Cross-national comparisons of the prevalences and correlates of mental disorders. WHO International Consortium in Psychiatric Epidemiology.
Cross-national comparisons of the prevalences and correlates of mental disorders. WHO International Consortium in Psychiatric Epidemiology.
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发表时间：
2000
影响因子：
11.1
通讯作者：
L. Andrade;J. Caraveo-Anduaga;P. Berglund;R. Bijl;R. Kessler;Olga V. Demler;E. Walters;C. Kylyc;D. Offord;T. B. Üstün;H. Wittchen
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作者：
L. Andrade;J. Caraveo-Anduaga;P. Berglund;R. Bijl;R. Kessler;Olga V. Demler;E. Walters;C. Kylyc;D. Offord;T. B. Üstün;H. Wittchen
国际精神病学流行病学联合会（ICPE）是由世卫组织于1998年设立的，目的是对精神障碍的发病率和相关因素进行跨国比较研究。本文描述了ICPE在北美（加拿大和美国）、拉丁美洲（巴西和墨西哥）和欧洲（德国、荷兰和土耳其）七个国家的调查结果，使用WHO复合国际诊断访谈（CIDI）的一个版本来生成诊断。使用DSM-III-R和DSM-IV标准报告结果，没有精神障碍的诊断等级规则，并使用物质使用障碍的等级规则。患病率估计差异很大-从荷兰和美国的任何精神障碍的终生患病率> 40%到土耳其的12%和墨西哥的20%。终生患病率与近期患病率估计值的比较表明，精神障碍往往是慢性的，尽管焦虑症的慢性化程度始终高于情绪障碍或药物使用障碍。回顾性报告表明，精神障碍通常发病年龄较早，估计焦虑症的中位数为15岁，情绪障碍为26岁，物质使用障碍为21岁。所有三类障碍都与一些社会经济不利因素（如低收入和教育，失业，未婚）呈正相关。回顾性发病年龄报告的分析表明，终身患病率在最近的队列中有所增加，但焦虑症的增加幅度小于情绪或物质使用障碍。在寻求专业治疗方面的拖延很普遍，特别是在早发病例中，只有少数患有流行性疾病的人得到了任何治疗。精神障碍是各类疾病中负担最重的疾病之一，因为其发病率高、慢性化、发病年龄早，并造成严重损害。需要针对早发性精神障碍患者开展早期外展和干预方案的示范项目，以及质量保证方案，以研究治疗不足的普遍问题。
The International Consortium in Psychiatric Epidemiology (ICPE) was established in 1998 by WHO to carry out cross-national comparative studies of the prevalences and correlates of mental disorders. This article describes the findings of ICPE surveys in seven countries in North America (Canada and USA), Latin America (Brazil and Mexico), and Europe (Germany, Netherlands, and Turkey), using a version of the WHO Composite International Diagnostic Interview (CIDI) to generate diagnoses. The results are reported using DSM-III-R and DSM-IV criteria without diagnostic hierarchy rules for mental disorders and with hierarchy rules for substance-use disorders. Prevalence estimates varied widely--from > 40% lifetime prevalence of any mental disorder in Netherlands and the USA to levels of 12% in Turkey and 20% in Mexico. Comparisons of lifetime versus recent prevalence estimates show that mental disorders were often chronic, although chronicity was consistently higher for anxiety disorders than for mood or substance-use disorders. Retrospective reports suggest that mental disorders typically had early ages of onset, with estimated medians of 15 years for anxiety disorders, 26 years for mood disorders, and 21 years for substance-use disorders. All three classes of disorder were positively related to a number of socioeconomic measures of disadvantage (such as low income and education, unemployed, unmarried). Analysis of retrospective age-of-onset reports suggest that lifetime prevalences had increased in recent cohorts, but the increase was less for anxiety disorders than for mood or substance-use disorders. Delays in seeking professional treatment were widespread, especially among early-onset cases, and only a minority of people with prevailing disorders received any treatment. Mental disorders are among the most burdensome of all classes of disease because of their high prevalence and chronicity, early age of onset, and resulting serious impairment. There is a need for demonstration projects of early outreach and intervention programmes for people with early-onset mental disorders, as well as quality assurance programmes to look into the widespread problem of inadequate treatment.