Risk Factors for Psychopathology in the WHO WMH Surveys

世界卫生组织 WMH 调查中的精神病理学危险因素

• 批准号: 7098044
• 负责人: RONALD C KESSLER
• 金额: $ 74.38万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-20 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7098044
• 关键词: World Health Organization; child abuse; clinical research; disease /disorder proneness /risk; gender difference; health surveys; human data; international cooperation; longitudinal human study; mental disorder diagnosis; mental health epidemiology; meta analysis; pathologic process; psychopathology; social class; socioeconomics

DESCRIPTION (provided by applicant): This proposal is a second resubmission of an earlier proposal that was submitted in response to PA-03-044 (Risk Factors for Psychopathology Using Existing Data Sets) to carry out comprehensive centralized secondary analyses of risk factors in the World Health Organization World Mental Health (WMH) surveys. The WMH surveys are a coordinated set of community psychiatric epidemiological surveys in 28 countries with a combined sample size of over 214,000 respondents. The diagnostic instrument is an expanded version of the WHO Composite International Diagnostic Interview (CIDI). The interviews also include a rich risk factor battery. The surveys are all being carried out by carefully trained and closely monitored lay interviewers, with centralized training and quality control monitoring used to maximize comparability of data across sites. Clinical reappraisal interviews using the Structured Clinical Interview for DSM-IV (SCID) are being administered to sub-samples in a number of sites to confirm the CIDI diagnoses. Most of the 28 surveys are funded only to assess the within-county societal burden of mental disorders, unmet needs for treatment, and barriers to obtaining treatment. Within-country analyses are largely limited to preparing government reports on these basic issues. None of the survey teams is funded to carry out cross-national comparative analyses. We propose to capitalize on this under-use of the WMH survey data by carrying out centralized secondary analyses in collaboration with the international WMH investigators. These secondary analyses will focus on three lines of research, all of which have been of long-standing interest to psychiatric epidemiologists: (1) sex differences in mental illness; (2) the association between social class and mental illness; and (3) the long-term effects of childhood adversities on adult mental illness. The unprecedented size and substantive richness of the WMH database will allow important contributions to be made in each of these three areas of investigation. Three major changes have been made in response to reviewer comments. First, the number of originally proposed lines of investigation was reduced from six to three. Second, we added a second FTE medical anthropology postdoctoral fellow and a senior medical anthropologist Co-Investigator to the team. Third, the level of detail in the description of data analysis plans has been substantially expanded in this revised submission in response to reviewer comments.

描述（由申请人提供）：该提案是对PA-03-044（使用现有数据集的心理病理学的危险因素）提交的早期提案的第二次重新提交，以在世界卫生组织世界心理健康（WMH）调查中进行全面的集中式次级次要分析。 WMH调查是一组协调的社区精神病流行病学调查，在28个国家，样本量总额超过214,000。诊断工具是WHO复合国际诊断访谈（CIDI）的扩展版本。访谈还包括丰富的风险因素电池。这些调查都是通过经过精心培训和经过密切监控的外行访调员进行的，用于集中式培训和质量控制监控，用于最大程度地提高跨站点数据的可比性。使用DSM-IV（SCID）的结构化临床访谈进行临床重新评估访谈正在对许多地点的子样本进行管理，以确认CIDI诊断。 28项调查中的大多数是为了评估精神障碍的县内社会负担，未满足的治疗需求以及获得治疗的障碍。国内分析在很大程度上仅限于为这些基本问题的政府报告做准备。没有一个调查团队用于进行跨国比较分析。我们建议通过与国际WMH调查人员合作进行集中式次要分析来利用WMH调查数据的不足。这些二次分析将集中在三项研究上，所有这些研究都对精神病学家长期以来一直具有兴趣：（1）精神疾病的性别差异； （2）社会阶层与精神疾病之间的联系； （3）儿童逆境对成人精神疾病的长期影响。 WMH数据库的前所未有的规模和实质性丰富度将允许在这三个调查领域中的每个领域中做出重要的贡献。为了响应审阅者的评论，已经进行了三个重大更改。首先，最初提出的调查线的数量从六个减少到三。其次，我们在团队中添加了第二个FTE医学人类学博士学博士后研究员和一名高级医学人类学家共同研究员。第三，数据分析计划描述中的细节水平已在此修订后的提交中大大扩展，以回应审阅者评论。