RISK FACTORS FOR PSYCHIATRIC DISORDERS

拟议的项目审查精神疾病分类学和选定的 精神疾病的危险因素， 代表性的社区样本。 精神疾病 使用三种方法进行检查：（a）DIS/DSM-III诊断， (b)DIS症状计数，以及（c）由 隶属度等级（GOM）分析。 GOM分析是 特别重要的是，它们提供了有关 基于故障的症状特征与 诊断类别，包括疾病分类框架， DIS-III. 这种折衷的精神病诊断方法也 允许检查各种心理健康问题， 在社区人群中最普遍（例如， 症状以及正式诊断）。 风险因素分析 重点放在三个方面：（a）工作特点在多大程度上 是精神障碍的危险因素，（B） 生活事件、社会支持、社会融合和 精神疾病，以及（c）环境影响的程度 居住区的特点是危险因素， 精神疾病 各种统计建模 风险分析中将采用的技术，包括 环境影响的多层次分析 方面的影响. 将特别注意互动， 以及风险因素的直接和间接影响 考察 建议的分析将有助于我们 对社区人群精神疾病的认识 以及确定将个人置于 精神疾病的风险增加。 拟议项目中使用的数据来自 流行病学集水区方案。 大多数分析将 用于杜克ECA样本，但选定的分析将使用 从所有五个非洲经委会网站汇集。 拟议的分析包括 横截面和纵向模型。 在可能的情况下， 暴露于感兴趣的风险因素的时间长度也将 考察 拟议项目利用丰富的资源， 项目的范围，并将审查长期的问题， 在精神病学的长期兴趣，在一个创造性的， 方法论上复杂的方式。

The proposed project examines psychiatric nosology and selected risk factors for psychiatric disorders in the context of a representative community-based sample. Psychiatric disorders are examined using three approaches: (a) DIS/DSM-III diagnoses, (b) DIS symptom counts, and (c) symptom profiles generated by grade of membership (GOM) analysis. The GOM analyses are particularly important in that they provide information about the extent to which empirically-based symptom profiles match the diagnostic categories that comprise the nosologic framework of DIS-III. This eclectic approach to psychiatric diagnosis also permits examination of the kinds of mental health problems that are most prevalent in community populations (e.g. symptom syndromes as well as formal diagnoses). Risk factor analyses focus on three areas: (a) the extent to which job characteristics are risk factors for psychiatric disorders, (b) the relationships among life events, social support, social integration, and psychiatric disorders, and (c) the extent to which environmental characteristics of the residential area are risk factors for psychiatric disorders. A variety of statistical modeling techniques will be employed in the risk analyses, including multilevel analysis for examining the impact of enviromental effects. Special attention will be devoted to the interactive, as well as the direct and indirect effects, of the risk factors examined. The proposed analyses will be contribute to our understanding of psychiatric disorders in community populations and the identification of variables that place individuals at increased risk of psychiatric disorders. The data to be used in the proposed project are from the Epidemiologic Catchment Area Program. Most analyses will be used on the Duke ECA sample, but selected analyses will use pooled from all five ECA sites. The proposed analyses included both cross-sectional and longitudinal models. Where possible, length of exposure to the risk factors of interest also will be examined. The proposed project capitalizes upon the richness and breadth of the ECA Project and will examine issues of long- standing interest in psychiatric epidemiology in a creative and methodologically sophisticated manner.