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      Epidemiology of anxiety disorders in the 21st century Translated title: Epidemiología de los trastornos de ansiedad en el siglo XXI Translated title: Epidémiologie des troubles anxieux au XXIe siècle

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          Abstract

          Anxiety disorders, including panic disorder with or without agoraphobia, generalized anxiety disorder, social anxiety disorder, specific phobias, and separation anxiety disorder, are the most prevalent mental disorders and are associated with immense health care costs and a high burden of disease. According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime. Substantial underrecognition and undertreatment of these disorders have been demonstrated. There is no evidence that the prevalence rates of anxiety disorders have changed in the past years. In cross-cultural comparisons, prevalence rates are highly variable. It is more likely that this heterogeneity is due to differences in methodology than to cultural influences. Anxiety disorders follow a chronic course; however, there is a natural decrease in prevalence rates with older age. Anxiety disorders are highly comorbid with other anxiety disorders and other mental disorders.

          Translated abstract

          Los trastornos de ansiedad, que incluyen el trastorno de pánico con o sin agorafobia, el trastorno de ansiedad generalizada, el trastorno de ansiedad social, las fobias específicas y el trastorno de ansiedad por separación son los trastornos mentales más prevalentes y están asociados con inmensos costos de atención de salud y una alta carga de enfermedad. De acuerdo con investigaciones basadas en grandes poblaciones, hasta un 33,7% de la población presenta un trastorno de ansiedad durante su vida. Se ha demostrado que el subdiagnóstico y el subtratamiento de estos trastornos es significativo. No existe evidencia acerca del cambío en las frecuencias de prevalencia de los trastornos de ansiedad en los últimos años. En comparaciones interculturales las frecuencias de prevalencía son altamente variables. Es más probable que esta heterogeneidad se deba a diferencias en la metodología más que a influencias culturales. Los trastornos de ansiedad siguen un curso crónico; sin embargo, hay una disminución natural en las frecuencias de prevalencia a mayor edad. Los trastornos de ansiedad son altamente comórbidos con otros trastornos ansiosos y otros trastornos mentales.

          Translated abstract

          Les troubles anxieux, dont le trouble panique avec ou sans agoraphobie, le trouble anxieux généralisé, l'anxiété sociale, les phobies spécifiques et l'anxiété de séparation, sont les troubles mentaux les plus prévalents avec des coûts immenses en termes de santé et une charge élevée. D'après de grandes études basées sur la population, jusqu'à 33,7 % de la population souffre d'un trouble anxieux au cours de la vie. Ces pathologies sont manifestement sous-diagnostiquées et sous-traitées. Leur prévalence n'a pas montré de modification ces dernières années et est très variable dans les comparaisons interculturelles. Cette hétérogénéité est probablement plus due à des biais méthodologiques qu'à des influences culturelles. L'évolution des troubles anxieux est chronique mais leur prévalence diminue cependant naturellement avec l'âge. Leur comorbidité avec les autres troubles anxieux et les autres maladies mentales est très élevée.

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          Most cited references34

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          World Health Organization.

          Ala Alwan (2007)
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            Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States.

            Estimates of 12-month and lifetime prevalence and of lifetime morbid risk (LMR) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) anxiety and mood disorders are presented based on US epidemiological surveys among people aged 13+. The presentation is designed for use in the upcoming DSM-5 manual to provide more coherent estimates than would otherwise be available. Prevalence estimates are presented for the age groups proposed by DSM-5 workgroups as the most useful to consider for policy planning purposes. The LMR/12-month prevalence estimates ranked by frequency are as follows: major depressive episode: 29.9%/8.6%; specific phobia: 18.4/12.1%; social phobia: 13.0/7.4%; post-traumatic stress disorder: 10.1/3.7%; generalized anxiety disorder: 9.0/2.0%; separation anxiety disorder: 8.7/1.2%; panic disorder: 6.8%/2.4%; bipolar disorder: 4.1/1.8%; agoraphobia: 3.7/1.7%; obsessive-compulsive disorder: 2.7/1.2. Four broad patterns of results are most noteworthy: first, that the most common (lifetime prevalence/morbid risk) lifetime anxiety-mood disorders in the United States are major depression (16.6/29.9%), specific phobia (15.6/18.4%), and social phobia (10.7/13.0%) and the least common are agoraphobia (2.5/3.7%) and obsessive-compulsive disorder (2.3/2.7%); second, that the anxiety-mood disorders with the earlier median ages-of-onset are phobias and separation anxiety disorder (ages 15-17) and those with the latest are panic disorder, major depression, and generalized anxiety disorder (ages 23-30); third, that LMR is considerably higher than lifetime prevalence for most anxiety-mood disorders, although the magnitude of this difference is much higher for disorders with later than earlier ages-of-onset; and fourth, that the ratio of 12-month to lifetime prevalence, roughly characterizing persistence, varies meaningfully in ways consistent with independent evidence about differential persistence of these disorders. Copyright © 2012 John Wiley & Sons, Ltd.
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              Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.

              This study presents estimates of lifetime and 12-month prevalence of 14 DSM-III-R psychiatric disorders from the National Comorbidity Survey, the first survey to administer a structured psychiatric interview to a national probability sample in the United States. The DSM-III-R psychiatric disorders among persons aged 15 to 54 years in the noninstitutionalized civilian population of the United States were assessed with data collected by lay interviewers using a revised version of the Composite International Diagnostic Interview. Nearly 50% of respondents reported at least one lifetime disorder, and close to 30% reported at least one 12-month disorder. The most common disorders were major depressive episode, alcohol dependence, social phobia, and simple phobia. More than half of all lifetime disorders occurred in the 14% of the population who had a history of three or more comorbid disorders. These highly comorbid people also included the vast majority of people with severe disorders. Less than 40% of those with a lifetime disorder had ever received professional treatment, and less than 20% of those with a recent disorder had been in treatment during the past 12 months. Consistent with previous risk factor research, it was found that women had elevated rates of affective disorders and anxiety disorders, that men had elevated rates of substance use disorders and antisocial personality disorder, and that most disorders declined with age and with higher socioeconomic status. The prevalence of psychiatric disorders is greater than previously thought to be the case. Furthermore, this morbidity is more highly concentrated than previously recognized in roughly one sixth of the population who have a history of three or more comorbid disorders. This suggests that the causes and consequences of high comorbidity should be the focus of research attention. The majority of people with psychiatric disorders fail to obtain professional treatment. Even among people with a lifetime history of three or more comorbid disorders, the proportion who ever obtain specialty sector mental health treatment is less than 50%. These results argue for the importance of more outreach and more research on barriers to professional help-seeking.
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                Author and article information

                Contributors
                Journal
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues Clin Neurosci
                Dialogues in Clinical Neuroscience
                Les Laboratoires Servier (France )
                1294-8322
                1958-5969
                September 2015
                September 2015
                : 17
                : 3
                : 327-335
                Affiliations
                Department of Psychiatry and Psychotherapy, University Medical Centre, Göttingen, Germany
                Department of Psychiatry and Psychotherapy, University Medical Centre, Göttingen, Germany
                Author notes
                Article
                10.31887/DCNS.2015.17.3/bbandelow
                4610617
                26487813
                9d916603-84b7-45fb-a376-2f1317544a33
                Copyright: © 2015 Institut la Conférence Hippocrate - Servier Research Group

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Clinical Research

                Neurosciences
                anxiety disorder,panic disorder,agoraphobia,generalized anxiety disorder,social anxiety disorder,specific phobia,separation anxiety disorder,epidemiology,comorbidity

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