Published online by Cambridge University Press: 10 August 2009
Epidemiology of mood disorders
Major depressive disorder (MDD) is the leading cause of disability among those age 5 and over, and the second leading source of disease burden, surpassing cardiovascular diseases, dementia, lung cancer, and diabetes (Murray and Lopez, 1996). The dramatic impact of mood disorders on distress to the affected individual and his or her family, lifetime disability, and suicide highlights the importance of etiologic research to inform treatment and prevention.
Community-based rates of mood disorder are essential to deriving estimates of population familial recurrence risk (λ) (Risch, 1990). Population prevalence estimates of mood disorders are available from two community surveys of the USA: the Epidemiologic Catchment Area (ECA) study of five sites in the USA (Robins and Regier, 1991), and the National Comorbidity Survey (NCS) of a probability sample of the USA conducted 10 years later (Kessler et al., 1994). Estimates of base rates of bipolar disorder (or manic episodes) were very low in both studies, averaging 0.8% in ECA and 1.6% in NCS. In contrast, there is a very high lifetime prevalence of MDD in the US population (females, 12% ECA; 21.3% NCS, and males, 5% ECA, 12.7% NCS). Similar base rates of mood disorders have been obtained in international studies as well (Weissman et al., 1996). With respect to demographic factors, the differences between the bipolar and major depression subtypes of mood disorders include the sex ratio that favors women for MDD but is nearly equal for men and women for bipolar disorder, and the age of onset that occurs nearly a decade earlier in MDD than in bipolar disorder (Weissman et al., 1991).
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