Diagnosis and Classification

Abstract

Almost one third of all individuals who are 18 years or older and live in the United States have experienced, at some time in their lives, an alcohol-abuse, substance-abuse, or mental disorder. In any 1-month period, three of 20 adults living in the United States experience these disorders. When alcohol or substance abuse is excluded from these statistics, the lifetime prevalence for mental disorders is 23%; the 1-month prevalence is 13%. These statistics are reported in the recent National Institute of Mental Health (NIMH) Epidemiologic Catchment Area (ECA) survey, which is the largest, population-based survey of the incidence of mental and substance-abuse disorders among individuals 18 years and older who live in the United States (Regier et al., 1990). Some readers may find these statistics even more striking when they consider that the disorders reflected in this survey are severe conditions, such as schizophrenia, organic brain disorders, depression, and incapacitating anxiety The statistics exclude millions of Americans who experience disorders of psychological or psychophysiological function, such as depersonalization disorders, disorders of impulse control (e.g., pathological gambling), chronic pain, Type A behavior, sexual disorders, and those individuals who experience dysfunction associated with life crises (e.g., death of a loved one, divorce, or sexual assault). These statistics do not reflect the incidence of mental disorders in childhood and adolescence. Nor does their summary here reflect the wide variability of incidence across factors such as geographic region, socioeconomic status, gender, or ethnicity.