Challenging the myth of an "epidemic" of common mental disorders: trends in the global prevalence of anxiety and depression between 1990 and 2010.
BACKGROUND
Anxiety disorders and major depressive disorder (MDD) are common and disabling mental disorders. This paper aims to test the hypothesis that common mental disorders have become more prevalent over the past two decades.


METHODS
We conducted a systematic review of prevalence, remission, duration, and excess mortality studies for anxiety disorders and MDD and then used a Bayesian meta-regression approach to estimate point prevalence for 1990, 2005, and 2010. We also conducted a post-hoc search for studies that used the General Health Questionnaire (GHQ) as a measure of psychological distress and tested for trends to present a qualitative comparison of study findings


RESULTS
This study found no evidence for an increased prevalence of anxiety disorders or MDD. While the crude number of cases increased by 36%, this was explained by population growth and changing age structures. Point prevalence of anxiety disorders was estimated at 3.8% (3.6-4.1%) in 1990 and 4.0% (3.7-4.2%) in 2010. The prevalence of MDD was unchanged at 4.4% in 1990 (4.2-4.7%) and 2010 (4.1-4.7%). However, 8 of the 11 GHQ studies found a significant increase in psychological distress over time.


CONCLUSIONS
The perceived "epidemic" of common mental disorders is most likely explained by the increasing numbers of affected patients driven by increasing population sizes. Additional factors that may explain this perception include the higher rates of psychological distress as measured using symptom checklists, greater public awareness, and the use of terms such as anxiety and depression in a context where they do not represent clinical disorders.
School of Population Health, University of Queensland, Herston, Australia; Queensland Centre for Mental Health Research, Wacol, Australia.
Amanda J
AJ
Baxter
Kate M
KM
Scott
Alize J
AJ
Ferrari
Rosana E
RE
Norman
Theo
T
Vos
Harvey A
HA
Whiteford
D001008:Anxiety Disorders / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000453:epidemiology*; D014943:Global Health / Q000706:statistics & numerical data*; D006801:Humans; D015995:Prevalence
anxiety/anxiety disorders; crossnational; depression; epidemiology; international; mood disorders; obesity; stress