A comparison of DSM-5 and DSM-IV agoraphobia in the World Mental Health Surveys
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Abstract
Description
Background:The Diagnostic and Statistical Manual of Mental Disorders, version 5(DSM‐5) definition of agoraphobia (AG) as an independent diagnostic entity makes ittimely to re‐examine the epidemiology of AG. Study objective was to presentrepresentative data on the characteristics of individuals who meetDSM‐IV criteria forAG (AG without a history of panic disorder [PD] and PD with AG) but notDSM‐5criteria,DSM‐5 but notDSM‐IV criteria, or both sets of criteria.Methods:Population‐based surveys from the World Mental Health Survey Initiativeincluding adult respondents (n= 136,357) from 27 countries across the world. TheComposite International Diagnostic Interview was used to assess AG and other disorders.Results:Lifetime and 12‐month prevalence estimates ofDSM‐5 AG (1.5% and 1.0%)were comparable toDSM‐IV (1.4% and 0.9%). Of respondents meeting criteria ineither system, 57.1% met criteria in both, while 24.2% met criteria forDSM‐5 onlyand 18.8% forDSM‐IV only. Severe role impairment due to AG was reported by alower proportion of respondents who met criteria only forDSM‐IV AG (30.4%) thanthose with bothDSM‐5 andDSM‐IV AG (44.0%;χ21= 4.7;P= 0.031). The proportionof cases with any comorbidity was lower among respondents who met criteria onlyforDSM‐IV AG (78.7%) than those who met both sets (92.9%;χ21= 14.5;P< 0.001).Conclusions:This first large survey shows that, compared to theDSM‐IV, theDSM‐5identifies a substantial group of new cases with AG, while the prevalence rateremains stable at 1.5%. Severity and comorbidity are higher in individuals meetingDSM‐5 AG criteria compared with individuals meetingDSM‐IV AG criteria only.