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Depression and Anxiety in the United States: Findings From the 2006 Behavioral Risk Factor Surveillance System

Ms. Strine, Dr. Mokdad, and Dr. Balluz are affiliated with the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Behavioral Surveillance Branch, 4770 Buford Highway, N.E., Mailstop K-66, Atlanta, GA 30341 (e-mail: tws2{at}cdc.gov). Dr. Gonzalez, Dr. Crider, and Dr. Berry are with the Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Dr. Kroenke is with the Department of Medicine, Indiana University School of Medicine, Indianapolis.

OBJECTIVE: This study examined the unadjusted and adjusted prevalence estimates of depression and anxiety at the state level and examined the odds ratios of depression and anxiety for selected risk behaviors, obesity, and chronic diseases. METHODS: The 2006 Behavioral Risk Factor Surveillance Survey, a random-digit-dialed telephone survey, collected depression and anxiety data from 217,379 participants in 38 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. Current depressive symptoms were assessed with the standardized and validated eight-item Patient Health Questionnaire, and lifetime diagnosis of depression and anxiety was assessed by two additional questions (one question for each diagnosis). RESULTS: The overall prevalence of current depressive symptoms was 8.7% (range by state and territory, 5.3%–13.7%); of a lifetime diagnosis of depression, 15.7% (range, 6.8%–21.3%); and of a lifetime diagnosis of anxiety, 11.3% (range, 5.4%–17.2%). After sociodemographic characteristics, adverse health behaviors, and chronic illnesses were adjusted for, cardiovascular disease, diabetes, asthma, smoking, and obesity were all significantly associated with current depressive symptoms, a lifetime diagnosis of anxiety, and a lifetime diagnosis of depression. Physically inactive adults were significantly more likely than those who were physically active to have current depressive symptoms or a lifetime diagnosis of depression, whereas those who drank heavily were significantly more likely than those who did not to have current depressive symptoms or a lifetime diagnosis of anxiety. CONCLUSIONS: Depression and anxiety were strongly associated with common chronic medical disorders and adverse health behaviors. Examination of mental health should therefore be an integral component of overall health care.

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