A Comparison of DSM-5 and DSM-IV Agoraphobia in the World Mental Health Surveys

Year: 2019
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Authors

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

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.
Depression and Anxiety. 2019 Jun;36(6):499-510. doi: 10.1002/da.22885

Topic

Anxiety,Phobia,Mental Health Around the World,L.E.B.A.N.O.N Study

Keywords

Agoraphobia, Anxiety, Anxiety Disorders, Cross-national, Disorders, Epidemiology, Phobia, Phobic
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