Vandad Sharifi1, Masoumeh Amin-Esmaeili2, Ahmad Hajebi3, Abbas Motevalian4, Reza Radgoodarzi5, Mitra Hefazi2, Afarin Rahimi-Movaghar6. 1. Department of Psychiatry and Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.m.aminesmaeeli@farabi.tums.ac.ir. 2. Department for Mental Health and Substance Use, Iranian Research Center for HIV/AIDS (IRCHA) and Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. 3. Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran. 4. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. 5. Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences and Tous Clinic, Tehran, Iran. 6. Iranian National Center for Addiction Studies (INCAS), Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.
Abstract
IMPORTANCE: No national information is available on the epidemiology of psychiatric disorders in Iran for the last decade. OBJECTIVES: To estimate the 12-month prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders in Iranian population, and to investigate the severity and correlates of psychiatric disorders. DESIGN, SETTING AND PARTICIPANTS: The Iranian Mental Health Survey (IranMHS) was a nationally representative face-to-face household survey with a multistage, cluster sampling design that was carried out in 2011. A total of 7886 community dwelling residents aged 15-64 were recruited. MAIN OUTCOME MEASURES: 12-month diagnoses of DSM-IV psychiatric disorders including mood, anxiety, and substance use disorders were assessed using a validated Persian translation of the Composite International Diagnostic Interview (CIDI; version 2.1). The Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) was administered by a psychiatrist on subjects screened positive for the presence of a psychotic disorder. The severity of psychiatric disorders was determined using criteria that included markers for disability, particular diagnoses and suicide attempts. RESULTS: The response rate was 86.2%. The 12-month weighted prevalence of "any psychiatric disorder" was 23.6% [95% confidence interval (CI): 22.4-24.8] with 26.5% of women and 20.8% of men having one or more psychiatric disorders. The most common category of psychiatric disorders was any anxiety disorder (15.6%) and the most prevalent particular disorder was major depressive disorder (12.7%), followed by generalized anxiety disorder (5.2%) and obsessive-compulsive disorder (5.1%). A 12-month psychotic disorder was observed in 0.5% of the population (95% CI: 0.33-0.66). Almost two-thirds (63.8%) of individuals with a mental disorder had moderate or serious illness. Unemployment, being widowed/divorced and urban living were associated with a greater likelihood of 12-month disorders; while, higher socioeconomic status and having a university degree were associated with a lower likelihood. CONCLUSION: The high prevalence of psychiatric disorders, particularly major depression, merits further attention in the country's mental health policy and program planning.
IMPORTANCE: No national information is available on the epidemiology of psychiatric disorders in Iran for the last decade. OBJECTIVES: To estimate the 12-month prevalence of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) psychiatric disorders in Iranian population, and to investigate the severity and correlates of psychiatric disorders. DESIGN, SETTING AND PARTICIPANTS: The Iranian Mental Health Survey (IranMHS) was a nationally representative face-to-face household survey with a multistage, cluster sampling design that was carried out in 2011. A total of 7886 community dwelling residents aged 15-64 were recruited. MAIN OUTCOME MEASURES: 12-month diagnoses of DSM-IV psychiatric disorders including mood, anxiety, and substance use disorders were assessed using a validated Persian translation of the Composite International Diagnostic Interview (CIDI; version 2.1). The Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) was administered by a psychiatrist on subjects screened positive for the presence of a psychotic disorder. The severity of psychiatric disorders was determined using criteria that included markers for disability, particular diagnoses and suicide attempts. RESULTS: The response rate was 86.2%. The 12-month weighted prevalence of "any psychiatric disorder" was 23.6% [95% confidence interval (CI): 22.4-24.8] with 26.5% of women and 20.8% of men having one or more psychiatric disorders. The most common category of psychiatric disorders was any anxiety disorder (15.6%) and the most prevalent particular disorder was major depressive disorder (12.7%), followed by generalized anxiety disorder (5.2%) and obsessive-compulsive disorder (5.1%). A 12-month psychotic disorder was observed in 0.5% of the population (95% CI: 0.33-0.66). Almost two-thirds (63.8%) of individuals with a mental disorder had moderate or serious illness. Unemployment, being widowed/divorced and urban living were associated with a greater likelihood of 12-month disorders; while, higher socioeconomic status and having a university degree were associated with a lower likelihood. CONCLUSION: The high prevalence of psychiatric disorders, particularly major depression, merits further attention in the country's mental health policy and program planning.
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