EPIDEMIOLOGY-- NATIONAL COMORBIDITY SURVEY REPLICATION

这项建议寻求支持在2000年，也就是最初的全国疾病控制系统十年后，复制全国共病调查。如果得到资助，重复调查将在15岁以上的10,000名新样本中进行，同时还将对NCS样本中最初的受访者进行已获资助的NIDA支持的重访调查。有两个具体目标。首先是调查两次调查之间的时间趋势及其在十年间的相关性。我们将调查DSM疾病的终生流行(所谓的“队列效应”)和这些疾病最近流行的趋势。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缩小的可能性，以及富人和穷人之间的心理健康差距扩大的可能性。我们还将研究这些疾病的服务使用模式的趋势，重点是在接受治疗的障碍患者比例、服务部门的治疗分布、治疗强度和充分性以及治疗辍学方面的变化。我们还将审查寻求治疗的一些与政策相关的预测因素的趋势，包括感知的需求、感知的治疗效果和寻求治疗的障碍。第二个具体目标是为2000年的美国生成具有全国代表性的数据，这些数据将被用作世界卫生组织(WHO)2000年世界精神卫生(WMH2000)倡议的一部分。在这个目标下，我们会与世界其他十多个国家的研究人员合作，在二零零零年与世界卫生组织合作进行精神健康需求评估调查。这些调查将提出类似的问题，涉及12个月来严重受损和持续性精神障碍的流行情况、这些障碍的治疗方法以及障碍和治疗的社会人口学相关性。我们还将从病人、他们的雇主和整个社会的角度来估计精神障碍的社会成本。收集和清理数据后，将准备一个公共使用数据集，供需要拟议调查提供的基准数据的许多学生、研究人员和卫生政策分析师访问。在发布数据的同时，我们将在数据发布后举办为期两年的公共数据集使用问题夏季讲习班。

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.