1. NHS Digital is the national information and technology provider for the health and care system. Our team of information analysis, technology and project management experts create, deliver and manage the crucial digital systems, services, products and standards upon which health and care professionals depend. Our vision is to harness the power of information and technology to make health and care better. NHS Digital is the new trading name for the Health and Social Care Information Centre (HSCIC). We provide 'Information and Technology for better health and care'. Find out more about our role and remit at digital.nhs.uk
2. Percentages are rounded to the nearest whole number.
3. The survey data were weighted to take account of selection probabilities and non-response, so that the results were representative of the household population aged 16 years and over. The results shown here and in the report reflect the responses received from people surveyed with this weighting applied.
4. The report is published every seven years. This is the fourth publication in the series. High quality screening and assessment tools are used and undiagnosed conditions are identified. Methods are kept comparable, so trends over time can be examined with surveys carried out in 1993, 2000, 2007 and 2014. A random sample of the household population is used, covering the whole adult age range and including people who do not use mental health services.
5. Common mental disorders (CMDs) comprise different types of depression and anxiety. The revised Clinical Interview Schedule (CIS-R) has been used on every wave of the APMS series to assess six types of CMD: depression, generalised anxiety disorder (GAD), panic disorder, phobias, obsessive compulsive disorder (OCD), and CMD not otherwise specified (CMD-NOS). Many people meet the criteria for more than one CMD. The CIS-R is also used to produce a score that reflects overall severity of symptoms of CMD. The scores for each section are then summed to produce a total CIS-R score, which is an indication of the overall severity of symptoms. A CIS-R score of 0-5, is used to denote people with few or no symptoms. A CIS-R score of 18 or more denotes more severe or pervasive symptoms of a level very likely to warrant intervention such as medication or psychological therapy.
6. Fieldwork was carried out between May 2014 and September 2015 using a two-phase approach. First, phase interviews were carried out by NatCen Social Research interviewers including structured assessments and screening instruments for mental disorders, and questions about other topics, such as general health, service use, risk factors and demographics. Second, phase interviews were carried out by clinically-trained research interviewers employed by the University of Leicester. A sub-sample of phase one respondents was invited to take part in the second phase interview to permit assessment of psychotic disorder, attention-deficit/hyperactivity disorder and autism. The assessment of these conditions requires a more detailed and flexible interview than was possible at the first phase, and the use of clinical judgement in establishing a diagnosis. As for all surveys, it should be acknowledged that prevalence rates are only estimates. If everyone in the population had been assessed the rate may be higher or lower than the survey estimate. Confidence intervals are given for key estimates in the methods chapter (Chapter 14). For low prevalence disorders, relatively few positive cases were identified. Particular attention should be given to uncertainty around these estimates and to any subgroup analysis based on these small samples. All comparisons made here and in the report have been tested and only statistically significant differences are described.
7. This presents findings about the extent of trauma and of screening positive for posttraumatic stress disorder (PTSD) in the general population. A positive screen did not mean that a disorder is necessarily present, only that there were sufficient symptoms to warrant further investigation. Traumatic events were defined as experiences that put a person -or someone close to them - at risk of serious harm or death, such as a natural disaster, a serious car accident, being raped, or a loved one dying by murder or suicide.
8. The use of validated mental disorder screens and assessments allows for identification of people with sub-threshold symptoms and those with an undiagnosed disorder. A positive screen only indicates that someone may have sufficient traits to warrant further and fuller investigation. Screen positive rates tend to be higher than actual rates of disorder. It should also be noted that the term 'screen' is used as a convention, and does not indicate that that the screening tests used in the survey are used as part of any national screening programme in England.
9. Bipolar disorder, previously known as manic depression, is a common, lifelong, mental health condition characterised by recurring episodes of depression and mania. It is associated with significant impairment. Before APMS 2014, bipolar disorder had not been assessed in the UK general population.
10. This chapter provides nationally representative estimates of the prevalence of suicidal thoughts, suicide attempts and self-harm, and trends in these since 2000. Their relationship to age, sex and other characteristics is described alongside findings on the methods and reasons reported for self-harming. Finally, results are presented on the help-seeking behaviour of people who have made a suicide attempt, and on the types of professional help received by those who have self-harmed.
11. Comorbidity refers to the presence of two or more conditions at the same time. Physical health conditions were measured by showing participants a list of health conditions and asking which a health professional had diagnosed them with. Five chronic conditions were considered. The identification of mental disorders followed the same approach as that in the mental disorder specific chapters. Mental wellbeing was assessed using the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), where a higher score indicates greater psychological wellbeing. Learning impairment was also included, assessed using the New Adult Reading Test (NART).
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