CROSS-CULTURAL PSYCHIATRIC ETHNOGRAPHY AND EPIDEMIOLOGY

跨文化精神病学民族志和流行病学

• 批准号: 6671470
• 负责人: WILLIAM T HOWARD
• 金额: $ 14.68万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2004-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6671470
• 关键词: Filipino; Philippines; alcoholism /alcohol abuse; anxiety; clinical research; culture; emotions; human subject; mental disorder diagnosis; mental health epidemiology; racial /ethnic difference

DESCRIPTION (Adapted from applicants abstract): Objective: This Mentored Clinical Scientist Development Award, K08, will enable the candidate to acquire training necessary to design, conduct, and analyze cross-cultural psychiatric ethnographic and epidemiologic research. Little is known regarding (1) the distribution and determinants of mental illness in the Philippines, in the millions of Asian-American in the U.S., and in the majority of the world's population who live in developing countries, and (2) to what degree DSM-IV and ICD-10 based psychiatric classification and methods of assessment are cross-culturally applicable. Career Development: The candidate proposes 12 months of career development that will include (1) additional training in epidemiology and statistics at The Johns Hopkins School of Public Health (JHSPH), (2) new interdisciplinary training, both in medical anthropology at JHSPH and in cross-cultural psychiatry at McGill University, and (3) mentorship and consultation with a panel of experts in psychiatric epidemiology, cross-cultural psychiatry, and world mental health. Proposed Study: The research plan will be conducted in Region IV and the National Capital Region (NCR) of Luzon, the largest of the Philippine islands. First, the candidate will conduct an ethnographic mental health study focusing on mood and anxiety symptoms and disorders. The candidate will interview approximately 75 adult Key Informants, including (1) medical and psychiatric patients, (2) non-patient community constituents, and (3) a variety of health care providers from Region IV and the NCR. Using information from the ethnography, a report will be prepared that (1) describes how Filipinos experience and express mental distress and illness; (2) describes how Filipinos explain the etiology, classification, and treatment of mental distress and illness; and (3) includes a dictionary of Filipino mental heath terms. Second, and after incorporating findings from the ethnography, an epidemiologic study will involve the administration of a structured interview to both adult psychiatric patients (150 + 50 re-interviews) primarily from the NCR and a representative community sample of adults (750 + 50 re-interviews) from Region IV. The core of the interview will consist of the mood and anxiety disorder sections of the World Health Organization's Composite International Diagnostic Interview (CIDI); however, the relatively shorter and more objective alcohol use disorder section will also be included. Goals of the epidemiologic study include (1) assessing the reliability, validity, and cross-cultural applicability of DSM-IV and ICD-10 based mood and anxiety disorders and methods of assessment in the Philippines and (2) determining what modifications may increase reliability and validity. Other goals include describing the relationship between anxiety, mood, and alcohol use disorders and (1) social and demographic characteristic; (2) patterns of health care services availability, utilization, and need; and (3) types and degrees of disability and functional impairment. Finally, the candidate will obtain Region IV community prevalence rate estimates for mood, anxiety, and alcohol use disorders.

描述（改编自申请人摘要）：目的：这是指导的 临床科学家发展奖K08将使候选人能够获得 设计，进行和分析跨文化精神病所必需的培训 人种学和流行病学研究。关于（1） 菲律宾的精神疾病分配和决定因素， 美国和世界上大多数的亚裔美国人数百万 居住在发展中国家的人口，（2）DSM-IV的程度和 基于ICD-10的精神科分类和评估方法是 跨文化适用。 职业发展：候选人提出了12个月的职业发展 将包括（1）在流行病学和统计学的其他培训 约翰·霍普金斯公共卫生学院（JHSPH），（2）新的跨学科 培训，无论是JHSPH的医学人类学还是跨文化的培训 麦吉尔大学的精神病学，以及（3）与 精神病流行病学专家小组，跨文化精神病学和 世界心理健康。 拟议的研究：研究计划将在IV区和 吕宋岛的国家首都地区（NCR）是菲律宾最大的群岛。 首先，候选人将进行人种学心理健康研究重点 关于情绪和焦虑症状和疾病。候选人将面试 大约有75位成人关键线人，包括（1）医学和精神病学 患者，（2）非患者社区成分，以及（3）各种健康 来自IV区和NCR的护理提供者。使用来自 民族志，将准备一份报告（1）描述菲律宾人如何 经历并表达精神困扰和疾病； （2）描述了菲律宾人如何 解释心理困扰的病因，分类和治疗 疾病; （3）包括菲律宾精神健康术语词典。第二， 并结合了人种志的发现后，一项流行病学研究 将涉及对两个成年人的结构化访谈的管理 精神病患者（150 + 50个重新介绍）主要来自NCR和A 来自地区的成年人的代表性社区样本（750 + 50个重新访问） iv。面试的核心将包括情绪和焦虑症 世界卫生组织综合国际诊断部分 访谈（CIDI）；但是，相对较短，更客观的酒精 使用障碍部分也将包括在内。流行病学研究的目标 包括（1）评估可靠性，有效性和跨文化 基于DSM-IV和ICD-10的适用性，基于ICD-10的情绪和焦虑症和方法 菲律宾评估和（2）确定可以进行哪些修改 提高可靠性和有效性。其他目标包括描述 焦虑，情绪和酒精使用障碍与（1）社会之间的关系 和人口特征； （2）医疗服务的模式 可用性，利用和需求； （3）残疾的类型和程度 和功能障碍。最后，候选人将获得IV区域 社区流行率估计情绪，焦虑和饮酒 疾病。