A Longitudinal Study in Psychiatric Epidemiology

描述(由申请人提供)：斯特灵县的研究跨越40年，利用了一个数据库，该数据库涉及1952年、1970年和1992年先后被选为代表大西洋加拿大某地区的4010名成年人。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。在最后一波数据收集中，也使用了诊断性访谈时间表、改良的简易精神状态检查和DSM-III-R的结构化临床访谈。大多数分析涉及抑郁症、焦虑症和酗酒等常见疾病。这项提议的目的是申请资金，以便：1)继续对研究结果进行初步分析和报告；2)建立一个数据档案，供其他科学家使用，并保护受试者的身份；3)继续与3名年轻研究人员共享数据。已发表的报告涉及抑郁症患病率和发病率的时间趋势及其与焦虑和吸烟的关系等主题。这项建议中描述的主题包括：以抑郁症为重点的死亡率预测因素的变化，认知功能障碍的预测因素，抑郁症受试者病程的变化，肥胖和酗酒与抑郁症的关系，这些主题与焦虑的关系的变化，与社会经济地位和社会角色的关系的变化，可能与卫生服务使用有关的精神疾病的分布和后遗症的变化，全科医生对精神疾病的看法的变化，以及全科医生关于精神药物使用的做法的变化。研究的前半部分表明，许多类型的精神障碍都会降低生活质量和数量。这项研究关注的是这些疾病的分布、它们的相关性和关联性，或者它们的临床特征是否发生了变化。

DESCRIPTION (provided by applicant): The Stirling County Study spans 40 years and draws on a database concerning 4010 adults selected sequentially to represent an area of 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, the Diagnostic Interview Schedule, the Modified Mini-Mental Status Examination, and the Structured Clinical Interview for DSM-III-R were also used. Most of the analyses concern the common disorders of depression, anxiety, and alcoholism. The purpose of this proposal is to request funds in order to: 1) continue primary analysis and reporting of findings; 2) prepare a data archive that will be appropriate for use by other scientists and will protect the identity of subjects; and 3) continue to share data with 3 young investigators. Published reports deal with such topics as time-trends in the prevalence and incidence of depression and its relationships to anxiety and cigarette smoking. The topics described in this proposal include: changes in the predictors of mortality with a focus on depression, predictors of cognitive dysfunction, changes in the course of illness among depressed subjects, relationships of obesity and alcoholism to depression, extensions of these topics to anxiety, changes in relationships to socioeconomic status and social roles, changes in the distribution and sequelae of psychiatric disorders as they may relate to health service use, changes in the perceptions of psychiatric disorders by general physicians, and changes in the practices of general physicians regarding use of psychotropic medications. The first half of the study indicated that many types of psychiatric disorders reduce both the quality and quantity of life. This research concerns whether such disorders are changing in their distribution, their correlates and associations, or in their clinical features.