Skip to main content Accessibility help
×
Home

Prevalence and treatment of common mental disorders in the English national population, 1993–2007

  • Nicola Spiers (a1), Tarik Qassem (a2), Paul Bebbington (a3), Sally McManus (a4), Michael King (a3), Rachel Jenkins (a5), Howard Meltzer (a6) and Traolach S. Brugha (a7)...

Abstract

Background

The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007.

Aims

To evaluate frequency of common mental disorders (CMDs), service contact and treatment.

Method

Common mental disorders were identified with the Clinical Interview Schedule – Revised (CIS-R). Service contact and treatment were established in structured interviews.

Results

There were 8615, 6126 and 5385 participants aged 16–64. Prevalence of CMDs was consistent (1993: 14.3%; 2000: 16.0%; 2007: 16.0%), as was past-year primary care physician contact for psychological problems (1993: 11.3%; 2000: 12.0%; 2007: 11.7%). Antidepressant receipt in people with CMDs more than doubled between 1993 (5.7%) and 2000 (14.5%), with little further increase by 2007 (15.9%). Psychological treatments increased in successive surveys. Many with CMDs received no treatment.

Conclusions

Reduction in prevalence did not follow increased treatment uptake, and may require universal public health measures together with individual pharmacological, psychological and computer-based interventions.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Prevalence and treatment of common mental disorders in the English national population, 1993–2007
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Prevalence and treatment of common mental disorders in the English national population, 1993–2007
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Prevalence and treatment of common mental disorders in the English national population, 1993–2007
      Available formats
      ×

Copyright

Corresponding author

Traolach Brugha, Department of Health Sciences, University of Leicester, Centre for Medicine, University Road, Leicester LE1 7RH, UK. Email: tsb@le.ac.uk

Footnotes

Hide All

Deceased.

Declaration of interest

None.

Footnotes

References

Hide All
1 Centre for Mental Health. The Economic and Social Costs of Mental Health Problems in 2009/10. Centre for Mental Health, 2015.
2 Weich, S, Bebbington, P, Rai, D, Stranges, S, McBride, O, Spiers, N, et al. The population impact of common mental disorders and long-term physical conditions on disability and hospital admission. Psychol Med 2013; 43: 921–31.
3 Compton, WM, Conway, KP, Stinson, FS, Grant, BF. Changes in the prevalence of major depression and comorbid substance use disorders in the United States between 1991–1992 and 2001–2002. Am J Psychiatry 2006; 163: 2141–7.
4 Marcus, SC, Olfson, M. National trends in the treatment for depression from 1998 to 2007. Arch Gen Psychiatry 2010; 67: 1265–73.
5 Kessler, RC, Demler, O, Frank, RG, Olfson, M, Pincus, HA, Walters, EE, et al. Prevalence and treatment of mental disorders, 1990 to 2003. N Engl J Med 2005; 352: 2515–23.
6 Spiers, N, Bebbington, P, McManus, S, Brugha, TS, Jenkins, R, Meltzer, H. Age and birth cohort differences in the prevalence of common mental disorder in England: National Psychiatric Morbidity Surveys 1993–2007. Br J Psychiatry 2011; 198: 479–84.
7 Dowrick, C, Frances, A. Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ 2013; 347: f7140.
8 Jenkins, R, Meltzer, H, Bebbington, P, Brugha, T, Farrell, M, McManus, S, et al. The British Mental Health Survey Programme: achievements and latest findings. Soc Psychiatry Psychiatr Epidemiol 2009; 44: 899904.
9 McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R. Adult Psychiatric Morbidity in England, 2007. Results of a Household Survey. The NHS Information Centre for Health and Social Care, 2009.
10 Meltzer, H, Gill, B, Petticrew, M, Hinds, K. OPCS Surveys of Psychiatric Morbidity in Great Britain. Report 1: The Prevalence of Psychiatric Morbidity among Adults Living in Private Households. HMSO, 1995.
11 Singleton, N, Bumpstead, R, O'Brien, M, Lee, A, Meltzer, H. Psychiatric Morbidity Among Adults Living in Private Households. TSO (The Stationery Office), 2001.
12 Calem, M, Bisla, J, Begum, A, Dewey, M, Bebbington, PE, Brugha, T, et al. Increased prevalence of insomnia and changes in hypnotics use in England over 15 years: analysis of the 1993, 2000, and 2007 National Psychiatric Morbidity Surveys. Sleep 2012; 35: 377–84.
13 Brugha, TS, Bebbington, PE, Singleton, N, Melzer, D, Jenkins, R, Lewis, G, et al. Trends in service use and treatment for mental disorders in adults throughout Great Britain. Br J Psychiatry 2004; 185: 378–84.
14 Clark, DM. Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: the IAPT experience. Int Rev Psychiatry 2011; 23: 318–27.
15 Baker, R, Bradburn, N, Johnson, R. Computer-assisted personal interviewing: an experimental evaluation of data quality and cost. J Off Statist 1995; 11: 413–31.
16 British Medical Association & Royal Pharmaceutical Society of Great Britain. British National Formulary. BMJ, 2000.
17 McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R. Adult Psychiatric Morbidity in England: Results of a Household Survey: Appendices and Glossary. NHS Information Centre for Health and Social Care, 2009.
18 Lewis, G, Pelosi, AJ, Araya, R, Dunn, G. Measuring psychiatric disorder in the community: a standardized assessment for use by lay interviewers. Psychol Med 1992; 22: 465–86.
19 World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO, 1992.
20 Qassem, T, Bebbington, P, Spiers, N, McManus, S, Jenkins, R, Dein, S. Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys. Soc Psychiatry Psychiatr Epidemiol 2015; 50: 1057–64.
21 De Leeuw, E, Heer, W. Trends in household survey response: a longitudinal and international comparison. In Survey Nonresponse (ed Groves, R): 4154. Wiley, 2002.
22 de Winter, AF, Oldehinkel, AJ, Veenstra, R, Brunnekreef, JA, Verhulst, FC, Ormel, J. Evaluation of non-response bias in mental health determinants and outcomes in a large sample of pre-adolescents. Eur J Epidemiol 2005; 20: 173–81.
23 Korkeila, K, Suominen, S, Ahvenainen, J, Ojanlatva, A, Rautava, P, Helenius, H, et al. Non-response and related factors in a nation-wide health survey. Eur J Epidemiol 2001; 17: 991–9.
24 Sogaard, AJ, Selmer, R, Bjertness, E, Thelle, D. The Oslo Health Study: the impact of self-selection in a large, population-based survey. Int J Equity Health 2004; 3: 3.
25 Moore, M, Yuen, HM, Dunn, N, Mullee, MA, Maskell, J, Kendrick, T. Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database. BMJ 2009; 339: b3999.
26 Lockhart, P, Guthrie, B. Trends in primary care antidepressant prescribing 1995-2007: a longitudinal population database analysis. Br J Gen Prac 2011; 61: e56572.
27 National Institute for Health and Care Excellence. Depression in Adults: Recognition and Management (CG90). NICE, 2009.
28 Collaborating Centre for Mental Health. WHO Guide to Mental and Neurological Health in Primary Care. Royal Society of Medicine Press, 2004.
29 Mojtabai, R, Jorm, AF. Trends in psychological distress, depressive episodes and mental health treatment-seeking in the United States: 2001–2012. J Affect Disord 2015; 174: 556–61.
30 Patten, SB, Williams, JV, Lavorato, DH, Bulloch, AG, Wiens, K, Wang, J. Why is major depression prevalence not changing? J Affect Disord 2015; 190: 93–7.
31 Fournier, JC, DeRubeis, RJ, Hollon, SD, Dimidjian, S, Amsterdam, JD, Shelton, RC, et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 2010; 303: 4753.
32 Cuijpers, P, Smit, F. Subthreshold depression as a risk indicator for major depressive disorder: a systematic review of prospective studies. Acta Psychiatr Scand 2004; 109: 325–31.
33 Barbui, C, Cipriani, A, Patel, V, Ayuso-Mateos, JL, van Ommeren, M. Efficacy of antidepressants and benzodiazepines in minor depression: systematic review and meta-analysis. Br J Psychiatry 2011; 198: 11–6.
34 Murray, CJ, Vos, T, Lozano, R, Naghavi, M, Flaxman, AD, Michaud, C, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2197–223.
35 Vos, T, Flaxman, AD, Naghavi, M, Lozano, R, Michaud, C, Ezzati, M, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380: 2163–96.
36 Thota, AB, Sipe, TA, Byard, GJ, Zometa, CS, Hahn, RA, Knight-Eily, LR, et al. Collaborative care to improve the management of depressive disorders: a community guide systematic review and meta-analysis. Am J Prev Med 2012; 42: 525–38.
37 Buszewicz, M, Griffin, M, McMahon, EM, Beecham, J, King, M. Evaluation of a system of structured, pro-active care for chronic depression in primary care: a randomised controlled trial. BMC Psychiatry 2010; 10: 61.
38 Stellefson, M, Dipnarine, K, Stopka, C. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis 2013; 10: E26.
39 Green, BB, Cook, AJ, Ralston, JD, Fishman, PA, Catz, SL, Carlson, J, et al. Effectiveness of home blood pressure monitoring, web communication, and pharmacist care on hypertension control: a randomized controlled trial. JAMA 2008; 299: 2857–67.
40 Foley, T. Bridging the Gap: The Financial Case for a Reasonable Rebalancing of Health and Care Resources. Royal College of Psychiatrists, Centre for Mental Health, 2013.
41 Kohn, R, Saxena, S, Levav, I, Saraceno, B. The treatment gap in mental health care. Bull World Health Organ 2004; 82: 858–66.
42 Andrews, G, Titov, N. Changing the face of mental health care through needs-based planning. Aust Health Rev 2007; 31 (suppl 1): 122–8.
43 Andrews, G, Titov, N. Is internet treatment for depressive and anxiety disorders ready for prime time? Med J Aust 2010; 192 (suppl 11): 45–7.
44 Ford, E, Clark, C, McManus, S, Harris, J, Jenkins, R, Bebbington, P, et al. Common mental disorders, unemployment and welfare benefits in England. Public Health 2010; 124: 675–81.
45 Meltzer, H, Bebbington, P, Brugha, T, Jenkins, R, McManus, S, Stansfeld, S. Job insecurity, socio-economic circumstances and depression. Psychol Med 2010; 40: 1401–7.
46 Stansfeld, SA, Pike, C, McManus, S, Harris, J, Bebbington, P, Brugha, T, et al. Occupations, work characteristics and common mental disorder. Psychol Med 2013; 43: 961–73.
47 Weich, S, Twigg, L, Holt, G, Lewis, G, Jones, K. Contextual risk factors for the common mental disorders in Britain: a multilevel investigation of the effects of place. J Epidemiol Community Health 2003; 57: 616–21.
48 Weich, S, Twigg, L, Lewis, G, Jones, K. Geographical variation in rates of common mental disorders in Britain: prospective cohort study. Br J Psychiatry 2005; 187: 2934.
49 Weich, S. Absence of spatial variation in rates of the common mental disorders. J Epidemiol Community Health 2005; 59: 254–7.
50 Judd, LL, Schettler, PJ, Akiskal, HS. The prevalence, clinical relevance, and public health significance of subthreshold depressions. Psychiatr Clin North Am 2002; 25: 685–98.
51 Morrell, CJ, Slade, P, Warner, R, Paley, G, Dixon, S, Walters, SJ, et al. Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care. BMJ 2009; 338: a3045.
52 Bellon, JA, Moreno-Kustner, B, Torres-Gonzalez, F, Monton-Franco, C, GildeGomez-Barragan, MJ, Sanchez-Celaya, M, et al. Predicting the onset and persistence of episodes of depression in primary health care. The predictD-Spain study: methodology. BMC Public Health 2008; 8: 256.
53 Brugha, TS, Smith, J, Austin, J, Bankart, J, Patterson, M, Lovett, C, et al. Can community midwives prevent antenatal depression? An external pilot study to test the feasibility of a cluster randomized controlled universal prevention trial. Psychol Med 2015; 20: 112.
54 Brugha, TS, Morrell, CJ, Slade, P, Walters, SJ. Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care. Psychol Med 2011; 41: 739–48.
55 Tan, L, Wang, MJ, Modini, M, Joyce, S, Mykletun, A, Christensen, H, et al. Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace. BMC Med 2014; 12: 74.
Type Description Title
PDF
Supplementary materials

Spiers et al. supplementary material
Supplementary Table S1-S3

 PDF (482 KB)
482 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Prevalence and treatment of common mental disorders in the English national population, 1993–2007

  • Nicola Spiers (a1), Tarik Qassem (a2), Paul Bebbington (a3), Sally McManus (a4), Michael King (a3), Rachel Jenkins (a5), Howard Meltzer (a6) and Traolach S. Brugha (a7)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *