This survey was conducted by the Australian Bureau of Statistics in order to provide a detailed overview of the prevalence of mental and substance-use disorders for Australia by way of a 1997 Australian national survey of mental health and well-being. This was the first Australian national household survey to replicate and extend the 1990 United States national comorbidity survey of adults aged 15-54 years, published in 1994, and the 1993 United Kingdom survey of psychiatric morbidity in adults aged 16-64 years, published in 1997. All of these surveys aimed at three questions:
1. How many adults in private households suffered from mental disorders?
2. How disabled were they by their psychiatric impairment?
3. What health services did they use and want?
In the Australian survey, close to 23% of adults reported having at least one psychiatric disorder in the previous 12 months and 14% were suffering from a disorder when interviewed. Only 35%, or about one-third of people with a mental disorder in the 12 months prior to the survey had actually consulted about it as a defined problem and most had seen a general practitioner, not a specialist. 50% of those disabled or having multiple comorbidities had consulted. The Australian survey divided up mental disorders under affective or mood disorders, anxiety disorders (and these included any anxiety disorder including PTSD), substance use disorders (which included licits and illicits and any harmful drug use/abuse), and then under other disorders they placed the personality disorders, cognitive impairment, and psychosis which did not have a category of its own.
About 1 in 6 people in the Australian community met criteria for any disorder during the prior year and 1 in 11 met criteria for active illness during the months preceding the interview. The other disorder section included a screen of questions which identified other neurotic disorders in 1.5% of the sample, personality disorder in 6.5%, cognitive impairment including early dementia in 1.3% of the sample, and active psychosis in 0.4% of the sample. Thus, the total prevalence in the year was 22.7% using the International Classification of Diseases 10 (ICD-10) and 20.3% using the Diagnostic and Statistical Manual (DSM-IV).
Women had higher rates of mood and anxiety disorders and lower rates of substance use disorders in contrast to men. The elderly had lower rates for all disorders except cognitive impairment. The young had much higher rates of substance use disorders. Currently married had lower rates for all disorders in contrast to those never married or presently separated. Disorders were more frequent generally in those with less education. Similarly, those who were employed had lower rates for all disorders. About 4% of people admitting to suffering from conditions suffered from 2 or 3 or more diagnoses at the one time (ie comorbidity).
References:
Andrews G, Henderson S, and Hall W (2001) ‘Prevalence, Comorbidity, Disability, and Service Utilisation: Overview of the Australian National Mental Health Survey’ British Journal of Psychiatry, 178, pp145-153.
Henderson S, Andrews G, and Hall W (2000) ‘Australia’s mental health: an overview of the general population survey’ Australian and New Zealand Journal of Psychiatry, 34, pp197-205.
Dr Ian Curtis is a senior psychiatrist in full-time practice in Brisbane. Dr Ian Curtis is also a public speaker with over 30 years experience. Dr Ian Curtis as been involved in preparing and presenting workshops and lectures for Queensland Health, the Queensland Police Service, the University of Queensland Medical School, and Brisbane Churches. He has also lectured at international venues in China, India, and the USA.