6. Serious Psychological Distress among Adults

In analyses of the 2004 National Survey on Drug Use and Health (NSDUH), serious psychological distress (SPD) was measured using the K6 screening instrument for nonspecific psychological distress (Furukawa, Kessler, Slade, & Andrews, 2003; Kessler et al., 2003; OAS, 2005c). In previous NSDUH reports, the K6 scale was referred to as a measure of serious mental illness (SMI), but this was changed in 2004 (see Appendix A, Section A.7, for a brief discussion).

In the 2003 NSDUH, the SMI module consisted of a broad array of mental health questions that preceded the K6 items. In the 2004 NSDUH, the sample of respondents aged 18 or older was split evenly between the "long-form" module used in the 2003 NSDUH and a "short-form" module consisting only of the K6 items. Results from the 2004 NSDUH showed that large differences in SPD prevalence rates occurred between the two modules, especially in the 18 to 25 age group (see Office of Applied Studies [OAS], 2005c, Appendix B, Section B.4.4).

The 2004 national SPD estimates were based only on data from the long-form module. However, in this report, the 2004 short-form scores have been adjusted to the long-form scores in order to make use of the entire 2004 sample. These data have been pooled with the 2003 long-form data to produce the SPD estimates in this report. For details on how this adjusted measure of SPD was created, see Aldworth, Chromy, Foster, Heller, and Novak (2005). This pooled measure is hereinafter referred to as SPD.

In 2003-2004, SPD was present in 9.6 percent of the population aged 18 or older (Table B.23). West Virginia had the highest rate of SPD in the past year (12.7 percent), while Hawaii had the lowest rate (7.1 percent). Six of the States in the top fifth among persons aged 26 or older were the same States that were in the top fifth among persons aged 18 to 25 (Figures 6.2 and 6.3).

The percentage of persons with SPD was higher in 2003-2004 (9.6 percent) than it was in 2002-2003 (8.8 percent). All four geographic regions also showed increases in SPD rates during the same period. The national increase among the 18 or older population was primarily the result of similar increases in the 26 or older group. Ten States showed significant increases in SPD in the 18 or older population during this period: Arizona, California, Florida, Illinois, Iowa, New Jersey, Pennsylvania, Texas, West Virginia, and Wyoming. There were no statistically significant decreases in SPD in any of the other States in this age group and no significant changes among any of the States in the 18 to 25 age group (Table C.23). The increases in SPD in the 26 or older age group and among all persons aged 18 or older do not appear to be a result of adjusting the half of the 2004 sample with the short-form version of the questions to the long-form level because the increases paralleled the single-year increases for the same period: 8.3 percent in 2002, 9.2 percent in 2003, and 9.9 percent in 2004 (see Table 6.1B from OAS, 2004b, and Table 6.1B from OAS, 2005b).

Below is a map, click here for the text describing this map.

Figure 6.1 Serious Psychological Distress in Past Year among Persons Aged 18 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 6.1

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

Below is a map, click here for the text describing this map.

Figure 6.2 Serious Psychological Distress in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 6.2

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

Below is a map, click here for the text describing this map.

Figure 6.3 Serious Psychological Distress in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 6.3

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.