Hasin DS, et al. - Researchers, in this study, aimed to report the current nationally representative findings on the prevalence, correlates, psychiatric comorbidity, functioning, and treatment of DSM-5 major depressive disorder (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. DSM-5 MDD was identified to be highly prevalent, comorbid, and disabling among US adults. Most of the cases received some treatment, however, a substantial minority did not. The DSM-5 MDD specifiers in the general population required further investigation

Methods

• A representative sample of US noninstitutionalized civilian adults (≥18 years) (n = 36,309) who participated in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III) were in-person interviewed.
• From April 2012 to June 2013, collection of data was performed and analysis was performed in 2016-2017.
• Outcomes assessed were prevalence of DSM-5 MDD and the DSM-5 specifiers.
• Researchers also measured odds ratios (ORs), adjusted ORs (aORs), and 95% CIs indicated associations with demographic characteristics and other psychiatric disorders.

Results

• NESARC-III had 36,309 adult participants, 12-month and lifetime prevalences of MDD were 10.4% and 20.6%, respectively.
• In this study, odds of 12-month MDD were observed to be markedly 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).
• Observations revealed that 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 and that 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.
• Moderate (39.7%) or severe (49.5%) lifetime MDD cases were recognized mostly.
• Some type of treatment was received by almost 70% with lifetime MDD.
• Among those with severe MDD, functioning was approximately 1 SD below the national mean.
• Occurrence of all episodes was noticed just after the death of someone close and lasted less than 2 months among 12.9% of those with lifetime MDD.
• Researchers noticed that 74.6% and 15.5% of MDD cases were characterized by the anxious/distressed specifier and the mixed-features specifier, respectively .
• Both specifiers were associated with early onset, poor course and functioning, and suicidality on controlling for severity.