A Longitudinal Study in Psychiatric Epidemiology

斯特林县的研究跨越了40年，从数据库中选取了大约4010名成年人，他们分别在1952年、1970年和1992年代表了加拿大大西洋沿岸的一个地区。纵向设计包括重复的横断面调查与队列随访相结合，数据包括与受试者及其普通医生进行的访谈。精神病诊断的程序一直被应用，在结构上与现代方法兼容，并且最近更新了用于情绪障碍的常用词汇的变化。在1996年完成的最后一波数据收集中，诊断访谈表的部分内容被用于与其他研究进行比较；对老年受试者进行修改后的迷你精神状态检查，以评估认知功能障碍；并采用DSM-III-R的结构化临床访谈进行效度评估。这项建议的目的是请求资金完成数据处理并进行初步分析和报告。基于40年的视角，最近发表了关于抑郁症患病率和发病率的时间趋势，关于非专业人员访谈和临床医生访谈的比较，以及关于纵向研究方法的演变的报告。时间趋势构成了未来分析的框架，要讨论的主题包括：焦虑和抑郁症共病的患病率和发病率；抑郁和焦虑的临床前因后果及其与吸烟的关系；死亡率;具有社会经济地位；随着女性角色的变化；使用保健服务；以及普通医生对精神疾病的认知。三位年轻的研究人员将利用这项研究的数据来研究认知功能障碍的精神病学前兆，处理多源数据的统计程序，以及改变精神药物治疗的做法。研究的前半部分表明，许多类型的精神疾病降低了生活的质量和数量。这项研究关注的是这些疾病的数量是否在增加，临床特征是否在变化。

The Stirling County Study spans 40 years and draws on a database of about 4010 adults selected sequentially to represent an area in Atlantic Canada in 1952, 1970, and 1992. The longitudinal design involves repeated cross-sectional surveys combined with cohort follow-up, and the data consist in interviews carried out with subjects and their general physicians. The procedures for psychiatric diagnosis have been consistently applied, are structurally compatible with modern approaches, and were recently updated for changes in the common words used for disturbances of mood. In the final wave of data gathering, completed in 1996, portions of the Diagnostic Interview Schedule were used to facilitate comparison with other studies; the Modified Mini-Mental Status Examination was administered to older subjects so that cognitive dysfunction could be estimated; and the Structured Clinical Interview for DSM-III-R was employed for a validity assessment. The purpose of this proposal is to request funds to complete data-processing and to conduct primary analysis and reporting. Based on the 40-year perspective, reports have recently been published on time-trends in the prevalence and incidence of depression, on comparison of lay-administered and clinician- administered interviews, and on the evolution of methods for longitudinal research. Time-trends constitute the framework for future analysis, and the topics to be addressed include: prevalence and incidence of anxiety and comorbidity with depression; clinical antecedents and subsequent course of depression and anxiety, their associations with smoking; with mortality; with socioeconomic status; with changes in the role of women; with health service use; and with the perceptions of psychiatric disorders by general physicians. Three young investigators will use data from the study to study psychiatric precursors of cognitive dysfunction, statistical procedures for handling multiple-source data, and changing practices regarding psychotropic medication. The first half of the study indicated that many types of psychiatric disorders reduce the quality and quantity of life. This research concerns whether such disorders are increasing in number or changing in clinical features.