CONTEXT Psychiatric disorders and substance use during pregnancy are associated with adverse outcomes for mothers and their offspring. Information about the epidemiology of psychiatric disorders and substance use in this population is lacking. OBJECTIVE To examine sociodemographic correlates, rates of DSM-IV Axis I psychiatric disorders, substance use and treatment-seeking among past-year pregnant and postpartum women in the United States. DESIGN, SETTING, AND PARTICIPANTS Face-to-face interviews were conducted in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (n = 43,093). MAIN OUTCOME MEASURES Prevalence of 12-month DSM-IV Axis I psychiatric disorders, substance use, and treatment seeking. RESULTS There were no significant differences in the 12-month prevalence of psychiatric disorders between past-year pregnant (25.3%), postpartum women (27.5%), and non-pregnant women of child-bearing age (30.1%), except for the significantly higher prevalence of major depressive disorder in postpartum women (9.3%) than in non-pregnant women (8.1%) (OR 1.59, 95% CI=1.15–2.20). Past-year pregnant and postpartum women had significantly lower rates of alcohol use disorders, and any substance use, except illicit drug use, than non-pregnant women. Age, marital status, health status, stressful life events, and history of traumatic experiences were all significantly associated with higher risk of psychopathology in pregnant and postpartum women. Most women with a current psychiatric disorder did not receive any mental health care in the 12-months prior to the survey regardless of pregnancy status. CONCLUSIONS Pregnancy per se is not associated with increased risk of mental disorders, though the risk of major depressive disorder may be increased during the postpartum period. Young, unmarried women with recent stressful life events, complicated pregnancies, and poor overall health were at significantly increased risk of mental disorders during pregnancy. Low rates of maternal mental health care underscore the need to improve recognition and delivery of treatment for mental disorders occurring during pregnancy and the postpartum.

U.S. Department of Health and Human Services.

Context Although young adulthood is often characterized by rapid intellectual and social development, college-age individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders. Objective To assess 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college attending peers in the United States. Design, Setting, Participants Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions ([NESARC] n=43,093). Analyses were done for the subsample of college-age individuals, defined as those aged 19-25 that were both attending (n=2,188) and not attending college (n=2,904) in the previous year. Main Outcome Measure Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-college attending peers. Results Almost half of college-age individuals had a psychiatric disorder in the past year. The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college attending peers. The unadjusted risk of alcohol use disorders was significantly greater for college students than their non-college attending peers (OR: 1.25, 95%, CI:1.04-1.50), though not after adjusting for background socio-demographic characteristics (AOR: 1.19, 95%: 0.98-1.44). College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or have used tobacco than their non-college-attending peers. Bipolar disorder was less common in individuals attending college. College students were significantly less likely to receive past year treatment for alcohol/drug use disorders than their non-college-attending peers. Conclusions Psychiatric disorders, particularly alcohol use disorders, are common in the college-age population. Although treatment rates varied across disorders, overall, less than 25% of individuals with a mental disorder sought treatment in the year prior to the survey. These findings underscore the importance of treatment and prevention interventions among college-age individuals.