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

Annelieke M. Roest, Ymkje Anna de Vries, Carmen C.W. Lim, Hans Ulrich Wittchen, Dan J. Stein, Tomasz Adamowski, Ali Al-Hamzawi, Evelyn J. Bromet, Maria Carmen Viana, Giovanni de Girolamo, Koen Demyttenaere, Silvia Florescu, Oye Gureje, Josep Maria Haro, Chiyi Hu, Elie G. Karam, José Miguel Caldas-de-Almeida, Norito Kawakami, Jean Pierre Lépine, Daphna Levinson & 10 others Maria E. Medina-Mora, Fernando Navarro-Mateu, Siobhan O’Neill, Marina Piazza, José A. Posada-Villa, Tim Slade, Yolanda Torres, Ronald C. Kessler, Kate M. 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.

Original languageEnglish
Pages (from-to)499-510
JournalDepression and Anxiety
Volume36
Issue number6
DOIs
Publication statusPublished - 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. M., de Vries, Y. A., Lim, C. C. W., Wittchen, H. U., Stein, D. J., 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 M. ; de Vries, Ymkje Anna ; Lim, Carmen C.W. ; Wittchen, Hans Ulrich ; Stein, Dan J. ; Adamowski, Tomasz ; Al-Hamzawi, Ali ; Bromet, Evelyn J. ; Viana, Maria Carmen ; de Girolamo, Giovanni ; Demyttenaere, Koen ; Florescu, Silvia ; Gureje, Oye ; Haro, Josep Maria ; Hu, Chiyi ; Karam, Elie G. ; Caldas-de-Almeida, José Miguel ; Kawakami, Norito ; Lépine, Jean Pierre ; Levinson, Daphna ; Medina-Mora, Maria E. ; Navarro-Mateu, Fernando ; O’Neill, Siobhan ; Piazza, Marina ; Posada-Villa, José A. ; Slade, Tim ; Torres, Yolanda ; Kessler, Ronald C. ; Scott, Kate M. ; 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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author = "Roest, {Annelieke M.} and {de Vries}, {Ymkje Anna} and Lim, {Carmen C.W.} and Wittchen, {Hans Ulrich} and Stein, {Dan J.} and Tomasz Adamowski and Ali Al-Hamzawi and Bromet, {Evelyn J.} and Viana, {Maria Carmen} and {de Girolamo}, Giovanni and Koen Demyttenaere and Silvia Florescu and Oye Gureje and Haro, {Josep Maria} and Chiyi Hu and Karam, {Elie G.} and Caldas-de-Almeida, {Jos{\'e} Miguel} and Norito Kawakami and L{\'e}pine, {Jean Pierre} and Daphna Levinson and Medina-Mora, {Maria E.} and Fernando Navarro-Mateu and Siobhan O’Neill and Marina Piazza and Posada-Villa, {Jos{\'e} A.} and Tim Slade and Yolanda Torres and Kessler, {Ronald C.} and Scott, {Kate M.} and {de Jonge}, Peter",
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Roest, AM, de Vries, YA, Lim, CCW, Wittchen, HU, Stein, DJ, Adamowski, T, Al-Hamzawi, A, Bromet, EJ, Viana, MC, de Girolamo, G, Demyttenaere, K, Florescu, S, Gureje, O, Haro, JM, Hu, C, Karam, EG, Caldas-de-Almeida, JM, Kawakami, N, Lépine, JP, Levinson, D, Medina-Mora, ME, Navarro-Mateu, F, O’Neill, S, Piazza, M, Posada-Villa, JA, Slade, T, Torres, Y, Kessler, RC, Scott, KM & 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 M.; de Vries, Ymkje Anna; Lim, Carmen C.W.; Wittchen, Hans Ulrich; Stein, Dan J.; Adamowski, Tomasz; Al-Hamzawi, Ali; Bromet, Evelyn J.; Viana, Maria Carmen; de Girolamo, Giovanni; Demyttenaere, Koen; Florescu, Silvia; Gureje, Oye; Haro, Josep Maria; Hu, Chiyi; Karam, Elie G.; Caldas-de-Almeida, José Miguel; Kawakami, Norito; Lépine, Jean Pierre; Levinson, Daphna; Medina-Mora, Maria E.; Navarro-Mateu, Fernando; O’Neill, Siobhan; Piazza, Marina; Posada-Villa, José A.; Slade, Tim; Torres, Yolanda; Kessler, Ronald C.; Scott, Kate M.; de Jonge, Peter.

In: Depression and Anxiety, Vol. 36, No. 6, 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 M.

AU - de Vries, Ymkje Anna

AU - Lim, Carmen C.W.

AU - Wittchen, Hans Ulrich

AU - Stein, Dan J.

AU - Adamowski, Tomasz

AU - Al-Hamzawi, Ali

AU - Bromet, Evelyn J.

AU - Viana, Maria Carmen

AU - de Girolamo, Giovanni

AU - Demyttenaere, Koen

AU - Florescu, Silvia

AU - Gureje, Oye

AU - Haro, Josep Maria

AU - Hu, Chiyi

AU - Karam, Elie G.

AU - Caldas-de-Almeida, José Miguel

AU - Kawakami, Norito

AU - Lépine, Jean Pierre

AU - Levinson, Daphna

AU - Medina-Mora, Maria E.

AU - Navarro-Mateu, Fernando

AU - O’Neill, Siobhan

AU - Piazza, Marina

AU - Posada-Villa, José A.

AU - Slade, Tim

AU - Torres, Yolanda

AU - Kessler, Ronald C.

AU - Scott, Kate M.

AU - de Jonge, Peter

PY - 2019/6

Y1 - 2019/6

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

KW - cross-national

KW - disorders

KW - epidemiology

KW - phobia/phobic

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