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Ronald C Kessler - One of the best experts on this subject based on the ideXlab platform.
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services for adolescents with psychiatric disorders 12 month data from the National Comorbidity Survey adolescent
Psychiatric Services, 2014Co-Authors: Jane E Costello, Ronald C Kessler, Nancy A Sampson, Jianping He, Kathleen R. MerikangasAbstract:ObjectiveThis study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents.MethodsData were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a Survey of DSM-IV mental, emotional, and behavioral disorders and service use.ResultsIn the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportio...
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prevalence correlates and treatment of lifetime suicidal behavior among adolescents results from the National Comorbidity Survey replication adolescent supplement
JAMA Psychiatry, 2013Co-Authors: Matthew K Nock, Irving Hwang, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts). Objectives To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors. Design Dual-frame National sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement. Setting Face-to-face household interviews with adolescents and questionnaires for parents. Participants A total of 6483 adolescents 13 to 18 years of age and their parents. Main Outcome Measures Lifetime suicide ideation, plans, and attempts. Results The estimated lifetime prevalences of suicide ideation, plans, and attempts among the respondents are 12.1%, 4.0%, and 4.1%, respectively. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the Survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders are also predictors of plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%), treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring. Conclusions Suicidal behaviors are common among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have preexisting mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts. These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts, and unplanned attempts.
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intermittent explosive disorder in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Katie A Mclaughlin, Irving Hwang, Nancy A Sampson, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Epidemiologic studies of adults show that DSM-IV intermittent explosive disorder (IED) is a highly prevalent and seriously impairing disorder. Although retrospective reports in these studies suggest that IED typically begins in childhood, no previous epidemiologic research has directly examined the prevalence or correlates of IED among youth. Objective To present epidemiologic data on the prevalence and correlates of IED among US adolescents in the National Comorbidity Survey Replication Adolescent Supplement. Design United States Survey of adolescent (age, 13-17 years) DSM-IV anxiety, mood, behavior, and substance disorders. Setting Dual-frame household-school samples. Participants A total of 6483 adolescents (interviews) and parents (questionnaires). Main outcome measures The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview (CIDI). Results Nearly two-thirds of adolescents (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence. Of these, 7.8% met DSM-IV/CIDI criteria for lifetime IED. Intermittent explosive disorder had an early age at onset (mean age, 12.0 years) and was highly persistent, as indicated by 80.1% of lifetime cases (6.2% of all respondents) meeting 12-month criteria for IED. Injuries related to IED requiring medical attention reportedly occurred 52.5 times per 100 lifetime cases. In addition, IED was significantly comorbid with a wide range of DSMIV/CIDI mood, anxiety, and substance disorders, with 63.9% of lifetime cases meeting criteria for another such disorder. Although more than one-third (37.8%) of adolescents with 12-month IED received treatment for emotional problems in the year before the interview, only 6.5% of respondents with 12-month IED were treated specifically for anger. Conclusions Intermittent explosive disorder is a highly prevalent, persistent, and seriously impairing adolescent mental disorder that is both understudied and undertreated. Research is needed to uncover risk and protective factors for the disorder, develop strategies for screening and early detection, and identify effective treatments.
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lifetime co morbidity of dsm iv disorders in the us National Comorbidity Survey replication adolescent supplement ncs a
Psychological Medicine, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Matthew D Lakoma, Alan M Zaslavsky, Shelli Avenevoli, Greif J Green, Daniel S Pine, Ries K MerikangasAbstract:BACKGROUND: Research on the structure of co-morbidity among common mental disorders has largely focused on current prevalence rather than on the development of co-morbidity. This report presents preliminary results of the latter type of analysis based on the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).MethodA National Survey was carried out of adolescent mental disorders. DSM-IV diagnoses were based on the Composite InterNational Diagnostic Interview (CIDI) administered to adolescents and questionnaires self-administered to parents. Factor analysis examined co-morbidity among 15 lifetime DSM-IV disorders. Discrete-time survival analysis was used to predict first onset of each disorder from information about prior history of the other 14 disorders. RESULTS: Factor analysis found four factors representing fear, distress, behavior and substance disorders. Associations of temporally primary disorders with the subsequent onset of other disorders, dated using retrospective age-of-onset (AOO) reports, were almost entirely positive. Within-class associations (e.g. distress disorders predicting subsequent onset of other distress disorders) were more consistently significant (63.2%) than between-class associations (33.0%). Strength of associations decreased as co-morbidity among disorders increased. The percentage of lifetime disorders explained (in a predictive rather than a causal sense) by temporally prior disorders was in the range 3.7-6.9% for earliest-onset disorders [specific phobia and attention deficit hyperactivity disorder (ADHD)] and much higher (23.1-64.3%) for later-onset disorders. Fear disorders were the strongest predictors of most other subsequent disorders. CONCLUSIONS: Adolescent mental disorders are highly co-morbid. The strong associations of temporally primary fear disorders with many other later-onset disorders suggest that fear disorders might be promising targets for early interventions. Language: en
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severity of 12 month dsm iv disorders in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Shelli Avenevoli, Jennifer Greif Green, Michael J Gruber, Jane E Costello, Kathleen R. MerikangasAbstract:CONTEXT: Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. OBJECTIVE: To present US National data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. DESIGN: The National Comorbidity Survey Replication Adolescent Supplement is a National Survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. SETTING: Dual-frame household and school samples of US adolescents. PARTICIPANTS: Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). MAIN OUTCOME MEASURES: The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite InterNational Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite InterNational Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. RESULTS: The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite InterNational Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high Comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number. CONCLUSIONS: The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high Comorbidity have important public health implications for targeting interventions. Language: en
Kathleen R. Merikangas - One of the best experts on this subject based on the ideXlab platform.
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major depression in the National Comorbidity Survey adolescent supplement prevalence correlates and treatment
Journal of the American Academy of Child and Adolescent Psychiatry, 2015Co-Authors: Shelli Avenevoli, Joel Swendsen, Marcy Burstein, Jianping He, Kathleen R. MerikangasAbstract:Objective To present the 12-month prevalence of DSM-IV major depressive disorder (MDD) and severe MDD; to examine sociodemographic correlates and Comorbidity; and to describe impairment and service use. Method Data are from the National Comorbidity Survey–Adolescent Supplement (NCS-A), a Nationally representative Survey of 10,123 adolescents aged 13 to 18 years that assesses DSM-IV disorders using the Composite InterNational Diagnostic Interview (CIDI) Version 3.0. One parent or surrogate of each participating adolescent was also asked to complete a self-administered questionnaire. Results Lifetime and 12-month prevalence of MDD were 11.0% and 7.5%, respectively. The corresponding rates of severe MDD were 3.0% and 2.3%. The prevalence of MDD increased significantly across adolescence, with markedly greater increases among females than among males. Most cases of MDD were associated with psychiatric Comorbidity and severe role impairment, and a substantial minority reported suicidality. The prevalence of severe MDD was about one-fourth of that of all MDD cases; estimates of impairment and clinical correlates were of 2- to 5-fold greater magnitude for severe versus mild/moderate depression, with markedly higher rates for suicidal thoughts and behaviors. Treatment in any form was received by the majority of adolescents with 12-month DSM-IV MDD (60.4%), but only a minority received treatment that was disorder-specific or from the mental health sector. Conclusion Findings underscore the important public health significance of depression among US adolescents and the urgent need to improve screening and treatment access in this population.
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services for adolescents with psychiatric disorders 12 month data from the National Comorbidity Survey adolescent
Psychiatric Services, 2014Co-Authors: Jane E Costello, Ronald C Kessler, Nancy A Sampson, Jianping He, Kathleen R. MerikangasAbstract:ObjectiveThis study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents.MethodsData were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a Survey of DSM-IV mental, emotional, and behavioral disorders and service use.ResultsIn the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportio...
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severity of 12 month dsm iv disorders in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Shelli Avenevoli, Jennifer Greif Green, Michael J Gruber, Jane E Costello, Kathleen R. MerikangasAbstract:CONTEXT: Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. OBJECTIVE: To present US National data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. DESIGN: The National Comorbidity Survey Replication Adolescent Supplement is a National Survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. SETTING: Dual-frame household and school samples of US adolescents. PARTICIPANTS: Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). MAIN OUTCOME MEASURES: The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite InterNational Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite InterNational Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. RESULTS: The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite InterNational Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high Comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number. CONCLUSIONS: The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high Comorbidity have important public health implications for targeting interventions. Language: en
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social phobia and subtypes in the National Comorbidity Survey adolescent supplement prevalence correlates and Comorbidity
Journal of the American Academy of Child and Adolescent Psychiatry, 2011Co-Authors: Marcy Burstein, Shelli Avenevoli, Gabriela Kattan, Anne Marie Albano, Kathleen R. MerikangasAbstract:Objective Social phobia typically develops during the adolescent years, yet no Nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and Comorbidity of social phobia in a large, Nationally representative sample of U.S. adolescents; and (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes. Method The National Comorbidity Survey Replication–Adolescent Supplement is a Nationally representative face-to-face Survey of 10,123 adolescents 13 to 18 years of age in the continental United States. Results Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited nongeneralized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance-only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also had a younger age of onset, higher levels of disability and clinical severity, and a greater degree of Comorbidity relative to adolescents with nongeneralized forms of the disorder. Conclusions This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group.
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validation of the diagnoses of panic disorder and phobic disorders in the us National Comorbidity Survey replication adolescent ncs a supplement
International Journal of Methods in Psychiatric Research, 2011Co-Authors: Jennifer Greif Green, Kathleen R. Merikangas, Nancy A Sampson, Ronald C Kessler, Shelli Avenevoli, Michael J Gruber, Matthew Finkelman, Alan M ZaslavskyAbstract:Validity of the adolescent version of the World Health Organization Composite InterNational Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological Survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.
Ellen E. Walters - One of the best experts on this subject based on the ideXlab platform.
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the importance of irritability as a symptom of major depressive disorder results from the National Comorbidity Survey replication
Molecular Psychiatry, 2010Co-Authors: Maurizio Fava, Irving Hwang, Nancy A Sampson, Ellen E. Walters, A J Rush, Ronald C KesslerAbstract:Irritability is a diagnostic symptom of major depressive disorder (MDD) in children and adolescents but not in adults in both the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) and InterNational Classification of Diseases (ICD-10) systems. We explore the importance of irritability for subtyping adult DSM-IV MDD in the National Comorbidity Survey Replication (NCS-R), a National US adult household Survey. The WHO Composite InterNational Diagnostic Interview (CIDI) was used to assess prevalence of many DSM-IV disorders in the lifetime and in the year before interview (12-month prevalence). MDD was assessed conventionally (that is, requiring either persistent sadness or loss of interest), but with irritability included as one of the Criterion A symptoms. We also considered the possibility that irritability might be a diagnostic symptom of adult MDD (that is, detect cases who had neither sad mood nor loss of interest). Twelve-month MDD symptom severity was assessed with the Quick Inventory of Depressive Symptomatology and role impairment with the Sheehan Disability Scale. After excluding bipolar spectrum disorders, irritability during depressive episodes was reported by roughly half of respondents with lifetime DSM-IV MDD. Irritability in the absence of either sad mood or loss of interest, in comparison, was rare. Irritability in MDD was associated with early age of onset, lifetime persistence, Comorbidity with anxiety and impulse-control disorders, fatigue and self-reproach during episodes, and disability. Irritability was especially common in MDD among respondents in the age range 18-44 and students. Further investigation is warranted of distinct family aggregation, risk factors and treatment response. Consideration should also be given to including irritability as a nondiagnostic symptom of adult MDD in DSM-V and ICD-11.
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a risk index for 12 month suicide attempts in the National Comorbidity Survey replication ncs r
Psychological Medicine, 2006Co-Authors: Guilherme Borges, Ellen E. Walters, Jules Angst, Matthew K Nock, Ayelet Meron Ruscio, Ronald C KesslerAbstract:Background. Clinical judgments about the likelihood of suicide attempt would be aided by an index of risk factors that could be quickly assessed in diverse settings. We sought to develop such a risk index for 12-month suicide attempts among suicide ideators. Method. The National Comorbidity Survey Replication (NCS-R), a household Survey of adults aged 18+, assessed the 12-month occurrence of suicide ideation, plans and attempts in a subsample of 5692 respondents. Retrospectively assessed correlates include history of prior suicidality, socio- demographics, parental psychopathology and 12-month DSM-IV disorders. Results. Twelve-month prevalence estimates of suicide ideation, plans and attempts are 2 . 6, 0 . 7 and 0 . 4% respectively. Although ideators with a plan are more likely to make an attempt (31 . 9%) than those without a plan (9 . 6 %), 43 % of attempts were described as unplanned. History of prior attempts is the strongest correlate of 12-month attempts. Other significant correlates include shorter duration of ideation, presence of a suicide plan, and several sociodemographic and parental psychopathology variables. Twelve-month disorders are not powerful correlates. A four-category summary index of correlates is strongly related to attempts among ideators (area under the receiver operator characteristic curve (AUC)=0 . 88). The distribution (conditional probability of attempt) of the risk index is : 19 . 0 % very low (0 . 0%), 51 . 1 % low (3 . 5 %), 16 . 2% intermediate (21 . 3 %), and 13 . 7% high (78 . 1%). Two-thirds (67 . 1 %) of attempts were made by ideators in the high-risk category. Conclusions. A short, preliminary risk index based on retrospectively reported responses to fully structured questions is strongly correlated with 12-month suicide attempts among ideators, with a high concentration of attempts among high-risk ideators.
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Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the National Comorbidity Survey Replication.
American Journal of Psychiatry, 2006Co-Authors: Katherine Shear, Robert Jin, Ellen E. Walters, Ayelet Meron Ruscio, Ronald C KesslerAbstract:Objective: Despite its inclusion in DSM-IV, little is known about the prevalence or correlates of adult separation anxiety disorder or its relationship to the childhood disorder. Results of the first epidemiological study of adult separation anxiety disorder, to the authors’ knowledge, and its relationship to childhood separation anxiety disorder are presented. Method: Data were from the National Comorbidity Survey Replication (NCS-R), a Nationally representative Survey of U.S. households. A fully structured, lay-administered diagnostic interview assessed a wide range of DSM-IV disorders, including separation anxiety disorder. No independent clinical validation was obtained of the assessment. Results: Lifetime prevalence estimates of childhood and adult separation anxiety disorders were 4.1% and 6.6%, respectively. Approximately one-third of the respondents who were classified as childhood cases (36.1%) had an illness that persisted into adulthood, although the majority classified as adult cases (77.5%) h...
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the prevalence and correlates of dsm iv intermittent explosive disorder in the National Comorbidity Survey replication
Archives of General Psychiatry, 2006Co-Authors: Ronald C Kessler, Robert Jin, Emil F. Coccaro, Maurizio Fava, Savina Jaeger, Ellen E. WaltersAbstract:CONTEXT: Little is known about the epidemiology of intermittent explosive disorder (IED). OBJECTIVE: To present Nationally representative data on the prevalence and correlates of DSM-IV IED. DESIGN: The World Health Organization Composite InterNational Diagnostic Interview was used to assess DSM-IV anxiety disorders, mood disorders, substance use disorders, and impulse control disorders. SETTING: The National Comorbidity Survey Replication, a face-to-face household Survey carried out in 2001-2003. PARTICIPANTS: A Nationally representative sample of 9282 people 18 years and older. MAIN OUTCOME MEASURE: Diagnoses of DSM-IV IED. RESULTS: Lifetime and 12-month prevalence estimates of DSM-IV IED were 7.3% and 3.9%, with a mean 43 lifetime attacks resulting in 1359 dollars in property damage. Intermittent explosive disorder-related injuries occurred 180 times per 100 lifetime cases. Mean age at onset was 14 years. Sociodemographic correlates were uniformly weak. Intermittent explosive disorder was significantly comorbid with most DSM-IV mood, anxiety, and substance disorders. Although the majority of people with IED (60.3%) obtained professional treatment for emotional or substance problems at some time in their life, only 28.8% ever received treatment for their anger, while only 11.7% of 12-month cases received treatment for their anger in the 12 months before interview. CONCLUSIONS: Intermittent explosive disorder is a much more common condition than previously recognized. The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment. Road rage, temper outbursts that involve throwing or breaking objects, and some types of intimate partner violence can sometimes be associated with IED. Language: en
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the epidemiology of panic attacks panic disorder and agoraphobia in the National Comorbidity Survey replication
Archives of General Psychiatry, 2006Co-Authors: Ronald C Kessler, Katherine Shear, Ayelet Meron Ruscio, Wai Tat Chiu, Ellen E. WaltersAbstract:Context Only limited information exists about the epidemiology of DSM-IV panic attacks (PAs) and panic disorder (PD). Objective To present Nationally representative data about the epidemiology of PAs and PD with or without agoraphobia (AG) on the basis of the US National Comorbidity Survey Replication findings. Design and Setting Nationally representative face-to-face household Survey conducted using the fully structured World Health Organization Composite InterNational Diagnostic Interview. Participants English-speaking respondents (N=9282) 18 years or older. Main Outcome Measures Respondents who met DSM-IV lifetime criteria for PAs and PD with and without AG. Results Lifetime prevalence estimates are 22.7% for isolated panic without AG (PA only), 0.8% for PA with AG without PD (PA-AG), 3.7% for PD without AG (PD only), and 1.1% for PD with AG (PD-AG). Persistence, lifetime number of attacks, and number of years with attacks increase monotonically across these 4 subgroups. All 4 subgroups are significantly comorbid with other lifetime DSM-IV disorders, with the highest odds for PD-AG and the lowest for PA only. Scores on the Panic Disorder Severity Scale are also highest for PD-AG (86.3% moderate or severe) and lowest for PA only (6.7% moderate or severe). Agoraphobia is associated with substantial severity, impairment, and Comorbidity. Lifetime treatment is high (from 96.1% for PD-AG to 61.1% for PA only), but 12-month treatment meeting published treatment guidelines is low (from 54.9% for PD-AG to 18.2% for PA only). Conclusion Although the major societal burden of panic is caused by PD and PA-AG, isolated PAs also have high prevalence and meaningful role impairment.
Nancy A Sampson - One of the best experts on this subject based on the ideXlab platform.
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services for adolescents with psychiatric disorders 12 month data from the National Comorbidity Survey adolescent
Psychiatric Services, 2014Co-Authors: Jane E Costello, Ronald C Kessler, Nancy A Sampson, Jianping He, Kathleen R. MerikangasAbstract:ObjectiveThis study examined 12-month rates of service use for mental, emotional, and behavioral disorders among adolescents.MethodsData were from the National Comorbidity Survey Adolescent Supplement (NCS-A), a Survey of DSM-IV mental, emotional, and behavioral disorders and service use.ResultsIn the past 12 months, 45.0% of adolescents with psychiatric disorders received some form of service. The most likely were those with ADHD (73.8%), conduct disorder (73.4%), or oppositional defiant disorder (71.0%). Least likely were those with specific phobias (40.7%) and any anxiety disorder (41.4%). Among those with any disorder, services were more likely to be received in a school setting (23.6%) or in a specialty mental health setting (22.8%) than in a general medical setting (10.1%). Youths with any disorder also received services in juvenile justice settings (4.5%), complementary and alternative medicine (5.3%), and human services settings (7.9%). Although general medical providers treated a larger proportio...
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prevalence correlates and treatment of lifetime suicidal behavior among adolescents results from the National Comorbidity Survey replication adolescent supplement
JAMA Psychiatry, 2013Co-Authors: Matthew K Nock, Irving Hwang, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts). Objectives To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors. Design Dual-frame National sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement. Setting Face-to-face household interviews with adolescents and questionnaires for parents. Participants A total of 6483 adolescents 13 to 18 years of age and their parents. Main Outcome Measures Lifetime suicide ideation, plans, and attempts. Results The estimated lifetime prevalences of suicide ideation, plans, and attempts among the respondents are 12.1%, 4.0%, and 4.1%, respectively. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the Survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders are also predictors of plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%), treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring. Conclusions Suicidal behaviors are common among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have preexisting mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts. These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts, and unplanned attempts.
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intermittent explosive disorder in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Katie A Mclaughlin, Irving Hwang, Nancy A Sampson, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Epidemiologic studies of adults show that DSM-IV intermittent explosive disorder (IED) is a highly prevalent and seriously impairing disorder. Although retrospective reports in these studies suggest that IED typically begins in childhood, no previous epidemiologic research has directly examined the prevalence or correlates of IED among youth. Objective To present epidemiologic data on the prevalence and correlates of IED among US adolescents in the National Comorbidity Survey Replication Adolescent Supplement. Design United States Survey of adolescent (age, 13-17 years) DSM-IV anxiety, mood, behavior, and substance disorders. Setting Dual-frame household-school samples. Participants A total of 6483 adolescents (interviews) and parents (questionnaires). Main outcome measures The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview (CIDI). Results Nearly two-thirds of adolescents (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence. Of these, 7.8% met DSM-IV/CIDI criteria for lifetime IED. Intermittent explosive disorder had an early age at onset (mean age, 12.0 years) and was highly persistent, as indicated by 80.1% of lifetime cases (6.2% of all respondents) meeting 12-month criteria for IED. Injuries related to IED requiring medical attention reportedly occurred 52.5 times per 100 lifetime cases. In addition, IED was significantly comorbid with a wide range of DSMIV/CIDI mood, anxiety, and substance disorders, with 63.9% of lifetime cases meeting criteria for another such disorder. Although more than one-third (37.8%) of adolescents with 12-month IED received treatment for emotional problems in the year before the interview, only 6.5% of respondents with 12-month IED were treated specifically for anger. Conclusions Intermittent explosive disorder is a highly prevalent, persistent, and seriously impairing adolescent mental disorder that is both understudied and undertreated. Research is needed to uncover risk and protective factors for the disorder, develop strategies for screening and early detection, and identify effective treatments.
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lifetime co morbidity of dsm iv disorders in the us National Comorbidity Survey replication adolescent supplement ncs a
Psychological Medicine, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Matthew D Lakoma, Alan M Zaslavsky, Shelli Avenevoli, Greif J Green, Daniel S Pine, Ries K MerikangasAbstract:BACKGROUND: Research on the structure of co-morbidity among common mental disorders has largely focused on current prevalence rather than on the development of co-morbidity. This report presents preliminary results of the latter type of analysis based on the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).MethodA National Survey was carried out of adolescent mental disorders. DSM-IV diagnoses were based on the Composite InterNational Diagnostic Interview (CIDI) administered to adolescents and questionnaires self-administered to parents. Factor analysis examined co-morbidity among 15 lifetime DSM-IV disorders. Discrete-time survival analysis was used to predict first onset of each disorder from information about prior history of the other 14 disorders. RESULTS: Factor analysis found four factors representing fear, distress, behavior and substance disorders. Associations of temporally primary disorders with the subsequent onset of other disorders, dated using retrospective age-of-onset (AOO) reports, were almost entirely positive. Within-class associations (e.g. distress disorders predicting subsequent onset of other distress disorders) were more consistently significant (63.2%) than between-class associations (33.0%). Strength of associations decreased as co-morbidity among disorders increased. The percentage of lifetime disorders explained (in a predictive rather than a causal sense) by temporally prior disorders was in the range 3.7-6.9% for earliest-onset disorders [specific phobia and attention deficit hyperactivity disorder (ADHD)] and much higher (23.1-64.3%) for later-onset disorders. Fear disorders were the strongest predictors of most other subsequent disorders. CONCLUSIONS: Adolescent mental disorders are highly co-morbid. The strong associations of temporally primary fear disorders with many other later-onset disorders suggest that fear disorders might be promising targets for early interventions. Language: en
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severity of 12 month dsm iv disorders in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Shelli Avenevoli, Jennifer Greif Green, Michael J Gruber, Jane E Costello, Kathleen R. MerikangasAbstract:CONTEXT: Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. OBJECTIVE: To present US National data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. DESIGN: The National Comorbidity Survey Replication Adolescent Supplement is a National Survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. SETTING: Dual-frame household and school samples of US adolescents. PARTICIPANTS: Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). MAIN OUTCOME MEASURES: The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite InterNational Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite InterNational Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. RESULTS: The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite InterNational Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high Comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number. CONCLUSIONS: The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high Comorbidity have important public health implications for targeting interventions. Language: en
Alan M Zaslavsky - One of the best experts on this subject based on the ideXlab platform.
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prevalence correlates and treatment of lifetime suicidal behavior among adolescents results from the National Comorbidity Survey replication adolescent supplement
JAMA Psychiatry, 2013Co-Authors: Matthew K Nock, Irving Hwang, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Although suicide is the third leading cause of death among US adolescents, little is known about the prevalence, correlates, or treatment of its immediate precursors, adolescent suicidal behaviors (ie, suicide ideation, plans, and attempts). Objectives To estimate the lifetime prevalence of suicidal behaviors among US adolescents and the associations of retrospectively reported, temporally primary DSM-IV disorders with the subsequent onset of suicidal behaviors. Design Dual-frame National sample of adolescents from the National Comorbidity Survey Replication Adolescent Supplement. Setting Face-to-face household interviews with adolescents and questionnaires for parents. Participants A total of 6483 adolescents 13 to 18 years of age and their parents. Main Outcome Measures Lifetime suicide ideation, plans, and attempts. Results The estimated lifetime prevalences of suicide ideation, plans, and attempts among the respondents are 12.1%, 4.0%, and 4.1%, respectively. The vast majority of adolescents with these behaviors meet lifetime criteria for at least one DSM-IV mental disorder assessed in the Survey. Most temporally primary (based on retrospective age-of-onset reports) fear/anger, distress, disruptive behavior, and substance disorders significantly predict elevated odds of subsequent suicidal behaviors in bivariate models. The most consistently significant associations of these disorders are with suicide ideation, although a number of disorders are also predictors of plans and both planned and unplanned attempts among ideators. Most suicidal adolescents (>80%) receive some form of mental health treatment. In most cases (>55%), treatment starts prior to onset of suicidal behaviors but fails to prevent these behaviors from occurring. Conclusions Suicidal behaviors are common among US adolescents, with rates that approach those of adults. The vast majority of youth with suicidal behaviors have preexisting mental disorders. The disorders most powerfully predicting ideation, though, are different from those most powerfully predicting conditional transitions from ideation to plans and attempts. These differences suggest that distinct prediction and prevention strategies are needed for ideation, plans among ideators, planned attempts, and unplanned attempts.
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intermittent explosive disorder in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Katie A Mclaughlin, Irving Hwang, Nancy A Sampson, Alan M Zaslavsky, Jennifer Greif Green, Ronald C KesslerAbstract:Context Epidemiologic studies of adults show that DSM-IV intermittent explosive disorder (IED) is a highly prevalent and seriously impairing disorder. Although retrospective reports in these studies suggest that IED typically begins in childhood, no previous epidemiologic research has directly examined the prevalence or correlates of IED among youth. Objective To present epidemiologic data on the prevalence and correlates of IED among US adolescents in the National Comorbidity Survey Replication Adolescent Supplement. Design United States Survey of adolescent (age, 13-17 years) DSM-IV anxiety, mood, behavior, and substance disorders. Setting Dual-frame household-school samples. Participants A total of 6483 adolescents (interviews) and parents (questionnaires). Main outcome measures The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview (CIDI). Results Nearly two-thirds of adolescents (63.3%) reported lifetime anger attacks that involved destroying property, threatening violence, or engaging in violence. Of these, 7.8% met DSM-IV/CIDI criteria for lifetime IED. Intermittent explosive disorder had an early age at onset (mean age, 12.0 years) and was highly persistent, as indicated by 80.1% of lifetime cases (6.2% of all respondents) meeting 12-month criteria for IED. Injuries related to IED requiring medical attention reportedly occurred 52.5 times per 100 lifetime cases. In addition, IED was significantly comorbid with a wide range of DSMIV/CIDI mood, anxiety, and substance disorders, with 63.9% of lifetime cases meeting criteria for another such disorder. Although more than one-third (37.8%) of adolescents with 12-month IED received treatment for emotional problems in the year before the interview, only 6.5% of respondents with 12-month IED were treated specifically for anger. Conclusions Intermittent explosive disorder is a highly prevalent, persistent, and seriously impairing adolescent mental disorder that is both understudied and undertreated. Research is needed to uncover risk and protective factors for the disorder, develop strategies for screening and early detection, and identify effective treatments.
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lifetime co morbidity of dsm iv disorders in the us National Comorbidity Survey replication adolescent supplement ncs a
Psychological Medicine, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Matthew D Lakoma, Alan M Zaslavsky, Shelli Avenevoli, Greif J Green, Daniel S Pine, Ries K MerikangasAbstract:BACKGROUND: Research on the structure of co-morbidity among common mental disorders has largely focused on current prevalence rather than on the development of co-morbidity. This report presents preliminary results of the latter type of analysis based on the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).MethodA National Survey was carried out of adolescent mental disorders. DSM-IV diagnoses were based on the Composite InterNational Diagnostic Interview (CIDI) administered to adolescents and questionnaires self-administered to parents. Factor analysis examined co-morbidity among 15 lifetime DSM-IV disorders. Discrete-time survival analysis was used to predict first onset of each disorder from information about prior history of the other 14 disorders. RESULTS: Factor analysis found four factors representing fear, distress, behavior and substance disorders. Associations of temporally primary disorders with the subsequent onset of other disorders, dated using retrospective age-of-onset (AOO) reports, were almost entirely positive. Within-class associations (e.g. distress disorders predicting subsequent onset of other distress disorders) were more consistently significant (63.2%) than between-class associations (33.0%). Strength of associations decreased as co-morbidity among disorders increased. The percentage of lifetime disorders explained (in a predictive rather than a causal sense) by temporally prior disorders was in the range 3.7-6.9% for earliest-onset disorders [specific phobia and attention deficit hyperactivity disorder (ADHD)] and much higher (23.1-64.3%) for later-onset disorders. Fear disorders were the strongest predictors of most other subsequent disorders. CONCLUSIONS: Adolescent mental disorders are highly co-morbid. The strong associations of temporally primary fear disorders with many other later-onset disorders suggest that fear disorders might be promising targets for early interventions. Language: en
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severity of 12 month dsm iv disorders in the National Comorbidity Survey replication adolescent supplement
Archives of General Psychiatry, 2012Co-Authors: Ronald C Kessler, Maria Petukhova, Nancy A Sampson, Katie A Mclaughlin, Alan M Zaslavsky, Shelli Avenevoli, Jennifer Greif Green, Michael J Gruber, Jane E Costello, Kathleen R. MerikangasAbstract:CONTEXT: Estimates of DSM-IV disorder prevalence are high; stringent criteria to define need for services are desired. OBJECTIVE: To present US National data on the prevalence and sociodemographic correlates of 12-month serious emotional disturbance (SED), defined by the US Substance Abuse and Mental Health Services Administration, from the National Comorbidity Survey Replication Adolescent Supplement. DESIGN: The National Comorbidity Survey Replication Adolescent Supplement is a National Survey of DSM-IV anxiety, mood, behavior, and substance disorders among US adolescents. SETTING: Dual-frame household and school samples of US adolescents. PARTICIPANTS: Total of 6483 pairs of adolescents aged 13 to 17 (interviews) and parents (questionnaires). MAIN OUTCOME MEASURES: The DSM-IV disorders were assessed with the World Health Organization Composite InterNational Diagnostic Interview and validated with blinded clinical interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Serious emotional disturbance was operationalized as a DSM-IV/Composite InterNational Diagnostic Interview disorder with a score of 50 or less on the Children's Global Assessment Scale (ie, moderate impairment in most areas of functioning or severe impairment in at least 1 area). Concordance of Composite InterNational Diagnostic Interview SED diagnoses with blinded Schedule for Affective Disorders and Schizophrenia for School-Age Children diagnoses was good. RESULTS: The estimated prevalence of SED was 8.0%. Most SEDs were due to behavior (54.5%) or mood (31.4%) disorders. Although respondents with 3 or more disorders made up only 29.0% of those with 12-month DSM-IV/Composite InterNational Diagnostic Interview disorders, they constituted 63.5% of SEDs. Predictive effects of high Comorbidity were significantly greater than the product of their disorder-specific odds ratios and consistent across disorder types. Associations of sociodemographic variables with SED were generally nonsignificant after controlling for disorder type and number. CONCLUSIONS: The high estimated 12-month prevalence of DSM-IV disorders among US adolescents is largely due to mild cases. The significant between-disorder differences in risk of SED and the significant effect of high Comorbidity have important public health implications for targeting interventions. Language: en
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validation of the diagnoses of panic disorder and phobic disorders in the us National Comorbidity Survey replication adolescent ncs a supplement
International Journal of Methods in Psychiatric Research, 2011Co-Authors: Jennifer Greif Green, Kathleen R. Merikangas, Nancy A Sampson, Ronald C Kessler, Shelli Avenevoli, Michael J Gruber, Matthew Finkelman, Alan M ZaslavskyAbstract:Validity of the adolescent version of the World Health Organization Composite InterNational Diagnostic Interview (CIDI) Version 3.0, a fully-structured research diagnostic interview designed to be used by trained lay interviewers, is assessed in comparison to independent clinical diagnoses based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). This assessment is carried out in the clinical reappraisal sub-sample (n = 347) of the US National Comorbidity Survey Adolescent Supplement (NCS-A), a large (n = 10,148) community epidemiological Survey of the prevalence and correlates of adolescent mental disorders in the US. The diagnoses considered are panic disorder and phobic disorders (social phobia, specific phobia, agoraphobia). CIDI diagnoses are found to have good concordance with K-SADS diagnoses (AUC = .81–.94), although the CIDI diagnoses are consistency somewhat higher than the K-SADS diagnoses. Data are also presented on criterion-level concordance in an effort to pinpoint CIDI question series that might be improved in future modifications of the instrument. Finally, data are presented on the factor structure of the fears associated with social phobia, the only disorder in this series where substantial controversy exists about disorder subtypes.
