Comorbidity of DSM–III–R Major Depressive Disorder in the General Population: Results from the US National Comorbidity Survey

TLDR

The study highlights that the lifetime prevalence of secondary major depressive disorder has risen in recent cohorts, while pure and primary depression rates have stayed stable, underscoring its public health importance. It presents general‑population data on the prevalence and correlates of comorbidity between DSM‑III‑R major depressive disorder and other DSM‑III‑R disorders. The analysis draws on the US National Comorbidity Survey, a large survey of 15‑54‑year‑old civilians, with diagnoses obtained via a modified Composite International Diagnostic Interview. Most lifetime MDD cases are secondary, occurring after another DSM‑III‑R disorder—particularly anxiety disorders—, the risk of subsequent MDD remains elevated for years, and secondary MDD is generally more persistent and severe than primary MDD.

Abstract

General population data are presented on the prevalence and correlates of comorbidity between DSM-III-R major depressive disorder (MDD) and other DSM-III-R disorders. The data come from the US National Comorbidity Survey, a large general population survey of persons aged 15-54 years in the non-institutionalised civilian population. Diagnoses are based on a modified version of the Composite International Diagnostic Interview (CIDI). The analysis shows that most cases of lifetime MDD are secondary. In the sense that they occur in people with a prior history of another DSM-III-R disorder. Anxiety disorders are the most common primary disorders. The time-lagged effects of most primary disorders on the risk of subsequent MDD continue for many years without change in magnitude. Secondary MDD is, in general, more persistent and severe than pure or primary MDD. This has special public health significance because lifetime prevalence of secondary MDD has increased in recent cohorts, while the prevalence of pure and primary depression has remained unchanged.