Prevalence and 3-Year Psychiatric and Mental Health Outcomes of Primary and Secondary Mood Disorders.

Background

Distinguishing between primary and secondary mood disorders (illness-or substance-induced) is important for appropriate treatment, yet their prevalence and outcomes in the general population remain understudied. Aim: To compare psychiatric and mental health outcomes between primary and secondary mood disorders over a 3-year follow-up.

Methods

We used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of the US adult population (Wave 1, 2001-2002; Wave 2, 2004-2005). Primary and secondary mood disorders were assessed following DSM-IV criteria. Outcomes assessed 3 years later included recurrence and persistence of mood disorders, suicide attempt, mental and physical health-related quality of life, and mental health help-seeking behavior. All analyses were adjusted for a wide range of sociodemographic and clinical characteristics.

Results

Among 3,602 participants with mood disorders during the 12 months before Wave 1, 298 (8.3%) had secondary and 3,304 (91.7%) primary mood diagnoses. Following adjustments, secondary mood disorders were associated with significantly poorer physical health-related quality of life (β=-2.75; 95% CI, -4.27 to -1.23) and lower 3-year recurrence (adjusted odds ratio [AOR]=0.51; 95% CI, 0.36 to 0.72) and persistence rates (AOR=0.49; 95% CI, 0.31 to 0.79) compared to primary mood disorders. Other outcomes showed no significant differences (all P>.05).

Conclusion

Secondary mood disorders were not rare and associated with poorer physical health-related quality of life than primary mood disorders. However, both groups showed similar risks of suicide attempts, impaired mental health-related quality of life, and rates of mental health help-seeking behavior. The findings for adults with secondary mood disorders align with efforts to integrate physical and mental health care.