Questioning One in Four: Part 1

By Neuroskeptic | May 27, 2009 1:10 pm

Link – Part 2, Part 3

One in four people suffer mental illness at some point in their lives.

Everyone knows that. But where does that number come from? The answer may surprise. Join me, if you will, as I explore the biography of a statistic.

“1 in 4″ is ubiquitous, at least in the English-speaking world. I can’t think of another such number which is better known, except perhaps the fact that 1 in 3 people will suffer from cancer.

Anyone who’s used the London Underground or watched British TV recently will be familiar with the Time to Change anti-stigma advertising drive. This £18 million campaign, run by the charities Mind and Rethink, is awash with “1 in 4″s, left right and center. Mind have it on their About Us page. The BBC have it on their main mental health page. There’s even a One in Four magazine. And so on.

In the next post, I’ll be examining the truth behind this statistic, but first, a little history. Google archive reveals that 1 in 4 is a child of the 1990s. English-language news media from the late 1980s contain the statement that in 1 in 4 (American) families will have a member who suffers from mental illness, but this is not the same thing.

As far as I can tell, “1 in 4 people” entered the popular mind in the early to mid 1990s. By 1995, it was common and being referred to as an accepted fact. See for example this snap-shot of the newspapers in 1995 under the search term (“one in four” + mental), showing that the idea had taken root by this point. Whereas the equivalent from 1992 is quite different.

Interestingly, the early 1990s also feature repeated references to 1 in 4 (Americans) suffering from mental illness in any given year; this statistic, however, gradually fades from view as the decade goes on. By 2000, 1 in 4 appears more often than ever, but now it refers almost mostly to lifetime prevalence.

These graphs show the number of Google archive hits from 1950 to 2008. I had hoped that this would illustrate my argument nicely, but sadly, the picture isn’t all that clear. Here it is anyway – the top graph shows the increase in (“1 in 4″ + mental) hits. The second shows, by way of comparison, the number of hits for just (“mental health”), which is much more level. That’s nice. But the bottom graphs shows that (“1 in 8″ + mental) also becomes more popular over about the same time-frame, which is a bit confusing, as 1 in 8 is not a number especially linked to mental health.

But – where did 1 in 4 come from? When I set out to write this post, I thought it would be fairly easy to find out, but having done a lot of digging, I genuinely don’t know.

My first guess was that it must have been the National Comorbidity Survey (NCS). The NCS was an ambitious attempt to measure the prevalence of mental disorders in a representative sample of the U.S. population, masterminded by Harvard Prof. Ronald C. Kessler. Data collection took place between 1990 – 1992 and the results started to be published in 1993 – just about the time when 1 in 4 started to appear in the media.

But in fact the headline finding from the NCS, as published in 1994, was that the lifetime prevalence of mental disorders was nearly 50%! That’s 1 in 2 (sic). The proportion estimated to suffer from a disorder in any given year was almost 1 in 3. But no sign of 1 in 4.

Meanwhile, in Britain, 1993 also saw the first Psychiatric Morbidity Survey, a similar enterprise. (Attentive Neuroskeptic fans will recall that this was the survey that the Mental Health Foundation recently distorted to make it look like rates of anxiety disorders are rising). Could this be the source? No, the headline number here was 1 in 6, which referred to mental illness in the past week, not over the lifetime.

Going further back, the Epidemiological Catchment Area (ECA) project, the first large-scale psychiatric epidemiology study, happened in the early 80’s. The ECA famously concluded that 1 in 3 Americans suffer at least one mental illness over the lifetime, and 1 in 5 do in any given six month period! 3, 5 – but still not 4.


The World Health Organization quoted 1 in 4 lifetime in 2001, to much media fanfare, and I have seen the WHO given as a source for the figure. But where did they get it from? Well, good question.

Their report, New Understanding New Hope: The World Health Report 2001, notes that according to the WHO’s own data, 450 million people worldwide currently suffer from a “neuropsychiatric conditions”. With 6 billion people on Earth that’s less than 1 in 12 (and that includes Alzheimer’s, Parkinson’s, epilepsy, etc.) And that’s at any one time, not over the whole lifetime.

The report then quotes at least 1 in 4 as a lifetime prevalence (on page 23). Finally! But this is not based on WHO data. Instead, they cite three references: Regier et al. 1988; Wells et al. 1989; and Almeida-Filho et al. 1997. Let’s check these references.

The first refers to an Epidemiological Catchment Area study of 12 month prevalence. Not lifetime. The ECA, as we’ve previously seen, gave a lifetime estimate of 1 in 3. The 12 month estimate is 15.4%, or 1 in 6. No 1 in 4 to be found here. The second refers to a 1989 paper from Christchurch, New Zealand. It reported a lifetime prevalence of 65.8% (sic) for any mental disorder. 2 in 3. For the “main” diagnoses, i.e. excluding most anxiety disorders, it was 36.6%. 1 in 3. The closest I could find to 1 in 4 in this study was 22.9% for main disorders, also excluding substance abuse disorders. 1 in 4, 1 in 3, or 2 in 3 – take your pick. The last reference is to a Brazilian study finding lifetime prevalence rates from 31.0% to 50.5% in three cities.

So, in 2001, the WHO quoted 1 in 4, but their only references, if taken seriously, put the lifetime prevalence is more like 1 in 2. So we still don’t know where 1 in 4 comes from.

Recently, the National Comorbidity Survey Replication (NCS-R), another Kessler project, claimed a lifetime prevalence of any disorder in Americans of 50.8%. But the proportion suffering from a disorder in any one year was estimated at about one in four. So that’s 1 in 4 at last, but that number appeared only appeared in 2005 – far too late to explain the origin of the meme. (And it was yearly, not lifetime, but you can see how people might have misinterpreted it.)

So, I give up. I don’t believe there is a single source for 1 in 4. If anyone thinks they know where I’ve gone wrong, please let me know. But as far as I can see, 1 in 4 lifetime represents a kind of informal average of all of the studies I’ve discussed. It’s a number that sticks in people’s minds because it’s high enough to capture the sense that “they’re very common” while not being so high as to make people think “that’s ridiculous” (as most of the actual estimates do). It’s less a statistic, more a collective guess.

In the next post, I’ll try to make sense of all these numbers.

[BPSDB]

ResearchBlogging.orgGrant, B. (2006). About 26% of people in the US have an anxiety, mood, impulse control, or substance disorder Evidence-Based Mental Health, 9 (1), 27-27 DOI: 10.1136/ebmh.9.1.27

  • http://www.frontierpsychiatrist.co.uk Frontier Psychiatrist

    Thanks for writing this post. I had no idea that the ‘one in four’ figure was so without basis. I must say that when I emailed Time to Change and they didn’t know where their figures came from I did assume that someone in the organisation had established a basis for their poster campaign before inflicting it on the UK population, but had just not got around to telling the press department. How fascinating that this is not the case.

    This commenter achieves a figure of 27.4% by adding up the point prevalence for neurotic disorder, personality disorder and psychotic disorder occuring over a 1.5 year period as calculated by the Psychiatric morbidity among adults living in private household 2000 report.

    I’ve been minded to start an assault on psychiatric population morbidity studies for some time now. They seem to come out quite regularly and are often uncritically accepted. I’m sure that there’s a critical literature about artefacts in this sort of work, but I haven’t managed to track it down as yet. Perhaps you have – I await your next post.

    Summerfield puts it nicely in a rapid response to Layard proposals:

    “The psychological instruments generally used to estimate population prevalences of “anxiety” and “depression” routinely over-recruit cases because their demand characteristics and narrow “symptom” focus say little about the complexity and ambiguity of an actual life situation. The Royal College of Psychiatrists and other authorities pronounce that “depression”, for example, is present in as much as 1 in 4 of the adult population. These figures are meant to identify people as “cases”, candidates for a professional intervention. This is artefactual nonsense: what is largely being tapped here is ordinary unhappiness and dissatisfaction in an age of the medicalisation and professionalism of everyday life and its problems”

    It’s interesting to me that there is actually quite a resistance in the laity to suggestions that the levels of psychiatric morbidity in the population are exaggerated. I think that this suits a social purpose. We have a nation where people are encouraged to think of themselves as part of an economy, rather than as part of a society; such societies have evolved to become strikingly unequal with evident winners and losers. For these ‘losers’ some causes of distress (depression etc. – a disease) are seen as more worthy of succour than others (unemployment – a personal failing). Questioning the myth that we are by and large all mentally ill then undermines what many may have come unconsciously to see as their ultimate route of escape.

    Finishing on a more prosaic level, as we share similar interests if you could link to my blog I would be much obliged FP

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Thanks -

    I did read that comment (27.4%) with interest. I don’t think that can account for the 1 in 4 meme, however, mainly because a) it’s a 12 month, not a lifetime prevalence and b) that number is hidden away in the data whereas 1 in 6 the “obvious” one (and is the one Mind quote).

    To be honest, if you browse the literature, you can come up with any number you like up to about 2 in 3 (in the Christchurch study). And you can get the numbers as low as you like by deciding that some disorders “don’t count” (personality disorders, substance abuse, and phobias, seem to be prone to this.)

    In other words 1 in 4 is no less true than any other number. But no more so. I think people unconciously settled on 1 in 4 because it’s not so high as to be laughable, but high enough to be memorable (and it rolls off the tongue).

    In my next post I’ll be discussing the validity of these surveys…

    As for linking to you, to be honest, I thought I already had! Obviously not – I have done now. :)

  • http://www.frontierpsychiatrist.co.uk Frontier Psychiatrist

    Actually there’s this:

    the epidemic in mental illness: clinical fact or survey artifact?

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Oh, interesting. And of course they wrote a book, The Loss of Sadness, which I keep meaning to read.

    I know of a couple of other critical papers but surprisingly few.

    Also, I just noticed something else weird. The Time to Change people don’t seem to know whether 1 in 4 refers to yearly or lifetime prevalence.

    This page, for instance, actually contains both, just a few lines apart.

    I think I’m going to write to them to complain about this. They don’t even have their own story straight.

  • http://www.frontierpsychiatrist.co.uk Frontier Psychiatrist

    I’d not heard of ‘The loss of sadness’ – seems right up my street.

    Strikes me as there’s now something of an epidemic of psychiatric population morbidity surveys. In the face of fear is another one, which achieves the impressive feat of both encouraging people to believe that it’s reasonable (or at least not unusual) to be worried about terrorist attacks, and justifying coercive government policy

  • Tom Grabowski

    Essentially the ‘Time to Change’ people are a bunch of charlatans drawn from the murky cross organisational links between charities Mental Health Media, Mind, Rethink and NIMHE – or whatever that useless Government quango chooses to call its latest evil reincarnation – who rely on a pot of massively duplicated ‘ anti stigma and discrimination’ funding from Comic Relief and the Sainsbury Family Trusts through the Sainsbury Centre for Mental Health and face no great risk of competent evaluation for effectiveness or professional scrutiny ( as you appear to have stumbled upon here ) from the Institute of Psychiatry at King’s College, London.

    The Institute of Psychiatry only links to these high profile anti-stigma and discrimination campaigns to lend itself a degree of credibility with people with MH issues it actually doesnt have. It’s anti-stigma and discrimination guru , Professor Graham Thornicroft routinely relies on the 1 in 4 statistic too.

    Thornicroft is also a Patron of Stand to Reason, a charity ran by a city banker with MH issues who in turn uses the 1 in 4 statistic to lobby support from lawyers and politicians.

    Time to Change isnt just cutting corners with the attention grabbing statistic though as Mental Health Media is now a part of Mind as this supposedly ‘user led’ media organisation was torpedoed by a former Director, now a Senior Policy Advisor at the Mental Health foundation , who used its funding and resources for very uncharitable aims and left in a hurry before his fellow Directors investigated the complaint about him.

    There was a bit of a public outcry, the Charity Commission was called in to make reassuring noises to the charities intended beneficiaries , it was all very hush hush, as these charity sector scandals invariably are.

    Best to assume charities mean and do well . Right?

    When the coast was clear the
    same Mental Health Foundation Senior Policy Advisor suddenly reappeared fronting another MH charity called the National Survivor User Network (NSUN) which received £750,000 from , you guessed it, Comic Relief .

    NSUN hasnt actually done anything yet , has few members and no credible national role but this is not unusual in the MH charity sector, it’s all about funding not outcomes. Create a vehicle to attract funding through networked funding channels get it, got it , move on.

    The same Policy Advisor recently turned up in Wales fronting an MH pilot for the Mental Health Foundation designed to encourage self management of mental illness and rehabilitation of MH patients back into mainstream work and life which is rather odd really as the man fronting the project has been totally dependent on the MH charity sector for work, status and purpose in life for the last 20 years and doesnt seem likely to mainstream himself any time soon.
    But true to form, the 1 in 4 statistic was of course used to sell the pilot to the Welsh Assembly.

    Lastly, the One in Four magazine also has links to the murky cross organisational players described above – suprised huh! – through SCMH , which set up NIMHE, Comic Relief and The South London and Maudsley , the Institute of Psychiatry’s next door neighbour and operational partner.

    In short, the decision to use the 1 in 4 statistic for a series of Government quango co-ordinated or related national campaigns was a political one , its basically propaganda, and it damages the reputations of all the parties mentioned above so I hope you do demand to know why its been so widely cited and used to , as the Time to Change People Put it, “chip away at some of the myths surrounding mental health ” and “change behaviour”.

    .

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Thanks for the detailed comment, Tom. I don’t know much about the politics of this – I just know that the numbers don’t add up.

    Speaking as a scientist, though, I think academics also have bear a lot of responsibility for this. Charities clearly promote the 1 in 4 statistic for their own purposes, but they can only get away with it because very similar numbers (indeed, as we’ve seen, higher numbers) appear in the scientific literature with very few caveats. When papers claiming that 50% of Americans at some point suffer from mental illness are published in major journals it’s hardly surprising that lay people get carried away…

  • http://www.blogger.com/profile/06832177812057826894 pj

    I’ve been doing a bit of work on prevalence studies recently. There’s some great ones out there – my favourite is the finding that 80% of doctors involved in MTAS had psychiatric distress as a result (this compares with a study of British military peacekeepers where the prevalence was 30%).

    It is at least partly dependent on the instrument used – so formal diagnostic interviews, such as a SCID, are a lot more reliable than things like the short questionnaires like the GHQ. Also, as you imply, it sorta depends on what you classify as a mental illness, whether you include personality disorders, whether you include alcohol or substance abuse, what you think about adjustment disorders and other minor psychiatric pathology.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Do you mean reliable, or valid? Because I would have thought that a self-report questionairre would probably be more reliable – given that there are no possible “rater effects”.

    But the big population surveys that find 50% of people have been mentally ill at some point all used lay-administered standardized interviews. To me, the fact that they find a lifetime prevalence of 50% says nothing about the mental health of the population and everything about the validity of such interviews.

    To be honest, I think I would only trust a prevalence study that used clinician-administered interviews, and only if I knew the clinicians personally and knew them not to be muppets.

  • http://www.blogger.com/profile/06832177812057826894 pj

    Reliable and valid. If you only ask 12 questions say, then reliability has to be a factor too.

    I agree you'd want a proper clinician administered survey, but even then, what a SCID might classify as a mental disorder may be different from a clinicians personal judgement.

  • Anonymous

    I suspect that it is in large part due to market forces. Psychiatry is a strong lobbyist. Psychiatrists want to hold on to whatever power they have. And to do so they need to create new mental illness diagnoses and expand the old ones. Put that together with Big Pharma, and you get the current situation where basically everybody is mentally ill, if you evaluate them, and needs some pills.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    That’s part of it, but not the only reason. I’ll be discussing that in a later post.

  • http://www.blogger.com/profile/06832177812057826894 pj

    “Psychiatry is a strong lobbyist. Psychiatrists want to hold on to whatever power they have. And to do so they need to create new mental illness diagnoses and expand the old ones.”Perhaps in other countries but in the UK psychiatry is under staffed and under funded, psychiatrists rarely see minor psychiatric pathology which is dealth with by GPs, and so concentrate on very severe depression and psychosis – and even there they have to rely on social workers, psychiatric nurses, and clinical psychologists to take a lot of the load.

  • http://www.blogger.com/profile/17686665037607780553 RAJ

    The APA’s Working group on autism has published its recommendations for changes in diagnostic schemes for autism. If the recommednations are implemented the prevelance of autism will rise to a one in four prevelance.

    http://www.psych.org/MainMenu/Research/DSMIV/DSMV/DSMRevisionActivities/DSM-V-Work-Group-Reports/Neurodevelopmental-Disorders-Work-Group-Report.aspx

    The recommendations are to remove the term Pervasive Developmental Disorder and replace it with Autism Spectrum Disorders. The sub-categories of Autistic Disorder, PDD/NOS and Asperger Syndrome would be removed and replaced with a severity scale (mild, moderate, severe). Two new sub-categories would be added, Atypical ASD and normal variation ASD defined as persons who possess a normal variation of human personality characterisics such as being socially isolated or possessing ‘social awkwardness’.

    Introverted personality types have been consistently reported as being present in about 25% of the general population, hence the one in four total of the general population that would meet diagnostic criteria for an Autism Spectrum Disorder.

    http://www.theatlantic.com/doc/200303/rauch

    If implemented thesechanges would render the entire concept of what autism is even more meaningless than current diagnostic schemes, but would confirm the one in four prevelance rates, not for al mental disorders, but for autism alone

  • http://www.blogger.com/profile/06832177812057826894 pj

    “If implemented thesechanges would render the entire concept of what autism is even more meaningless than current diagnostic schemes”No they wouldn’t because no one would seriously describe “normal variation” as a disorder. Which, I imagine, is why they adopted the term “normal variation”!

    The new DSM format is apparently to move towards a true spectrum approach – but if you have a spectrum then you’re going to have a ‘normal’ end. This doesn’t sound to me like an attempt to pathologise people, rather it is an attempt to address criticism that the categorical approach is too rigid.

    You can criticise that approach if you like but I think it is silly to criticise a true spectrum approach as if it is a categorical approach.

  • http://www.blogger.com/profile/06832177812057826894 pj

    In fact, if you read the report they say:

    “Symptom severity for ASD could be defined along a continuum that includes normal traits, subclinical symptoms and three different severity levels for the disorder”So they are explicitly limiting the disorder to the three severity levels (most, moderate, less) then defining subclinical and normal variation – and these latter two would not be part of the disorder!

  • http://www.blogger.com/profile/17686665037607780553 RAJ

    “So they are explicitly limiting the disorder to the three severity levels (most, moderate, less) then defining subclinical and normal variation – and these latter two would not be part of the disorder!

    The recommendation includes 5 sub-categories under the umbrella term of Autism Spectrum Disorders (ASD), including atypical ASD and normal variants found in 25%of the general population.

    If the latter two are not part of the disorder, why include them among the 5 sub-categories in the proposed ASD definition.

    While autism has always come under the domain of child psychiatry not all concede that it is a spectrum disorer ranging from severe to normal. The proponents of autism as a spectrum disorder have no explanation for the autopsy and MRI studies that have poven that autism as currently defined is a disorder causes by a disruption in early brain development and what seperates an individual with an ASD from normal variants of human characterists is the structural abnormalities in the brain, present in ASD but absent in normal variants which will now be included as part of an Autism Spectrum Disorder.

  • http://www.blogger.com/profile/06832177812057826894 pj

    “The recommendation includes 5 sub-categories under the umbrella term of Autism Spectrum Disorders (ASD), including atypical ASD and normal variants found in 25%of the general population.

    If the latter two are not part of the disorder, why include them among the 5 sub-categories in the proposed ASD definition.”Look, you clearly have some bee in your bonnet about this, so I’m not going to argue any further. I’m just pointing out that if you actually read what the draft proposal says, it states:

    “Symptom severity for ASD could be defined along a continuum that includes normal traits, subclinical symptoms and three different severity levels for the disorder. One possible model: Most severe ASD…Moderately severe ASD…Less severe ASD…Subclinical AS Symptoms…Normal Variation”So we see here that ASD only covers the three severity levels, the rest is part of the autistic spectrum but is not part of autistic spectrum disorder. So you are wrong.

  • http://www.blogger.com/profile/17686665037607780553 RAJ

    “So we see here that ASD only covers the three severity levels, the rest is part of the autistic spectrum but is not part of autistic spectrum disorder. So you are wrong”.

    Here is the proposal

    I. Autism Spectrum DISORDER

    A. Severe ASD
    B. Moderate ASD
    C. Mild ASD
    d. Atypical ASD
    E. Normal ASD

    All 5 categories are DEFINED as being on an Autism Spectrum DISORDER.

    Whats so difficult to understand about that.

    You have you own bee in your own bonnet… And you are wrong aout how this proposal is defining Autsim Spectrum Disorder.

    If implemented this would increase the prevelance of autism spectrum disorders to the one in four that is the subject of the post.

  • http://www.blogger.com/profile/06832177812057826894 pj

    As I said, bizarre bee in your bonnet. I simply directly quoted the link. You have decided to interpret the text in a way that is not consistent with what it says.

    I smell an internet crank, and I will respond no more.

  • http://www.blogger.com/profile/17064348309163649672 Mandy

    I find the comment about this being an 'internet crank' quite crass..considering the amount of work and information that has been provided.

    As with everything…we all have our own personal bias and reasons for that. Being 100% objective all the time would take some doing. However, it is important to get counter balances and people who actually question things rather than reading something and just believing it to be true (particularly when so much money is being spent in response to '1 in 4' statements.

    The proof of the pudding in regards to funding is what difference it actually makes. As in, will 18 million quid stop the stigma?

    Where are the surveys on stigma and more importantly who did those surveys and why?

    And “No”, I am not disputing their is stigma but am questioning in whose best interest it is to keep saying there is stigma and accessing funding. Certainly these anti stigma campaigns haven't made the slightest difference in my life… or the lives of my father and friends who suffer mental illness.

    I am very cynical of campaigns that don't seem to do much of anything apart from promote the organisations who are running them.

    Please do keep doing your own research and blogging about it. It won't please everyone but at least it gives people the opportunity to see another angle.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    I don't think PJ was accusing me of being an internet crank. He wouldn't dare…;)

    I would love for a serious and succesful campaign to address mental health stigma. But I think the fact that Time to Change is using 1 in 4 without even knowing where it came from is a bad sign about their seriousness.

    Also, although this is a can of worms, in my personal experience “internalized” stigma (i.e. shame and unwillingness to admit) about mental health problems is at least as harmful as more straightforward prejudice and discrimination.

    Time to Change and most other such campaigns seem to treat the mentally ill as some kind of ethnic minority subject to racism. I think this is unhelpful because a) the truth is a lot more complex and b) it feeds into a siege mentality amongst the mentally ill which discourages facing up to and talking about ones problems, and encourages placing all the blame for difficulties on other people, which is ultimately disempowering.

  • http://www.frontierpsychiatrist.co.uk Frontier Psychiatrist

    This comment thread seems to have gone down an autism cul-de-sac since I last read it. Back to '1 in 4' however and I emailed 'one in four' magazine to ask them where they see the number as coming from. Here's what they said:

    The statistic is widely used and has been produced by more than one survey.

    The WHO found it globally, in 2001: “One in four people around the world will suffer from mental health problems at some point in their lives, according to a report from the World Health Organisation (WHO).” BBC news

    And,

    “The Mind: A User's Guide, edited by Dr Raj Persaud, provides easy-to-understand information designed to help the one-in-four people in the UK who suffer from some form of mental problem during their lives and those who care for them. The Mind is the brainchild of the Royal College of Psychiatrists, with chapters written by 60 mental health experts,
    including two from the University of Bristol.” The Medical News website

    And,

    “The Adult Psychiatric Morbidity Survey 2007 was carried out for The NHS IC by the National Centre for Social Research (NatCen) in collaboration with the University of Leicester and provides data on the prevalence of both treated and untreated psychiatric disorder among those aged 16 and over in England. It examines the prevalence of key conditions such as anxiety, depression, eating disorders, post-traumatic stress disorder, personality disorders, gambling and drug and alcohol misuse across gender, age, ethnic group, marital status and adjusted household income. Across all conditions, the survey showed nearly one in four people (23 per cent) in England experience at least one psychiatric disorder and that those affected were more likely to have a lower adjusted household income.”
    from the Royal Coll of Psychiatrists website.

    And,

    Have a look at the websites of Mind, SANE, the Mental Health Foundation and Time to Change – they all use it widely, as to many others.

  • http://www.blogger.com/profile/06832177812057826894 pj

    So only by the 2007 survey, where incidence has increased I believe, were they able to get anywhere near 25% (I believe the previous figures have been nearer 20%).

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    Ah – well…

    The fact that it appears in a blurb for a book by Raj Persaud, and on the websites of Mind, Sane, MHF and Time to Change, certainly shows that the statistic is widely used. Even more widely than I had suspected.

    They quote the WHO 2001 report whcih, as I said in the post, appears to have just made 1 in 4 up out of thin air since the references they give actually found much higher lifetime prevalence estimates.

    They quote the 2007 PMS. This is interesting because it did find a figure of about 1 in 4 but that's a one-week prevalence estimate. Not lifetime. There has never been a lifetime prevalence study in the UK (to my knowledge).

    This also can't be the source of the 1 in 4 meme since this study was only conducted in 2007 and not published until 2009, whereas the meme goes back long before that.

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    pj notes that previous PMS estimates were lower. This is true, but it's not because mental disorders actually became more common from 2000 to 2007; it's because in the 2007 survey they used additional diagnoses (ADHD, PTSD, and others).

  • http://www.blogger.com/profile/06647064768789308157 Neuroskeptic

    One other thing – I'm sympathetic to One in Four magazine and I don't blame them for quoting the one in four lifetime statistic. They're quite right that it appears everywhere, including in an authoritative WHO report. It would be entirely reasonable to assume that it was true. I had assumed it was true (or rather, an accurate report of a lifetime prevalence estimate…I don't trust those estimates but that's another story) until I wrote this post.

  • http://www.blogger.com/profile/17064348309163649672 Mandy

    If I misread…or went off on a wrong tangent about what PJ wrote…apologies.

    I wouldn't trust anything Raj Persuad says/writes since he has been shown up as more than a tad fraudulent. Is fine and dandy, I think, to quote other people and give them due credit in doing so.. but to claim their work as your own is something else.

    I would actually like to see something more democratic in regards to researching what stigma exists around the mentally ill as well as research as to why. Actually, in regards to all these campaigns started up 'on behalf of' the mentally ill…I believe,
    they are more exclusive than inclusive. Sure many would argue it is difficult (if not impossible) to get a majority perspective or detailed analysis based on peoples' experiences but using that as an excuse for certain cliques to act as the voices of the many is taking the mickey.

    and yep I am biased (through my own experiences) but open to other people's views and experiences.

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No brain. No gain.

About Neuroskeptic

Neuroskeptic is a British neuroscientist who takes a skeptical look at his own field, and beyond. His blog offers a look at the latest developments in neuroscience, psychiatry and psychology through a critical lens.

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