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Prevalence and treatment of 12-month DSM-IV disorders in the Northern Ireland study of health and stress

Abstract

Purpose

Prior to the current Northern Ireland Study of Health and Stress there have been no epidemiological studies which estimate the prevalence and treatment of mental health disorders across Northern Ireland based on validated diagnostic criteria. This paper provides the first nationally representative estimates of 12-month DSM-IV anxiety, mood, impulse-control and substance disorders. Severity, demographic correlates, treatment and treatment adequacy of 12-month disorders are also examined.

Methods

Data were derived from a nationally representative face-to-face household survey of 4,340 participants (2,441 females and 1,899 males) aged 18 years and older living in Northern Ireland using the World Health Organization Composite International Diagnostic Interview. Analyses were implemented using the SUDAAN software system.

Results

12-month prevalence estimates were anxiety 14.6 %; mood 9.6 %; impulse control 3.4 %; substance 3.5 %; any disorder 23.1 %. Of the 12-month cases, 28.8 % were classified as serious; 33.4 % as moderate; and 37.8 % as mild. Females were more likely to have anxiety and mood disorders (p < 0.05) while males were more likely to have impulse-control and substance disorders. Just 40 % of individuals with any 12-month DSM-IV disorder received treatment in the previous 12 months. 78.6 % of those with a mental disorder who sought treatment received minimally adequate treatment.

Conclusions

12-month DSM-IV disorders are highly prevalent in Northern Ireland. A large proportion of those with mental health problems did not seek treatment. Further research is required to investigate the reasons behind low levels of treatment contact.

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Acknowledgments

We thank the staff of the WMH Data Collection and Data Analysis Coordination Centres for assistance with instrumentation, fieldwork, and consultation on data analysis. A complete list of all within-country and cross-national WMH publications can be found at http://www.hcp.med.harvard.edu/wmh/. The NISHS was supported by a grant from R&D Division Northern Ireland. The survey was carried out in conjunction with the World Health Organization World Mental Health (WMH) Survey Initiative which is supported by the National Institute of Mental Health (NIMH; R01 MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb. None of the funders had any role in the design, analysis, interpretation of results, or preparation of this paper. All researchers involved in the study are independent from the sponsor.

Ethical approval

This study was approved by the University of Ulster Research Ethics and Governance Committee. All participants in the NISHS gave written informed consent before taking part.

Conflict of interest

BB, SM, SO’N and FF have support from Research and Development (R&D) Division Northern Ireland and the WMH Survey Initiative for the submitted work. BB, SM, SO’N and FF have no relationships with R&D Division Northern Ireland that might have an interest in the submitted work in the previous 3 years. Their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and BB, SM, SO’N and FF have no non-financial interests that may be relevant to the submitted work.

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Correspondence to Brendan Bunting.

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Bunting, B., Murphy, S., O’Neill, S. et al. Prevalence and treatment of 12-month DSM-IV disorders in the Northern Ireland study of health and stress. Soc Psychiatry Psychiatr Epidemiol 48, 81–93 (2013). https://doi.org/10.1007/s00127-012-0518-5

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  • DOI: https://doi.org/10.1007/s00127-012-0518-5

Keywords

  • Epidemiology
  • Mental health disorders
  • Service use
  • Northern Ireland