***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In order to estimate the prevalence of affective disorders in Hungary a sample of the Hungarian adult population ( 18 - 64 years ) selected at r and om was interviewed using the Diagnostic Interview Schedule ( DIS ) which generated DSM-III-R diagnoses . The lifetime rate for Major Depressive Disorder ( MDD ) was 15.1 % , and for Bipolar Disorders ( BD ) 5.1 % . The female-to-male ratio was 2.7 for MDD and nearly equal for BD . The 1-year and 1-month period prevalence rates were 7.1 % and 2.6 % for MDD and 0.9 % and 0.5 % for manic episodes . A higher rate of divorced or separated persons was found among individuals with a lifetime diagnosis of MDD . Besides these , the lifetime diagnosis of BD coexisted with higher rates of the never-married state . The highest hazard rate for the development of BD or MDD was in the range 15 - 19 years but in MDD another peak was also found in the range 45 - 50 years . The first peak was characteristic of the recurrent , and the other one of the single form of MDD . Insomnia , loss of energy , decreased interest , concentration problems were the most common symptoms during the depressive episode , independent of polarity . Higher rates of lifetime diagnosis of dysthymia and all kinds of anxiety disorder were revealed among persons with MDD . BD was associated with GAD ( Generalized Anxiety Disorder ) , and panic disorder more often than chance 3,258 r and omly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule ( DIS ) . Six‐month prevalence figures for DIS/DSM III diagnoses are given , and selected figures for the one‐month and one‐year prevalence , and the one‐year symptom‐free rates . The six‐month prevalence for any diagnosis is 17.1 % , comparable to findings from other population studies using DSM III derived diagnoses , but lower than studies using the PSE . The prevalence rates for most disorders tended to be lowest in the elderly , but this was not as marked as the drop in lifetime prevalence . Men had higher prevalence for substance use disorders than women , but women had higher rates for affective disorders and anxiety/somatoform disorders . Prevalences for all disorders were either similar or lower in those who were married or living as though married , than in those who were not cohabiting . One‐year symptom‐free rates were highest for those with substance use disorders and lowest for those with anxiety/somatoform disorders ‐ largely due to the persistence of phobias The usefulness of the  Zung Self-Rating Depression Scale  as a screening instrument to uncover masked depression , and the benefits of early identification and treatment with alprazolam , were evaluated in a general medical practice population . There was a 95 % scale acceptance by patients and a 12 % overall prevalence of depression based on SDS results . Patients who scored in the depressed range on the SDS were , on a r and omized basis , either identified immediately to their physicians and treated with alprazolam ( N = 21 ) or identified after 4 weeks ( natural history controls , N = 20 ) . Treatment result ed in improvement in 66 % of the identified group versus a 35 % spontaneous improvement in the control group ( p less than .05 ) OBJECTIVE To evaluate the recognition , management , and outcomes of depressed patients presenting in primary care . DESIGN Epidemiologic survey with 12-month follow-up . SETTING Primary care clinics of a staff-model health maintenance organization . PATIENTS AND MAIN OUTCOME MEASURES Consecutive primary care attenders aged 18 to 65 years ( n = 1952 ) were screened using the 12-item General Health Question naire ( GHQ-12 ) , and a stratified r and om sample ( n = 373 ) completed a psychiatric assessment , including the Composite International Diagnostic Interview ( CIDI ) , the 28-item GHQ  , and a brief self-rated disability question naire ( BDQ ) . Three-month follow-up assessment ( n = 347 ) repeated the  GHQ-28 and BDQ  , and 12-month follow-up ( n = 308 ) repeated the  CIDI , GHQ-28 , and BDQ .  Use of psychotropic drugs and mental health services was assessed using computerized pharmacy and visit registration records . RESULTS Structured interviews found 64 cases of current major depression ( weighted prevalence , 6.6 % ) and 58 cases of current subthreshold depression ( weighted prevalence , 8.8 % ) . Of those with major depression , 64 % ( n = 41 ) were recognized as psychologically distressed by the primary care physician , 56 % ( n = 36 ) filled at least one antidepressant prescription during the next 3 months , and 39 % ( n = 25 ) made at least one specialty mental health visit . Compared with recognized cases , those with unrecognized major depression were less symptomatic at baseline ( GHQ-28 score , 15.31 vs 11.07 ; P = .006 ) but showed a similar rate of improvement over 12 months ( F test for difference in slopes , P = .93 ) . CONCLUSIONS While many depressed primary care patients may go unrecognized and untreated , this group appears to have milder and more self-limited depression . A narrow focus on increased recognition may not improve overall outcomes . Treatment re sources might be best directed toward more intensive follow-up and relapse prevention among those now treated & NA ; Using prospect i ve data from the National Institute of Mental Health ( NIMH ) Epidemiologic Catchment Area surveys , we examined the relationship of depressive symptoms among patients seen by general medical practitioners  , with the subsequent development of major depressive disorder  . The goals of the analysis were to determine 1 ) the 1‐year psychiatric status of these individuals , and 2 ) to evaluate factors associated with the risk of major depressive disorder ( MDD ) or dysthymia .  Between 1980 and 1984 , collaborators of the NIMH Epidemiologic Catchment Area program recruited 18,571 adult participants after probability sampling of census tracts and households in five metropolitan areas . To assess the occurrence of psychiatric conditions over time , staff administered the Diagnostic Interview Schedule soon after sampling and again at follow‐up 1 year later . For this analysis , the study sample was limited to respondents who reported seeing a general medical physician in the previous 6 months and who were free of current depressive disorder at the baseline interview . Overall , 41 % of the general medical patients reported experiencing at least one depressive symptom in the past 6 months . Between 3 and 5 % of the individuals with depressive symptoms developed MDD or dysthymia at the follow‐up interview . Although individuals with depressed mood had a slightly higher estimated relative risk compared with individuals with vegetative , or nonvegetative ( cognitive ) depressive symptoms , no single classification of symptoms was appreciably more likely to signal MDD or dysthymia 1 year later . However , the risk of depression increased with the number of depressive symptoms reported . ( ABSTRACT TRUNCATED AT 250 WORDS Abstract This article reports the initial results of a prospect i ve study on the prevalence of  psychiatric disorders in the Dutch population aged 18–64 . The objectives and the design of the study are described elsewhere in this issue . A total of 7076 people were interviewed in person in 1996 . The presence of the following disorders was determined by means of the CIDI : mood disorders , anxiety disorders , eating disorders , schizophrenia and other non-affective psychoses , and substance use disorders . Psychiatric disorders were found to be quite common . Some 41.2 % of the adult population under 65 had experienced at least one DSM-III-R disorder in their lifetime , among them 23.3 % within the preceding year . No gender differences were found in overall morbidity . Depression , anxiety , and alcohol abuse and dependence were most prevalent , and there was a high degree of comorbidity between them . The prevalence rate encountered for schizophrenia was lower ( 0.4 % lifetime ) than generally presumed . A comparison with findings from other countries is made . Relevant determinants of psychiatric morbidity were analysed A two-phase study of psychiatric prevalence has been carried out among the inhabitants ( aged 18 - 64 ) of a Dutch health area ( Nijmegen ) . In phase 1 , a r and om sample of 3232 persons answered the  GHQ-30  ( response rate : 75 % ) . In phase 2 , 486 of the respondents were interviewed with the full PSE within two weeks . The relationship of PSE-'caseness ' ( ID greater than or equal to 5 ) and  GHQ score was expressed in a logistic regression model , the parameters of which showed strong agreement with the Canberra results , for all socio-demographic variables examined , except for urbanization . By means of the logistic model the point-prevalence of PSE cases was calculated at 7.3 % ( range 5.5%-9.2 % ) . Prevalence did not differ significantly in men and women . Higher case rates were found in the age category of 55 - 59 years , among divorced and widowed persons , the lower educational and occupational levels , the unemployed , chronically ill and unable to work , and with city people . This study adds further evidence to a growing body of epidemiological data suggesting similar rates and patterns of psychiatric disorder in population s in industrialized countries The spectrum of depression is much wider than that reflected in the current diagnostic nomenclature . A large proportion of subjects with depression both in treatment and in the community fail to meet diagnostic criteria for either major depressive disorder ( MDD ) or dysthymia . Inclusion of subthreshold categories of depression dramatically improves the coverage of treated depression , particularly in community sample s , and better enables the characterization of its longitudinal course . This paper investigates the application of diagnostic criteria for both threshold and subthreshold categories of depression in a prospect i ve longitudinal community study of young adults from Zurich , Switzerl and . We present the prevalence and treatment rates of each of the depressive subtypes , the degree of diagnostic overlap and the longitudinal stability of subthreshold and threshold categories of depression . The findings indicate that the prevalence rates of subthreshold categories of depression are quite high in the community , and that a substantial proportion of subthreshold depressives , particularly those with recurrent depression , receive treatment . There is a strong tendency for individuals to meet multiple depressive subtypes over time , with little stability of individual categories among those who continue to manifest depression over a 15-year period . The prospect i ve longitudinal data reveal that major depression is both an antecedent to and sequela of subthreshold categories , providing evidence for the validity of the spectrum concept of depression . However , the need for a threshold for the symptom criteria is suggested by the lack of predictive value of minor depression and depressive symptoms only . These result suggest that both the current symptom threshold for a depressive syndrome and recurrence , but not the minimum duration of depressive episodes , are important components of the classification of depression A two-stage psychiatric survey of a r and om sample s of adults aged 18 - 64 from Camberwell is described . Agency  interviewers  carried out the first stage ( N = 800 ) , using the shorter form of the Present State Examination ( PSE ) . MRC interviewers , using the full PSE , saw a stratified sample of these ( N = 310 ) in the second stage . A second interview was sought with all those of Index of Definition ( ID ) level 5 and above at the first interview ( " cases " ) and with r and om sample of those below that level 20.9 % refused or were never available for the first interview . Of the 800 subjects successfully interviewed , 10 % refused a further interview and 124 % of those finally selected for this interview were either unavailable or changed their minds . The MRC data , weighted to represent the whole sample , are used in our analyses . The prevalence of psychiatric disorder as defined in our study was calculated at 6.1 % for men and 14.9 % for women . Women showed a higher prevalence of disorder in the age-groups 25 - 34 and 45 - 54 , but in men there was no significant association with age . In contrast to the findings of Brown & Harris ( 1978 ) , social class did not have a strong association with disorder .  Single men had much higher rates than married men , while the reverse was true in women . In both sexes employment was associated with lower rates of disorder . An attempt to explain the high prevalence in women in terms of their role in marriage and child-care was only partly successful 3,258 r and omly selected adult household residents of Edmonton were interviewed by trained lay interviewers using the Diagnostic Interview Schedule ( DIS ) . Lifetime prevalence for 16 DIS/DSM III diagnoses are given . Overall 33.8 % of the population had one or more diagnoses and , excluding substance use disorders , one fifth of the population had a diagnosis . The most common lifetime diagnosis was alcohol abuse/dependence , followed by phobia and major depressive episode . Men were more likely to have had substance use disorders and antisocial personality disorder and women more likely to have had major depressive episode , dysthymia , agoraphobia and simple phobia . Those who were married had generally lower lifetime prevalences . Those over age 65 had the lowest prevalence of any age groups The lifetime prevalence rates are presented for mental disorders in a r and om sample of people born in Icel and in 1931 , interviewed at the age of 55–57 years . The diagnoses are made according to DSM‐III , on the basis of the National Institute of Mental Health 's diagnostic Interview Schedule ( NIMH‐DIS ) used by trained lay interviewers . The most common diagnoses were alcohol 
    Output:
    
Conclusions : The prevalence of mood disorders reported in high- quality studies is generally lower than rates commonly reported in the general psychiatric literature .