About half of Americans will meet the criteria for a DSM-IV disorder sometime in their life, with first onset usually in childhood or adolescence. Interventions aimed at prevention or early treatment need to focus on youth.

Although mental disorders are widespread, serious cases are concentrated among a relatively small proportion of cases with high comorbidity.

The brevity, strong psychometric properties, and ability to discriminate DSM-IV cases from non-cases make the K10 and K6 attractive for use in general-purpose health surveys. The scales are already being used in annual government health surveys in the US and Canada as well as in the WHO World Mental Health Surveys. Routine inclusion of either the K10 or K6 in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

The brevity and accuracy of the K6 and K10 scales make them attractive screens for SMI. Routine inclusion of either scale in clinical studies would create an important, and heretofore missing, crosswalk between community and clinical epidemiology.

Clinical calibration in larger samples might show that a weighted version of the 18-question ASRS outperforms the six-question ASRS screener. Until that time, however, the unweighted screener should be preferred to the full ASRS, both in community surveys and in clinical outreach and case-finding initiatives.

LTHOUGH COMMUNITY SURveys of mental disorders have been conducted in the United States since the end of World War II, 1-3 it was not until the early 1980s that fully structured lay interviews were developed to diagnose specific mental disorders. The first such instrument was the Diagnostic Interview Schedule (DIS), 4 which was developed for use in the Epidemiologic Catchment Area (ECA) study 5 to estimate the general population prevalence of mental disorders by Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) criteria. 6 Major depressive disorder (MDD) prevalence estimates in the ECA sites were 3.0% to 5.9% for lifetime and 1.7% to 3.4% for 12-month. 7 The first nationally representative survey using a method similar to the ECA, the National Comorbidity Survey (NCS), 8 was conducted a decade later in 1990-1992. The NCS diagnostic instrument was a modified version of the Composite International Diagnostic Interview (CIDI) 9 to assess mental disorders by Author Affiliations are listed at the end of this article.

Background: General population survey data are presented on the lifetime prevalence of suicide attempts as well as transition probabilities to onset of ideation, plans among ideators, and attempts among ideators either with or without a plan. Risk factors for these transitions are also studied.

Efforts are needed to increase the detection and treatment of adult ADHD. Research is needed to determine whether effective treatment would reduce the onset, persistence, and severity of disorders that co-occur with adult ADHD.