Epidemiology - National Comorbidity Survey Replication

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DESCRIPTION (provided by applicant): This application seeks support for continued analysis of the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of the prevalence and correlates of DSM-IV. The two original NCS-R specific aims were: to investigate time trends in the prevalence and correlates of mental disorders over the decade of the 1990s by comparing results in the results of the baseline NCS; and to expand the assessment of prevalence and correlates beyond the NCS. To these ends, the NCS-R repeated many NCS questions, updated diagnostic assessments to DSM-IV criteria (vs. DSM-III-R in the baseline NCS), expanded the number of disorders assessed, and included many new questions not in the NCS. The current application has four specific aims: (1) to disseminate and support a public use NCS-R dataset; (2) to complete analyses for the NCS-R aim of studying time trends in prevalence, treatment, treatment adequacy, and correlates compared to the baseline NCS; (3) to complete analyses for the NCS-R aim of addressing important substantive and methodological issues that were not covered in the baseline NCS; and (4) to continue our collaboration with NIMH and other colleagues in the larger U01 who are carrying out separate African-American and Latino/Asian-American surveys. The third aim is the most complex of the four, as it has six sub-aims. These include the following: (i) to estimate the prevalence, clinical severity, and correlates of individual DSM-IV disorders, expanding the number and variety of disorders assessed compared to the NCS; (ii) to evaluate disorder-specific nosological issues aimed at guiding revisions of the DSM-V system; (iii) to estimate the comparative effects of individual mental and physical disorders on role functioning and utilities; (iv) to analyze the ways in which comorbidity adds to the impairments associated with individual mental disorders; (v) to analyze the effects of mental vs. physical disorders on family burden; and (vi) to analyze the temporal unfolding of multivariate comorbid disorder profiles over the life course.