A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys

Annelieke Roest, Ymkje Anna de Vries , Carmen Lim, Hans-Ulrich Wittchen, Dan Stein, Tomasz Adamowski , Ali Al-Hamzawi , Evelyn Bromet , Maria Carmen Viana, Giovanni di Girolamo, Koen Demyttenaere, Silvia Florescu, Oye Gureje , Josep Maria Haro, Chiyi Hu, Elie Karam, José Miguel Caldas‐de‐Almeida , Norito Kawakami , Jean Pierre Lepine, Daphna Levinson & 10 others Maria Elena Medina Mora, Fernando Navarro-Mateau, Siobhan O'Neill, Marina Piazza, José A. Posada‐Villa, Tim Slade, Yolanda Torres, Ronald Kessler, Kate Scott, Peter de Jonge

Research output: Contribution to journalArticle

Abstract

Background: The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria. Methods: Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders. Results: Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5% and 1.0%) were comparable to DSM-IV (1.4% and 0.9%). Of respondents meeting criteria in either system, 57.1% met criteria in both, while 24.2% met criteria for DSM-5 only and 18.8% for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4%) than those with both DSM-5 and DSM-IV AG (44.0%; χ 2 1 = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7%) than those who met both sets (92.9%; χ 2 1 = 14.5; P < 0.001). Conclusions: This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.

LanguageEnglish
Pages499-510
Number of pages12
JournalDepression and Anxiety
Volume36
Issue number6
Early online date6 Feb 2019
DOIs
Publication statusPublished - 4 Jun 2019

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Agoraphobia
Health Surveys
Diagnostic and Statistical Manual of Mental Disorders
Mental Health
Panic Disorder
Global Health
Comorbidity

Keywords

  • agoraphobia
  • anxiety/anxiety disorders
  • cross-national
  • disorders
  • epidemiology
  • phobia/phobic

Cite this

Roest, A., de Vries , Y. A., Lim, C., Wittchen, H-U., Stein, D., Adamowski , T., ... de Jonge, P. (2019). A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys. Depression and Anxiety, 36(6), 499-510. https://doi.org/10.1002/da.22885
Roest, Annelieke ; de Vries , Ymkje Anna ; Lim, Carmen ; Wittchen, Hans-Ulrich ; Stein, Dan ; Adamowski , Tomasz ; Al-Hamzawi , Ali ; Bromet , Evelyn ; Viana, Maria Carmen ; di Girolamo, Giovanni ; Demyttenaere, Koen ; Florescu, Silvia ; Gureje , Oye ; Haro, Josep Maria ; Hu, Chiyi ; Karam, Elie ; Caldas‐de‐Almeida , José Miguel ; Kawakami , Norito ; Lepine, Jean Pierre ; Levinson, Daphna ; Medina Mora, Maria Elena ; Navarro-Mateau, Fernando ; O'Neill, Siobhan ; Piazza, Marina ; Posada‐Villa, José A. ; Slade, Tim ; Torres, Yolanda ; Kessler, Ronald ; Scott, Kate ; de Jonge, Peter. / A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys. In: Depression and Anxiety. 2019 ; Vol. 36, No. 6. pp. 499-510.
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abstract = "Background: The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria. Methods: Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders. Results: Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5{\%} and 1.0{\%}) were comparable to DSM-IV (1.4{\%} and 0.9{\%}). Of respondents meeting criteria in either system, 57.1{\%} met criteria in both, while 24.2{\%} met criteria for DSM-5 only and 18.8{\%} for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4{\%}) than those with both DSM-5 and DSM-IV AG (44.0{\%}; χ 2 1 = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7{\%}) than those who met both sets (92.9{\%}; χ 2 1 = 14.5; P < 0.001). Conclusions: This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5{\%}. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.",
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Roest, A, de Vries , YA, Lim, C, Wittchen, H-U, Stein, D, Adamowski , T, Al-Hamzawi , A, Bromet , E, Viana, MC, di Girolamo, G, Demyttenaere, K, Florescu, S, Gureje , O, Haro, JM, Hu, C, Karam, E, Caldas‐de‐Almeida , JM, Kawakami , N, Lepine, JP, Levinson, D, Medina Mora, ME, Navarro-Mateau, F, O'Neill, S, Piazza, M, Posada‐Villa, JA, Slade, T, Torres, Y, Kessler, R, Scott, K & de Jonge, P 2019, 'A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys', Depression and Anxiety, vol. 36, no. 6, pp. 499-510. https://doi.org/10.1002/da.22885

A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys. / Roest, Annelieke; de Vries , Ymkje Anna ; Lim, Carmen; Wittchen, Hans-Ulrich; Stein, Dan; Adamowski , Tomasz; Al-Hamzawi , Ali; Bromet , Evelyn; Viana, Maria Carmen; di Girolamo, Giovanni; Demyttenaere, Koen; Florescu, Silvia; Gureje , Oye ; Haro, Josep Maria; Hu, Chiyi; Karam, Elie; Caldas‐de‐Almeida , José Miguel; Kawakami , Norito; Lepine, Jean Pierre; Levinson, Daphna; Medina Mora, Maria Elena; Navarro-Mateau, Fernando; O'Neill, Siobhan; Piazza, Marina; Posada‐Villa, José A.; Slade, Tim; Torres, Yolanda ; Kessler, Ronald; Scott, Kate; de Jonge, Peter.

In: Depression and Anxiety, Vol. 36, No. 6, 04.06.2019, p. 499-510.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys

AU - Roest, Annelieke

AU - de Vries , Ymkje Anna

AU - Lim, Carmen

AU - Wittchen, Hans-Ulrich

AU - Stein, Dan

AU - Adamowski , Tomasz

AU - Al-Hamzawi , Ali

AU - Bromet , Evelyn

AU - Viana, Maria Carmen

AU - di Girolamo, Giovanni

AU - Demyttenaere, Koen

AU - Florescu, Silvia

AU - Gureje , Oye

AU - Haro, Josep Maria

AU - Hu, Chiyi

AU - Karam, Elie

AU - Caldas‐de‐Almeida , José Miguel

AU - Kawakami , Norito

AU - Lepine, Jean Pierre

AU - Levinson, Daphna

AU - Medina Mora, Maria Elena

AU - Navarro-Mateau, Fernando

AU - O'Neill, Siobhan

AU - Piazza, Marina

AU - Posada‐Villa, José A.

AU - Slade, Tim

AU - Torres, Yolanda

AU - Kessler, Ronald

AU - Scott, Kate

AU - de Jonge, Peter

PY - 2019/6/4

Y1 - 2019/6/4

N2 - Background: The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria. Methods: Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders. Results: Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5% and 1.0%) were comparable to DSM-IV (1.4% and 0.9%). Of respondents meeting criteria in either system, 57.1% met criteria in both, while 24.2% met criteria for DSM-5 only and 18.8% for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4%) than those with both DSM-5 and DSM-IV AG (44.0%; χ 2 1 = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7%) than those who met both sets (92.9%; χ 2 1 = 14.5; P < 0.001). Conclusions: This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.

AB - Background: The Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-5) definition of agoraphobia (AG) as an independent diagnostic entity makes it timely to re-examine the epidemiology of AG. Study objective was to present representative data on the characteristics of individuals who meet DSM-IV criteria for AG (AG without a history of panic disorder [PD] and PD with AG) but not DSM-5 criteria, DSM-5 but not DSM-IV criteria, or both sets of criteria. Methods: Population-based surveys from the World Mental Health Survey Initiative including adult respondents (n = 136,357) from 27 countries across the world. The Composite International Diagnostic Interview was used to assess AG and other disorders. Results: Lifetime and 12-month prevalence estimates of DSM-5 AG (1.5% and 1.0%) were comparable to DSM-IV (1.4% and 0.9%). Of respondents meeting criteria in either system, 57.1% met criteria in both, while 24.2% met criteria for DSM-5 only and 18.8% for DSM-IV only. Severe role impairment due to AG was reported by a lower proportion of respondents who met criteria only for DSM-IV AG (30.4%) than those with both DSM-5 and DSM-IV AG (44.0%; χ 2 1 = 4.7; P = 0.031). The proportion of cases with any comorbidity was lower among respondents who met criteria only for DSM-IV AG (78.7%) than those who met both sets (92.9%; χ 2 1 = 14.5; P < 0.001). Conclusions: This first large survey shows that, compared to the DSM-IV, the DSM-5 identifies a substantial group of new cases with AG, while the prevalence rate remains stable at 1.5%. Severity and comorbidity are higher in individuals meeting DSM-5 AG criteria compared with individuals meeting DSM-IV AG criteria only.

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KW - anxiety/anxiety disorders

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Roest A, de Vries YA, Lim C, Wittchen H-U, Stein D, Adamowski T et al. A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys. Depression and Anxiety. 2019 Jun 4;36(6):499-510. https://doi.org/10.1002/da.22885