Social Consequences of Mental Disorders: A Ten-Year Follow-up Study

精神障碍的社会后果：十年跟踪研究

基本信息

批准号：
8642672
负责人：
RAMIN MOJTABAI
金额：
$ 27.96万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-04-01 至 2016-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8642672
关键词：
Accounting Address Age Anxiety Anxiety Disorders Birth Cardiovascular Diseases Communities Comorbidity Cross-Sectional Studies Data Data Analyses Developed Countries Development Diagnostic and Statistical Manual of Mental Disorders Disease Divorce Drops Economic Burden Employment Epidemiologic Studies Funding General Population Health Health Services Research Healthcare Impairment Income Individual Intervention Interview Life Life Cycle Stages Light Link Longitudinal Studies Longitudinal Surveys Marketing Marriage Measures Medical Mental Health Mental disorders Mood Disorders Moods Multivariate Analysis New Zealand Observational Study Occupational Occupations Outcome Participant Period Analysis Play Policies Population Population Attributable Risks Pregnancy in Adolescence Prospective Studies Psyche structure Recording of previous events Reporting Research Resource Allocation Respondent Risk Role Rural Sampling Schools Scoring Method Severities Socioeconomic Status Staging Subgroup Suicide Surveys Symptoms System Techniques Unemployment Variant Work Youth adverse outcome age group base burden of illness cohort contextual factors cost disability economic cost economic outcome experience follow-up functional outcomes physical conditioning prospective public health relevance severe mental illness sex social unemployment insurance

项目摘要

DESCRIPTION (provided by applicant): Past research has found strong associations between common mental disorders and adverse social outcomes such as school drop-out, teen pregnancy, unemployment, marital instability and impairment in role functioning. However, most studies of these associations in the US have been based on cross-sectional data or selected populations. Cross-sectional studies cannot disentangle reciprocal associations likely to exist between mental disorders and social adversities and studies based on selected samples cannot be generalized to the whole population. Prospective data in representative samples of the entire population are needed. There are few such studies with a focus on mental health in the US. While the associations of mental disorders with social outcomes have been studied in birth cohort and other longitudinal studies in other industrialized countries, variations in contextual factors, such as school systems, job markets, and unemployment insurance policies hinder generalization of results to the US. There is a need for comparable US studies to document the adverse consequences of mental disorders in the US. In this project, we propose to examine the development of adverse social and functional outcomes in individuals with lifetime histories of mood, anxiety, substance and conduct disorders in the 5,001 participants of the US National Comorbidity Survey between ages 15-54 at baseline who were followed-up and re-interviewed 10 years later. In Aim 1 we determine the extent to which baseline mental disorders predict subsequent disruptions in schooling, employment and marriage as well as earnings. In Aim 2 we focus on the associations of pre-existing mental disorders with subsequent impairments in role functioning. In Aim 3 we look at social adversities at the population level and determine the proportion of these outcomes that can be attributed to mental disorders at the population level. In Aim 4, we assess whether the associations of mental disorders with adverse outcomes vary by sex, socio-economic status, and age. Analyses will use propensity score techniques to adjust for observed potential confounders preceding the onset of mental disorders that could explain associations with subsequent outcomes. Results of the study could be useful in ongoing policy debates about the importance of investing in research and treatment of mental disorders and could help identify subgroups for targeted intervention to avert adverse social outcomes.

描述（由申请人提供）：过去的研究发现，常见的精神障碍与不良社会后果（例如辍学、青少年怀孕、失业、婚姻不稳定和角色功能受损）之间存在密切关联。然而，美国对这些关联的大多数研究都是基于横截面数据或选定的人群。横断面研究无法理清精神障碍与社会逆境之间可能存在的相互关联，基于选定样本的研究也无法推广到整个人群。需要整个人群的代表性样本的前瞻性数据。在美国，很少有此类关注心理健康的研究。虽然其他工业化国家的出生队列和其他纵向研究已经研究了精神障碍与社会结果的关联，但学校系统、就业市场和失业保险政策等背景因素的差异阻碍了结果在美国的推广。美国需要进行类似的研究来记录美国精神障碍的不利后果。在这个项目中，我们建议对 5,001 名基线年龄在 15-54 岁之间的美国国家合并症调查参与者进行跟踪调查，研究终生有情绪、焦虑、物质和品行障碍史的个体的不良社会和功能结果的发展情况。 10年后再次接受采访。在目标 1 中，我们确定基线精神障碍在多大程度上预测随后的学业、就业、婚姻以及收入中断。在目标 2 中，我们重点关注先前存在的精神障碍与随后的角色功能障碍之间的关联。在目标 3 中，我们着眼于人口层面的社会逆境，并确定这些结果中可归因于人口层面的精神障碍的比例。在目标 4 中，我们评估了精神障碍与不良后果的关联是否因性别、社会经济地位和年龄而异。分析将使用倾向评分技术来调整精神障碍发作之前观察到的潜在混杂因素，这些混杂因素可以解释与后续结果的关联。该研究的结果可能有助于正在进行的关于投资精神障碍研究和治疗重要性的政策辩论，并有助于确定有针对性的干预亚组，以避免不良的社会后果。