Abstract
mentaldisorders in a nationally representative US sample. 2 These studies established the methods ofmodern psychiatric epidemiology in the United States, including the use of reliable lay-administered structured diagnostic assessment tools to ascertain standardized diagnosticcriteria,3–4 the comparison of clinical interviews with lay interviews to evaluate diagnosticvalidity,5–7 and the application of sampling strategies to identify nationally representativesamples. Combined with earlier and richly informative international studies in psychiatricepidemiology,8–10 the ECA, NCS, and related surveys demonstrated that mental disorderswere highly prevalent in the general population and placed mental illness squarely on thenation's and the world's public health agenda.11These studies have also changed how we view psychopathology. Most mental illnesses, forexample, begin far earlier in life than was previously believed. In addition, findings such asthe frequency of comorbidity among the major diagnostic entities have led to systematic studiesof their boundaries and renewed questions about categorical vs dimensional approaches toclassification. Nonetheless, many critical issues were not addressed by earlier studies. Whilethe overall 12-month prevalence of any mental illness was reported to be in the range of 30%,significant questions about the disability associated with these syndromes remain. How severeare the disorders reported to be present in 30% of the population? What is the economic andpublic health impact of these conditions? How long is the delay between onset and diagnosis?And to what extent have we made progress in providing appropriate evidence-based treatmentsto those who are ill?The 4 articles from the National Comorbidity Survey Replication (NCS-R) published in thisissue of the ARCHIVES address each of these questions.12–15 The NCS-R uses theinternational World Health Organization-Composite International Diagnostic Interview(WHO-CIDI),6 a fully structured lay-administered interview, to generate
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