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ESEMeD is the first study to highlight the magnitude of mental disorders in the six European countries studied. Mental disorders were frequent, more common in female, unemployed, disabled persons, or persons who were never married or previously married. Younger persons were also more likely to have mental disorders, indicating an early age of onset for mood, anxiety and alcohol disorders.

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Objectives: (1) To investigate whether there is an association between obesity and mental disorders in the general populations of diverse countries, and (2) to establish whether demographic variables (sex, age, education) moderate any associations observed. Design: Thirteen cross-sectional, general population surveys conducted as part of the World Mental Health Surveys initiative. Subjects: Household residing adults, 18 years and over (n ¼ 62 277). Measurements: DSM-IV mental disorders (anxiety disorders, depressive disorders, alcohol use disorders) were assessed with the Composite International Diagnostic Interview (CIDI 3.0), a fully structured diagnostic interview. Obesity was defined as a body mass index (BMI) of 30 kg/m 2 or greater; severe obesity as BMI 35 þ . Persons with BMI less than 18.5 were excluded from analysis. Height and weight were self-reported. Results: Statistically significant, albeit modest associations (odds ratios generally in the range of 1.2-1.5) were observed between obesity and depressive disorders, and between obesity and anxiety disorders, in pooled data across countries. These associations were concentrated among those with severe obesity, and among females. Age and education had variable effects across depressive and anxiety disorders. Conclusions: The findings are suggestive of a modest relationship between obesity (particularly severe obesity) and emotional disorders among women in the general population. The study is limited by the self-report of BMI and cannot clarify the direction or nature of the relationship observed, but it may indicate a need for a research and clinical focus on the psychological heterogeneity of the obese population.

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Objectives-To estimate the prevalence and workplace consequences of adult attention-deficit/ hyperactivity disorder (ADHD).Methods-Ann ADHD screen was administered to 18-44 year-old respondents in ten national surveys in the WHO World Mental Health (WMH) Survey Initiative (n = 7075 in paid or self employment; response rate 45.9-87.7% across countries). Blinded clinical reappraisal interviews were administered in the US to calibrate the screen. Days out of role were measured in the WHO Disability Assessment Schedule (WHO-DAS). Questions were also asked about ADHD treatment.Results-An average of 3.5% of workers in the ten countries was estimated to meet DSM-IV criteria for adult ADHD (inter-quartile range: 1.3-4.9%). ADHD was more common among males than females and less common among professionals than other workers. ADHD was associated with a statistically significant 22.1 annual days of excess lost role performance compared to otherwise Conclusions-ADHD is a relatively common condition among working people in the countries studied and is associated with high work impairment in these countries. This impairment, in conjunction with the low treatment rate and the availability of cost-effective therapies, suggests that ADHD would be a good candidate for targeted workplace screening and treatment programs. NIH Public Access• A high proportion of childhood ADHD persists into adulthood.• An average of 3.5% of workers in nationally representative surveys carried out in 10 countries met criteria for current DSM-IV adult ADHD.• Workers with ADHD have an average 8.4 excess sickness absence days per year and even higher annualized average excess numbers of workdays associated with reduced work quantity (21.7 days) and quality (13.6 days).• Only a small majority of these workers are treated for ADHD despite evidence that such treatment can be quite effective in improving functioning.• ADHD is a good candidate for targeted workplace screening and treatment programs.• Evaluation is needed to determine the extent to which best-practices outreach and treatment interventions would result in improvements in work performance that have a positive returnon-investment from the employer perspective.

A potentially traumatic event (PTE) contributes to trauma through its frequency, conditional probability of posttraumatic stress disorder (PTSD), and experience of other PTEs. A cross-sectional survey was conducted, enrolling 21,425 adults nationally representative of six European countries. Using the WHO-Composite International Diagnostic Interview, 8,797 were interviewed on 28 PTEs and PTSD. Prevalence of 12-month PTSD was 1.1%. When PTSD was present, the mean number of PTEs experienced was 3.2. In a multivariate analysis on PTEs and gender, six PTEs were found to be more traumatic, and to explain a large percentage of PTSD, as estimated by their attributable risk of PTSD: rape, undisclosed private event, having a child with serious illness, beaten by partner, stalked, beaten by caregiver.

This first cross-national study of the joint effect of mental and physical conditions on the probability of severe disability finds that co-morbidity exerts modest synergistic effects. Clinicians need to accord both mental and physical conditions equal priority, in order for co-morbidity to be adequately managed and disability reduced.