A Longitudinal Study in Psychiatric Epidemiology

斯特灵县的这项研究跨越了40年，利用了一个数据库，其中包括大约4010名成年人，这些成年人依次在1952年、1970年和1992年被选为加拿大大西洋地区的代表。纵向设计包括重复的横断面调查和队列跟踪调查，数据来自对受试者及其普通医生的访谈。精神病学诊断的程序一直得到应用，在结构上与现代方法兼容，最近更新了用于情绪障碍的常见词汇的变化。在1996年完成的最后一波数据收集中，部分诊断性访谈时间表被用来与其他研究进行比较；对老年受试者进行了改进的迷你精神状态检查，以便评估认知功能障碍；并使用了DSM-III-R的结构化临床访谈进行效度评估。这项提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、外行人管理的访谈和临床医生管理的访谈的比较以及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，要讨论的专题包括：焦虑和抑郁症的患病率和发病率；抑郁症和焦虑症的临床先例和后续病程，它们与吸烟的关系；与死亡率的关系；与社会经济地位的关系；与妇女作用的变化；与保健服务的使用；与普通医生对精神疾病的看法。三名年轻的研究人员将使用这项研究的数据来研究认知功能障碍的精神病学先兆，处理多源数据的统计程序，以及有关精神药物药物的改变做法。研究的前半部分表明，许多类型的精神障碍降低了生活的质量和数量。这项研究关注的是此类疾病的数量是否在增加，或者临床特征是否发生了变化。

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.