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首页> 外文期刊>JAMA psychiatry >Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States
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Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States

机译：成人DSM-5主要抑郁症及其在美国的细节流行病学

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DSM-5 defined major depressive disorder (MDD) or on MDD specifiers as defined in DSM-5 . Objective ?To present current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 MDD and initial information on the prevalence, severity, and treatment of DSM-5 MDD severity, anxious/distressed specifier, and mixed-features specifier, as well as cases that would have been characterized as bereavement in DSM-IV . Design, Setting, and Participants ?In-person interviews with a representative sample of US noninstitutionalized civilian adults (e18 years) (n = 36/309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 to June 2013 and were analyzed in 2016-2017. Main Outcomes and Measures ?Prevalence of DSM-5 MDD and the DSM-5 specifiers. Odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders. Results ?Of the 36/309 adult participants in NESARC-III, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively. Odds of 12-month MDD were significantly lower in men (OR, 0.5; 95% CI, 0.46-0.55) and in African American (OR, 0.6; 95% CI, 0.54-0.68), Asian/Pacific Islander (OR, 0.6; 95% CI, 0.45-0.67), and Hispanic (OR, 0.7; 95% CI, 0.62-0.78) adults than in white adults and were higher in younger adults (age range, 18-29 years; OR, 3.0; 95% CI, 2.48-3.55) and those with low incomes ($19/999 or less; OR, 1.7; 95% CI, 1.49-2.04). Associations of MDD with psychiatric disorders ranged from an aOR of 2.1 (95% CI, 1.84-2.35) for specific phobia to an aOR of 5.7 (95% CI, 4.98-6.50) for generalized anxiety disorder. Associations of MDD with substance use disorders ranged from an aOR of 1.8 (95% CI, 1.63-2.01) for alcohol to an aOR of 3.0 (95% CI, 2.57-3.55) for any drug. Most lifetime MDD cases were moderate (39.7%) or severe (49.5%). Almost 70% with lifetime MDD had some type of treatment. Functioning among those with severe MDD was approximately 1 SD below the national mean. Among 12.9% of those with lifetime MDD, all episodes occurred just after the death of someone close and lasted less than 2 months. The anxious/distressed specifier characterized 74.6% of MDD cases, and the mixed-features specifier characterized 15.5%. Controlling for severity, both specifiers were associated with early onset, poor course and functioning, and suicidality. Conclusions and Relevance ?Among US adults, DSM-5 MDD is highly prevalent, comorbid, and disabling. While most cases received some treatment, a substantial minority did not. Much remains to be learned about the DSM-5 MDD specifiers in the general population.
机译：DSM-5定义了重度抑郁症（MDD）或DSM-5中定义的MDD特异性。客观的介绍关于DSM-5 MDD的患病率、相关性、精神病共病、功能和治疗的最新全国代表性研究结果，以及关于DSM-5 MDD的患病率、严重程度和治疗的初步信息，焦虑/痛苦的说明符和混合特征说明符，以及在DSM-IV中被定性为丧亲的病例。设计、设置和参与者？对参加2012-2013年全国酒精及相关疾病三级流行病学调查（NESARC-III）的美国非住院平民成年人（e18岁）（n=36/309）的代表性样本进行面谈。数据收集于2012年4月至2013年6月，并在2016-2017年进行了分析。主要成果和措施？DSM-5 MDD和DSM-5规范的患病率。优势比（ORs）、调整后的ORs（AOR）和95%的CI表明与人口统计学特征和其他精神疾病相关。后果在NESARC-III的36/309成年参与者中，MDD的12个月和终生患病率分别为10.4%和20.6%。男性（OR，0.5；95%CI，0.46-0.55）和非裔美国人（OR，0.6；95%CI，0.54-0.68）、亚洲/太平洋岛民（OR，0.6；95%CI，0.45-0.67）患12个月MDD的几率显著较低，拉美裔（OR，0.7；95%可信区间，0.62-0.78）成年人比白人成年人高，年轻人（年龄范围，18-29岁；OR，3.0；95%可信区间，2.48-3.55）和低收入人群（19/999或更低；OR，1.7；95%可信区间，1.49-2.04）更高。MDD与精神疾病的关联范围从特定恐惧症的aOR为2.1（95%可信区间，1.84-2.35）到广泛性焦虑症的aOR为5.7（95%可信区间，4.98-6.50）。MDD与物质使用障碍的关联范围从酒精的aOR为1.8（95%CI，1.63-2.01）到任何药物的aOR为3.0（95%CI，2.57-3.55）。大多数终生MDD病例为中度（39.7%）或重度（49.5%）。几乎70%的终生MDD患者接受了某种类型的治疗。重度MDD患者的功能比全国平均水平低约1 SD。在12.9%的终身MDD患者中，所有发作都发生在一位亲密的人去世后，持续时间不到2个月。74.6%的MDD病例以焦虑/苦恼为特征，15.5%的MDD病例以混合特征为特征。控制严重程度后，这两个指标都与早发、病程和功能不良以及自杀有关。结论和相关性？在美国成年人中，DSM-5 MDD非常普遍、共病和致残。虽然大多数病例接受了一些治疗，但有相当一部分患者没有接受。关于一般人群中的DSM-5 MDD说明符还有很多需要了解的地方。

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