Prevalence, Diagnosis, and Treatment of Depression and Generalized Anxiety Disorder in a Diverse Urban Community

• Published in: Psychiatric services (Washington, D.C.) Vol. 59; no. 6; pp. 641 - 647
• Main Authors: Gwynn, R. Charon, McQuistion, Hunter L, McVeigh, Katharine H, Garg, Renu K, Frieden, Thomas R, Thorpe, Lorna E
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychiatric Association 01.06.2008; American Psychiatric Publishing, Inc
• Subjects: Adult; Adult and adolescent clinical studies; Anxiety; Anxiety Disorders - diagnosis; Anxiety Disorders - drug therapy; Anxiety Disorders - epidemiology; Anxiety disorders. Neuroses; Biological and medical sciences; Community health care; Cross-Sectional Studies; Depression; Depression - diagnosis; Depression - drug therapy; Depression - epidemiology; Female; Humans; Male; Medical diagnosis; Medical sciences; Mental depression; Mental health care; Middle Aged; Miscellaneous; Mood disorders; New York City; Noncitizens; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk factors; Urban areas; United States; North America; America; New York City; United States > US; New York City New York; Human; Mood disorder; Social environment; Urban environment; Prevalence; Accessibility; Anxiety disorder; Mental health; Depression; Health service; Epidemiology; Treatment; Generalized anxiety disorder; Sociodemographic factor; Cross sectional study; Young adult; Adult; Diagnosis; Elderly; Public health
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/ps.2008.59.6.641

This study assessed the prevalence, diagnosis, and treatment of major depressive disorder and generalized anxiety disorder among New York City adults. As part of the first community-specific Health and Nutrition Examination Survey in the United States, depression and anxiety were assessed in a representative sample of 1,817 noninstitutionalized adults in 2004. A total of 8% had major depressive disorder and 4% had generalized anxiety disorder. Respondents with depression were more likely to be formerly married, publicly insured, younger, and U.S. born. Only 55% of adults with depression were diagnosed, and 38% of those with depression or anxiety were in treatment; individuals with a diagnosis of depression were more likely to receive treatment than those without a diagnosis (61% versus 7%; p<.001). Immigrants with depression were 60% less likely to be diagnosed than their U.S.-born counterparts; immigrants arriving in this country ten or more years ago had slightly more anxiety than immigrants arriving less than ten years ago (3% versus 2%, not significant). Among respondents with anxiety, 23% reported disability compared with 15% of those with depression. Compared with adults with neither diagnosis, adults with depression or anxiety were twice as likely to smoke tobacco (p<.05), adults with depression were twice as likely to have diabetes (p<.01), and those with anxiety were twice as likely to have asthma (p<.01). Mental disorders are often disabling and inadequately diagnosed and treated. Foreign-born adults experience barriers to diagnosis and treatment despite having less depression; anxiety may increase with time since immigration. Increased awareness of and linkage to mental health services are needed, especially in larger, more diverse urban communities.