The Stirling County Study: Then and now

Abstract

The Stirling County Study was started more than 40 years ago. In the context of the field of community-based psychiatric epidemiology as a whole, the Stirling Study is reviewed using three time periods. The early years are illustrated by comparison of the Lundby, Midtown, and Stirling Studies. This period ended in critical reviews which emphasized the absence of agreement about psychiatric diagnosis and which suggested that prevalence was over-estimated especially by Stirling and Midtown, both of which gave a current overall rate of about 20%. During the middle years effort in the Stirling Study and in psychiatric epidemiology generally was concentrated on issues of reliability and validity of diagnosis. The recent years are illustrated by comparison with the Epidemiologic Catchment Area Program, the Edmonton Epidemiologic Survey, and the National Comorbidity Survey. A current overall rate of approximately 20% can no longer be thought of as an over-estimation since it has appeared in numerous studies. Similarities and differences across studies will, however, continue to draw attention. In terms of similarities, the findings from the Stirling Study from 1952–1970 seem to support a “birth cohort” effect for depression which has been commonly but retrospectively reported in the newer studies. While recent findings from the Stirling Study are not yet available, it is possible that peak prevalence has moved downward from older to younger people as time has moved forward from 1952 to 1992. In terms of differences, results about depression in the Stirling Study are unusual in that they suggest equal vulnerability for men and women. This finding is worthy of attention because long-term outcome of depression was much worse for men than women in terms of association with death and in the liklihood of remaining chronically or recurrently depressed.