PSYCHIATRIC SERVICES ' ps.psychiatryonline.org ' December 2008 Vol. 59 No. 12
Depression and anxiety are two
major causes of morbidity
and mortality in the United
States and are associated with im-
paired health-related quality of life
and social functioning (1–4), as well
as with excess disability (5–7). In ad-
dition, psychiatric conditions, partic-
ularly depressive disorders, are asso-
ciated with increased prevalence of
chronic diseases and often precipitate
or exacerbate these conditions (8).
Fortunately, depression and anxiety
can often be successfully treated with
medication and psychotherapies (9).
However, most adults do not seek
care, and those who do often do not
receive appropriate care (9).
The state health departments in
collaboration with the Centers for
Disease Control and Prevention
(CDC) and the Center for Mental
Health Services, Substance Abuse
and Mental Health Services Adminis-
tration, collaborated on the imple-
mentation of the Anxiety and Depres-
sion Module for the Behavioral Risk
Factor Surveillance System (BRFSS).
This module collects information
about depression and its severity with
the clinically validated eight-item Pa-
tient Health Questionnaire depres-
sion measure (PHQ-8). Additionally,
two questions were included on life-
time diagnosis of depression and anx-
iety (one each). The BRFSS is the
world’s largest ongoing telephone
health survey system. Given its large
Depression and Anxiety in the United
States: Findings From the 2006 Behavioral
Risk Factor Surveillance System
Tara W. Strine, M.P.H.
Ali H. Mokdad, Ph.D.
Lina S. Balluz, M.P.H., Sc.D.
Olinda Gonzalez, Ph.D.
Raquel Crider, Ph.D.
Joyce T. Berry, Ph.D.
Kurt Kroenke, M.D.
Ms. Strine, Dr. Mokdad, and Dr. Balluz are affiliated with the Centers for Disease Con-
trol and Prevention, National Center for Chronic Disease Prevention and Health Promo-
tion, Behavioral Surveillance Branch, 4770 Buford Highway, N.E., Mailstop K-66, At-
lanta, GA 30341 (e-mail: email@example.com). Dr. Gonzalez, Dr. Crider, and Dr. Berry are