Differentiating DSM-IV Anxiety and Depressive Disorders in the General Population: Comorbidity and Treatment Consequences

• Published in: Canadian journal of psychiatry 2000-03, Vol.45 (2), p.166-172
• Main Authors: Ohayon, Maurice M, Shapiro, Colin M, Kennedy, Sidney H
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antidepressive Agents - therapeutic use; Anxiety; Anxiety Disorders - drug therapy; Anxiety Disorders - epidemiology; Anxiety Disorders - psychology; Biological and medical sciences; Comorbidity; Depressive Disorder - drug therapy; Depressive Disorder - epidemiology; Depressive Disorder - psychology; Diagnosis, Differential; Epidemiology; Female; Humans; Male; Medical sciences; Mental depression; Mental disorders; Middle Aged; Nosology. Terminology. Diagnostic criteria; Population Surveillance; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sleep Wake Disorders - psychology; Techniques and methods
• ISSN: 0706-7437; 1497-0015
• DOI: 10.1177/070674370004500207

Objective: To attempt, for the first time, to apply a positive and differential diagnosis process in the general population during interviews using DSM-IV classification to ascertain the profile and occurrence of concomitant mental disorders. Method: A representative sample of 1832 individuals aged 15 years or older living in the metropolitan area of Toronto were interviewed by means of telephone interviews. The participation rate was 72.8%. Results: Overall, 13.2% (n = 242) of the sample had either a mood disorder (n = 127; 6.9%) or an anxiety disorder (n = 770; 9.3%) at the time of their interview. The prevalence was higher among women (16.5%) than amongmen (9.7%), with an odds ratio of 1.8. The comorbidity of mood and anxiety disorders was found in 3%(n = 55) of the sample. Less than one-third of respondents with a mood and/or anxiety disorder were being treated by aphysician for a mental disorder. However, these individuals were greater consumers of health care services. Most of them consulted a physician an average of 5 times in the past year. Individuals on medication diagnosed with a mood and an anxiety disorder consulted a physician an average of 12 times in the past year. Only 13% of them were treated with antidepressants and under 9% with anxiolytics. Conclusions: More than 70% of subjects with a mood disorder also complained of insomnia. With the differential process, 12%> of the subjects manifesting a full-fledged anxiety disorder were diagnosed with only a mood disorder because the anxiety occurred only in the course of the mood disorder. About two-thirds of the subjects diagnosed in this study were undiagnosed and untreated by their physician.