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Prevalence of Past-Year Mental and Substance Use Disorders, 2021–2022

Heather Ringeisen, Mark J. Edlund, Heidi Guyer, Jill A. Dever, L. Rand Carpenter, Mark Olfson, Michael B. First, Paul J. Geiger, Dan Liao, Andy Peytchev, Christine Carr, Lydia Chwastiak, Lisa B. Dixon, Maria Monroe‐DeVita, T. Scott Stroup, Jeff Swanson, Marvin S. Swartz, Robert D. Gibbons, Leyla Stambaugh, Natalie Bareis, Thomas E. Smith, Ronald C. Kessler

2025Psychiatric Services7 citationsDOIOpen Access PDF

Abstract

OBJECTIVE: The authors aimed to estimate the past-year prevalence of mental and substance use disorders, including schizophrenia spectrum disorders (schizophrenia, schizoaffective, or schizophreniform disorder), among U.S. adults ages 18-65 years from samples of households and prisons and stratified samples from selected homeless shelters and state psychiatric hospitals. Such information is vital to meet the treatment needs of individuals with these disorders. METHODS: (N=5,679 participants; N=4,764 in households). Weighted past-year prevalence estimates of mental and substance use disorders were calculated. Level of impairment and the likelihood that a disorder was caused by the COVID-19 pandemic were assessed. RESULTS: The prevalence estimates of lifetime and past-year schizophrenia spectrum disorders were 1.8% (95% CI=1.3%-2.5%) and 1.2% (95% CI=0.9%-1.8%), respectively. The most common past-year disorders were major depressive disorder (15.5%, 95% CI=13.6%-17.5%) and generalized anxiety disorder (GAD; 10.0%, 95% CI=8.3%-12.1%). About one in 10 participants had at least one substance use disorder (10.6%, 95% CI=8.7%-12.9%). Half of those with an MDPS mental disorder had moderate or serious impairment. CONCLUSIONS: The prevalence rates of lifetime and past-year schizophrenia spectrum disorders were two to four times higher than previously reported. The prevalence rates of major depressive disorder and GAD were substantially higher than reported in past national studies. Almost 20% of these cases were likely due to the pandemic. Increased mental health treatment resources are urgently needed.

Topics & Concepts

PsychiatrySchizoaffective disorderSchizophrenia (object-oriented programming)Prevalence of mental disordersSchizophreniform disorderGeneralized anxiety disorderPrevalenceMajor depressive disorderBipolar disorderAnxietySubstance abuseDepression (economics)MedicinePanic disorderMental healthPsychologyPsychosisEpidemiologyInternal medicineMoodEconomicsMacroeconomicsSchizophrenia research and treatmentMental Health Treatment and AccessCOVID-19 and Mental Health