey found that
    the number of people with a serious mental illness who were treated by
    a specialist increased by 20 percent between 1997 and 2001.
    3) The authors examined trends in the prevalence and rate of treatment
    of mental disorders among people 18 to 54 years of age during roughly
    the past decade. The authors conclude: Despite an increase in the rate
    of treatment, most patients with a mental disorder did not receive
    treatment.[1.2]
    References (abridged):
    1. Department of Health and Human Services. Mental health: a report of
    the Surgeon General. Bethesda, Md.: National Institute of Mental
    Health, 1999
    2. President's New Freedom Commission on Mental Health. Achieving the
    promise: transforming mental health care in America
    3. Robins LN, Regier DA, eds. Psychiatric disorders in America: The
    Epidemiologic Catchment Area Study. New York: Free Press, 1991
    4. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month
    prevalence of DSM-III-R psychiatric disorders in the United States:
    results from the National Comorbidity Survey. Arch Gen Psychiatry
    1994;51:8-19
    5. Manderscheid RW, Atay JE, Hernandez-Cartagana MR, et al. Highlights
    of organized mental health services in 1998 and major national and
    state trends. In: Manderscheid RW, Henderson MJ, eds. Mental health,
    United States, 2000. Washington, D.C.: Government Printing Office,
    2001:135-71
    New Engl. J. Med. http://www.nejm.org