National Comorbidity Survey - Adolescent (NCS-A)

国家共病研究(NCS-A)的青少年部分是对10,000名美国青少年的综合概率和以学校为基础的多种族样本。麦克马斯特大学的大卫·奥福德博士和他的团队以及我们耶鲁大学的研究小组为青少年改编了成人诊断访谈。这项研究首次提供了关于一般人群中青年精神障碍患病率及其相关因素的全国性数据。我们的研究团队与其他国家专家合作，选择了一系列衡量重大精神障碍风险因素的指标。 我们的研究小组在研究和分析的设计和实施上投入了大量的精力。首先，我们在NIMH的工作人员监督了全结构复合国际诊断面谈的临床验证，并与针对青少年和儿童的半结构临床诊断面谈K-SADS进行了比较。我们的几名临床工作人员和六名临床访谈人员还使用K-SADS和我们研究小组开发的家庭研究访谈对100名患有双相情感障碍或品行障碍的青少年进行了效度研究。作为这项研究的一部分，我们开发了一种方法，用于对由非专业访谈者进行的高度结构化的诊断性访谈进行临床评估，这似乎是对一般人群中的儿童和青少年进行可靠和有效访谈的最佳方法。我们还回顾了200多盘录音带和对父母和青少年的诊断性访谈，以提供采访的独立评级。我们小组中的数据分析师还花费了大量精力来检查错误、开发诊断算法、分析有效性研究以及准备其他数据分析方法。 为了在大规模人群研究中测试我们收集生物样本的能力，我们还开发了一项研究，从采访前后的整个样本中收集唾液，以评估皮质醇、脱氢表雄酮和睾酮水平。对前2000个病例的初步分析表明，男性和女性的基线皮质醇水平是相同的，随着年龄的增长而增加，并显示出较大的日变化。我们还发现，患有ADHD的儿童的皮质醇基线较低，有行为问题或药物使用障碍的青少年在整个访谈过程中皮质醇的下降幅度低于那些没有这些问题的青少年。我们目前正在与国家儿童健康与发展研究所(George Chrousos博士)和俄勒冈大学(朱迪·卡梅隆博士)的专家合作，为这项研究的其余受试者确定检测和分析。

The Adolescent Component of the National Comorbidity Study (NCS-A) is a combined probability and school-based multi-ethnic sample of 10,000 US adolescents. Dr. David Offord and his team at McMaster University and our research group at Yale adapted the adult diagnostic interview for adolescents. This study provides the first national data on the prevalence and correlates of mental disorder in youth in the general population. Our research team has worked collaboratively with other national experts to select a series of measures of risk factors for major mental disorders. Our research group devoted substantial effort to the design and implementation of the study and the analyses. First, our staff at the NIMH supervised the clinical validation of the fully structured Composite International Diagnostic Interview compared to clinical diagnostic interviews with the semi-structured clinical diagnostic interview for adolescents and children, the K-SADS. Several of our clinical staff and six clinical interviewers also conducted the validity study of 100 adolescents with bipolar disorder or conduct disorder using both the K-SADS and the Family Study Interview for Physical and Mental Health developed by our research group. As part of this study, we developed methods for conducting clinical appraisals of highly structured diagnostic interviews administered by lay interviewers that appear to be an optimal method for conducting reliable and valid interviews of children and adolescents in the general population. We also reviewed more than 200 audiotapes and diagnostic interviews of parents and youth to provide independent ratings of the interviews. Data analysts in our group also spent a substantial effort to error checking, developing diagnostic algorithms, analyzing the validity study, and preparing other measures for data analysis. In order to test our ability to collect biologic samples in large population-based studies, we also developed a study to collect saliva from the entire sample both before and after the interview to assess cortisol, DHEA, and testosterone levels. Preliminary analyses of the first 2000 cases show that baseline cortisol levels are equal for males and females, increase with age and exhibit large diurnal changes. We also found that children with ADHD have lower baseline cortisol and that youth with conduct problems or substance use disorders have less of a decrease in cortisol across the duration of the interview than those without these conditions. We are currently working with experts at the National Institute for Child Health and Development (Dr. George Chrousos) and at the University of Oregon (Dr. Judy Cameron) to determine assays and analyses for the remaining subjects in this study.