EPIDEMIOLOGY-- NATIONAL COMORBIDITY SURVEY REPLICATION

这项建议寻求支持在2000年，也就是最初的全国共病调查十年后，进行全国共病调查的复制。如果获得资助，将对年龄在15岁以上的10,000名新样本进行重复调查，同时对NIDA支持的NCS样本中的原始受访者进行重新访谈调查。有两个具体目标。第一个是调查两次调查之间十年的时间趋势及其相关性。我们将调查DSM疾病的终生患病率（所谓的“队列效应”）和这些疾病的近期患病率的趋势。我们将研究这些趋势的社会人口学相关性，例如抑郁症的性别差异在过去十年中减少的可能性，以及富人和穷人之间的心理健康差距增加的可能性。我们还将研究这些疾病的服务使用模式的趋势，重点关注疾病患者接受治疗比例的变化、跨服务部门的治疗分布、治疗强度和充足性以及治疗退出情况。我们还将研究寻求治疗的一些与政策相关的预测因素的趋势，包括感知需求、感知治疗效果和寻求治疗的障碍。第二个具体目标是在2000年为美国产生具有全国代表性的数据，这些数据将作为世界卫生组织（WHO） 2000年世界精神卫生倡议（WMH2000）的一部分使用。根据这一目标，我们将与世界上其他十几个国家的调查人员协调，这些调查人员正在与卫生组织合作，在2000年进行心理健康需求评估调查。调查将询问有关严重损害和持续性精神障碍的12个月患病率、这些疾病的治疗以及疾病和治疗的社会人口学相关性的平行问题。我们还将从病人、他们的雇主和整个社会的角度估计精神障碍的社会成本。将准备一个公共使用数据集，供许多需要拟议调查提供的基准数据的学生、研究人员和卫生政策分析师访问，并在数据收集和清理完毕后立即提供。在数据发布的同时，我们将在发布后的两年内举办关于使用公共数据集的夏季研讨会。

This proposal seeks support for a replication of the National Comorbidity Survey to be carried out in the year 2000, a decade after the original NCS. If funded, the replication survey would be administered to a new sample of 10,000 respondents in the age range 15 plus in conjunction with an already funded NIDA- supported reinterview survey of the original respondents in the NCS sample. There are two specific aims. The first is to investigate time trends and their correlates over the decade between the two surveys. We will investigate trends in both the lifetime prevalences (so-called "cohort effects") of DSM disorders and in recent prevalences of these disorders. We will examine sociodemographic correlates of these trends, such as the possibilities that the sex difference in depression has decreased over the last decade and that the mental health gap between rich and poor people has increased. We will also examine trends in patterns of service use for these disorders, focusing on changes in the proportion of people with disorders in treatment, in the distribution of treatment across service sectors, in treatment intensity and adequacy, and in treatment dropout. We will also examine trends in a number of policy-relevant predictors of seeking treatment, including perceived need, perceived efficacy of treatment, and barriers to seeking treatment. The second specific aim is to generate nationally representative data for the U.S. in the year 2000 that will be used as part of the World Health Organization's (WHO) World Mental Health 2000 (WMH2000) Initiative. Under this aim we will coordinate with investigators in a dozen other countries around the world who are working with the WHO to carry out mental health needs assessment surveys in the year 2000. The surveys will ask parallel questions about the 12-month prevalences of seriously impairing and persistent mental disorders, treatment of these disorders, and the sociodemographic correlates of disorders and treatment. We will also estimate the societal costs of mental disorders from the perspective of the ill person, their employers, and the total society. A public use dataset that can be accessed by many students, researchers, and health policy analysts who need benchmark data of the sort provided by the proposed survey will be prepared and made available as soon as the data are collected and cleaned. In conjunction with the data release we will hold summer workshops in the use of the public dataset for two years after release.