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'Serious Psychological Distress' Affects Millions of Americans

A large government survey reveals the pervasive nature of major depression: an estimated 31 million adults reported experiencing a major depressive episode at some point in their lives.

An estimated 24.6 million American adults, or 11.3 percent of U.S. residents over age 18, reported experiencing "serious psychological distress" during the preceding year, according to the 2005 National Survey on Drug Use and Health. More than an estimated 30 million adults reported experiencing at least one episode of major depression during their lives.

Researchers gathered the information by administering the K6 instrument to respondents as part of the larger survey (see article above). The scale consists of six questions about symptoms of emotional distress experienced by respondents during one month in the prior year at a time when they were feeling their worst emotionally.

The six items ask about symptoms related to feelings of depression, anxiety, restlessness, and hopelessness and were scored on the basis of their frequency. The scale ranges from 0 to 24 points, and respondents with a score of 13 or higher were classified as experiencing serious psychological distress.

They then extrapolated the results to population estimates.

Women reported more psychological distress (14 percent) than did men (8.4 percent). Additionally, in 2005 adults who used illicit drugs during the previous year were significantly more likely to report serious psychological distress than those who did not use an illicit drug (22 percent vs. 9.6 percent).

Prior year illicit drug use was higher among adults with serious psychological distress (26.9 percent) than those without it (12.1 percent).

Among the 24.6 million adults with serious psychological distress in the prior year, 11.1 million (45.3 percent) received treatment for a mental health problem during that year, according to the survey.

Of those, slightly more than 39 percent received a prescription medication for their mental health problem.

About 28.5 percent received outpatient treatment, and 4.6 percent received inpatient treatment for a psychiatric problem during the year prior to the survey.

The survey also included a module of questions that gathered information on whether respondents had experienced a lifetime or past-year major depressive episode, defined as a period of at least two weeks in which respondents experienced a depressed mood or loss of interest or pleasure in daily activities and had symptoms that met DSM-IV criteria for a major depressive episode.

According to the survey, there is substantial overlap in the populations classified as having serious psychological distress and who experienced a major depressive episode, but meeting criteria for psychological distress "indicates that the respondent exhibited a high level of distress due to any type of mental problem (including general symptoms related to phobia, anxiety and depression)...."

A total of 30.8 million adults, or 14.2 percent of adults aged 18 or older, have had at least one major depressive episode during their lifetimes, according to the survey.

About half this number (15.8 million adults) experienced such an episode during the preceding year. The lifetime prevalence for major depressive episodes was 15.7 percent for respondents aged 18 to 25, 16 percent among those aged 26 to 49, and 11.6 for those aged 50 or older.

In comparison, about 3.4 million youth aged 12 to 17 reported having at least one major depressive episode over the course of their lives. A little more than 2 million experienced such an episode over the prior year.

Among adults who had a major depressive episode in the prior year, 65.6 percent reported receiving treatment for depression during that same period. Women were more likely to receive treatment than men (70.9 percent vs. 55.6 percent).

The 2005 National Survey on Drug Use and Health is posted at <oas.samhsa.gov/nsduh/2k5Results.htm>.

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