Risk Factors for Psychopathology in the WHO WMH Surveys

世界卫生组织 WMH 调查中的精神病理学危险因素

• 批准号: 7231833
• 负责人: RONALD C KESSLER
• 金额: $ 59.33万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-20 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7231833
• 关键词: Risk; Factors; Psychopathology; WHO; WMH

DESCRIPTION (provided by applicant): This proposal is submitted in response to PA-03-044 (Risk Factors for Psychopathology Using Existing Data Sets) to carry out comprehensive centralized secondary analyses of risk factors in the World Health Organization World Mental Health (WMH) surveys. The WMH surveys are a coordinated set of community psychiatric epidemiological surveys in 27 countries with a combined sample size of nearly 200,000 respondents. The diagnostic instrument is an expanded version of the WHO Composite International Diagnostic Interview (CIDI). The interviews also include a rich risk factor battery. The surveys are all being carried out by carefully trained and closely monitored lay interviewers, with centralized training and quality control monitoring used to maximize comparability of data across sites. Clinical reappraisal interviews using the Structured Clinical Interview for DSM-IV (SCID) are being administered to sub-samples in a number of sites to confirm the CIDI diagnoses. Most of the 27 surveys are funded only to assess the within-county societal burden of mental disorders, unmet needs for treatment, and barriers to obtaining treatment. Within country analyses are largely limited to preparing government reports on these basic issues. None of the survey teams is funded to carry out cross-national comparative analyses. We propose to capitalize on this under-use of the WMH data by carrying out centralized secondary analyses in collaboration with the international WMH investigators. These secondary analyses will focus on six lines of research, all of which have been of long-standing interest to psychiatric epidemiologists: (1) sex differences in mental illness; (2) the association between social class and mental illness; (3) patterns and effects of assortative mating on the course and intergenerational transmission of mental illness; (4) the long-term effects of childhood adversities on adult mental illness; (5) the effects of temporally primary early-onset mental disorders on the onset and course of subsequent secondary mental disorders; and (6) the role of PTSD in mediating the effects of traumatic life events on other types of mental illness. The unprecedented size and substantive richness of the WMH database will allow important contributions to be made in each of these six areas of investigation.

说明(申请人提供)：本提案是根据PA-03-044(使用现有数据集进行精神病理学的风险因素)提交的，目的是对世界卫生组织世界精神卫生(WMH)调查中的风险因素进行全面的集中二级分析。WMH调查是一套协调的社区精神疾病流行病学调查，在27个国家进行，总样本量接近20万名受访者。该诊断工具是世卫组织综合国际诊断访谈(CIDI)的扩展版本。采访还包括一系列丰富的风险因素。这些调查都是由经过仔细培训和密切监测的非专业面谈人员进行的，并采用集中培训和质量控制监测，以最大限度地提高各地点数据的可比性。使用DSM-IV结构化临床访谈(SCID)的临床复评访谈正在对多个地点的子样本进行，以确认CIDI的诊断。27项调查中的大多数仅用于评估县内精神疾病的社会负担、未得到满足的治疗需求以及获得治疗的障碍。在国内，分析在很大程度上仅限于就这些基本问题编写政府报告。没有一个调查小组得到资助进行跨国比较分析。我们建议利用这种未充分利用的卫生保健数据，与国际卫生保健调查人员合作进行集中的二次分析。这些二次分析将集中在六个方面的研究，所有这些都是精神病学流行病学家长期感兴趣的：(1)精神疾病的性别差异；(2)社会阶层和精神疾病之间的联系；(3)各种交配对精神疾病病程和代际传播的模式和影响；(4)童年逆境对成人精神疾病的长期影响；(5)暂时性原发早发性精神障碍对继发性精神障碍发病和病程的影响；以及(6)创伤后应激障碍在创伤生活事件对其他类型精神疾病的影响中的中介作用。世界卫生组织数据库的规模之大和实质内容之丰富，将使其能够在这六个调查领域中的每一个领域作出重要贡献。