A Longitudinal Study in Psychiatric Epidemiology

描述（由申请人提供）：斯特林县的研究跨越40年，并借鉴了一个数据库，涉及4010名成年人依次选择代表加拿大大西洋地区在1952年，1970年和1992年。纵向设计包括重复的横断面调查结合队列随访，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在应用，在结构上与现代方法兼容，最近更新了用于情绪障碍的常用词的变化。在最后一波数据收集中，还使用了诊断性访谈计划、改良简易精神状态检查和DSM-III-R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。本提案的目的是申请资金，以便：1）继续进行初步分析和报告结果; 2）准备一份适合其他科学家使用并保护受试者身份的数据档案; 3）继续与3名年轻研究者分享数据。发表的报告涉及抑郁症流行和发病率的时间趋势及其与焦虑和吸烟的关系等主题。本提案所述的专题包括：死亡率预测因素的变化，重点是抑郁症，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，这些主题对焦虑的扩展，与社会经济地位和社会角色关系的变化，精神疾病的分布和后遗症的变化，因为它们可能与卫生服务的使用有关，普通医生对精神疾病的看法的变化，以及普通医生使用精神药物的做法的变化。研究的前半部分表明，许多类型的精神疾病都会降低生活的质量和数量。本研究关注这些疾病的分布、相关性和关联性或临床特征是否发生变化。

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.