Mental Disorders in America
Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year.1 When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people.2 Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness.1 In addition, mental disorders are the leading cause of disability in the U.S. and Canada.3 Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.1
In the U.S., mental disorders are diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV).4
- The median age of onset for mood disorders is 30 years.5
- Depressive disorders often co-occur with anxiety disorders and substance abuse.5
- Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44.3
- While major depressive disorder can develop at any age, the median age at onset is 32.5
- Major depressive disorder is more prevalent in women than in men.6
- Symptoms of dysthymic disorder (chronic, mild depression) must persist for at least two years in adults (one year in children) to meet criteria for the diagnosis. Dysthymic disorder affects approximately 1.5 percent of the U.S. population age 18 and older in a given year.1, This figure translates to about 3.3 million American adults.2
- The median age of onset of dysthymic disorder is 31.1
- The median age of onset for bipolar disorders is 25 years.5
- In 2006, 33,300 (approximately 11 per 100,000) people died by suicide in the U.S.7
- More than 90 percent of people who kill themselves have a diagnosable mental disorder, most commonly a depressive disorder or a substance abuse disorder.8
- The highest suicide rates in the U.S. are found in white men over age 85.9
- Schizophrenia affects men and women with equal frequency.12
- Schizophrenia often first appears in men in their late teens or early twenties. In contrast, women are generally affected in their twenties or early thirties.12
Anxiety disorders include panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, and phobias (social phobia, agoraphobia, and specific phobia).
- Anxiety disorders frequently co-occur with depressive disorders or substance abuse.1
- Most people with one anxiety disorder also have another anxiety disorder. Nearly three-quarters of those with an anxiety disorder will have their first episode by age 21.5 5
- Panic disorder typically develops in early adulthood (median age of onset is 24), but the age of onset extends throughout adulthood.5
- About one in three people with panic disorder develops agoraphobia, a condition in which the individual becomes afraid of being in any place or situation where escape might be difficult or help unavailable in the event of a panic attack.12
- The first symptoms of OCD often begin during childhood or adolescence, however, the median age of onset is 19.5
- PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.5
- About 19 percent of Vietnam veterans experienced PTSD at some point after the war.13 The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.
- GAD can begin across the life cycle, though the median age of onset is 31 years old.5
- Approximately 15 million American adults age 18 and over, or about 6.8 percent of people in this age group in a given year, have social phobia.1
- Social phobia begins in childhood or adolescence, typically around 13 years of age.5
Agoraphobia involves intense fear and anxiety of any place or situation where escape might be difficult, leading to avoidance of situations such as being alone outside of the home; traveling in a car, bus, or airplane; or being in a crowded area.5
- The median age of onset of agoraphobia is 20 years of age.5
Specific phobia involves marked and persistent fear and avoidance of a specific object or situation.
- Specific phobia typically begins in childhood; the median age of onset is seven years.5
The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.
- In their lifetime, an estimated 0.6 percent of the adult population in the U.S. will suffer from anorexia, 1.0 percent from bulimia, and 2.8 percent from a binge eating disorder. 14
- Women are much more likely than males to develop an eating disorder. They are three times as likely to experience anorexia (0.9 percent of women vs. 0.3 percent of men) and bulimia (1.5 percent of women vs. 0.5 percent of men) during their life. They are also 75 percent more likely to have a binge eating disorder (3.5 percent of women vs. 2.0 percent of men).14
- The mortality rate among people with anorexia has been estimated at 0.56 percent per year, or approximately 5.6 percent per decade, which is about 12 times higher than the annual death rate due to all causes of death among females ages 15-24 in the general population.15
- ADHD, one of the most common mental disorders in children and adolescents, also affects an estimated 4.1 percent of adults, ages 18-44, in a given year.1
- ADHD usually becomes evident in preschool or early elementary years. The median age of onset of ADHD is seven years, although the disorder can persist into adolescence and occasionally into adulthood.5
Autism is part of a group of disorders called autism spectrum disorders (ASDs), also known as pervasive developmental disorders. ASDs range in severity, with autism being the most debilitating form while other disorders, such as Asperger syndrome, produce milder symptoms.
- Estimating the prevalence of autism is difficult and controversial due to differences in the ways that cases are identified and defined, differences in study methods, and changes in diagnostic criteria. A recent study by the Centers for Disease Control and Prevention (CDC) reported the prevalence of autism among 8 year-olds to be about 1 in 110.16
- Autism and other ASDs develop in childhood and generally are diagnosed by age three.17
Personality disorders represent "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it."4 These patterns tend to be fixed and consistent across situations and are typically perceived to be appropriate by the individual even though they may markedly affect their day-to-day life in negative ways. Among American adults ages 18 and over, an estimated 9.1% have a diagnosable personality disorder.18 Several more common personality disorders include:
Antisocial Personality Disorder
Antisocial personality disorder is characterized by an individual's disregard for social rules and cultural norms, impulsive behavior, and indifference to the rights and feelings of others.
- Approximately 1.0 percent of people aged 18 or over have antisocial personality disorder.18
Avoidant Personality Disorder
Avoidant personality disorder is characterized by extreme social inhibition, sensitivity to negative evaluation, and feelings of inadequacy. Individuals with avoidant personality disorder frequently avoid social interaction for fear of being ridiculed, humiliated, or disliked.
- An estimated 5.2 percent of people age 18 or older have an avoidant personality disorder.18
Borderline Personality Disorder (BPD) is defined by the DSM-IV as "a pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts.”
- Approximately 1.6 percent of Americans age 18 or older have BPD.18