Prevalence Rates Of Psychiatric Disorders Research Articles

Headache syndromes and psychiatric disorders: Association and familial transmission

This paper examines the association between psychiatric disorders and headache syndromes in a longitudinal epidemiologic sample of young adult who were selected from the general population of Zurich, Switzerland. Headache syndromes were defined according to the newly introduced diagnostic criteria of the International Headache Society in 1988. The prevalence rates of psychiatric disorders, according to specific headache subtypes, were examined both cross-sectionally and longitudinally. In the cross-sectional data, migraine with aura was associated with hypomania, recurrent brief depression, and all of the anxiety disorders, whereas only the phobic disorders and panic were elevated among subjects with migraine without aura. Similar findings emerged for the longitudinal data, with the exception that major depression was associated with both subtypes of migraine. Subjects with tension-type headaches did not differ from controls with respect to any of the affective or anxiety disorders in both the cross-sectional and longitudinal data. Prospective study data indicated that the age of onset of anxiety disorders generally preceded that of migraine and that the onset of affective disorders in the majority of comorbid subjects followed that of the onset of migraine. In order to investigate the mechanism for the associations between anxiety/depression syndromes and migraine, patterns of co-transmission of migraine and anxiety/depression were examined in data from a controlled family history study of migraine. The results were consistent with a syndromic relationship between migraine and anxiety/depression, rather than their representing discrete manifestations of shared underlying etiology. The implications of these data for research and clinical work are discussed.

The prevalence of dementia, depression and neurosis in later life: the Liverpool MRC-ALPHA Study.

Prevalence rates for psychiatric disorders in the elderly are presented from the initial cross-sectional stage of a longitudinal community study of the incidence of dementia in the city of Liverpool. Together with five other centres in the UK the MRC-ALPHA project forms part of the MRC multicentre incidence study of dementia and cognitive decline. An age- and sex-stratified random sample of 5222 subjects aged > or = 65 was interviewed at home using the Geriatric Mental State-AGECAT package to provide computer diagnoses. The overall age-standardized prevalence rates for organic disorder (4.7%) depressive illness (10.0%) and the neuroses (2.5%) are consistent with levels found in previous smaller studies that have used GMS-AGECAT. Each of these diagnoses is more common in females than males. A rise in organic disorder with age is confirmed as continuing into the oldest age groups for both sexes. An apparent decline with age observed for depression and neurosis diagnoses disappears when organic cases are excluded from the analysis.

New methods in cross-cultural psychiatry: psychiatric illness in Taiwan and the United States

Cross-cultural psychiatric research has suffered from many methodological shortcomings. To answer some of these shortcomings, the present study compared rates of psychiatric disorders in Taiwan and the United States by combining data from both countries into a single data set. Results from large, community-based surveys in the United States and Taiwan, the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area survey and the Taiwan Psychiatric Epidemiological Project, were combined into a single data set. This integration of the data sets was possible because both surveys used the NIMH Diagnostic Interview Schedule to ascertain cases. The integrated data sets were then analyzed with identical algorithms to generate lifetime prevalence rates of psychiatric disorders according to DSM-III criteria for both the United States and Taiwan. Lifetime prevalence rates of psychiatric illness in Taiwan were generally lower than U.S. rates. The rates of any disorder were 21.56% in Taiwan and 35.55% in the United States (Z = 22.34, p less than 10(-109]. The rates of most specific disorders were lower in Taiwan, and none of the rates was higher in Taiwan. While a culturally determined response bias may have lowered the rates in Taiwan somewhat, the results appear to be valid. Implications for the future use of structured diagnostic interviews in cross-cultural research are discussed.

Social Deprivation and Rates of Treated Mental Disorder

A review of the literature shows that there are strong associations of treated prevalence rates of psychiatric disorder with social class, sex, marital status, ethnic group and living alone; and moderate associations with living in inner-city areas and a high degree of residential mobility. The Jarman-8 index of social deprivation correlates with psychiatric admission rates for patients aged less than 65 years (R2 = 0.38). Individual census variables can themselves account for up to 0.71 of the variance in the admission rates, while combined in a stepwise multiple regression the census variables will account for over 0.95 of this variation. Multiple regression models using individual census variables and derived indices should be applied next on a wider geographical basis, and to narrower age, sex and diagnosis-specific psychiatric morbidity rates.

Geropsychiatry in Long‐Term Care: A Nurse‐Centered Approach

High prevalence rates of psychiatric disorders and disruptive behaviors in nursing home residents create the need for structured programs of psychiatric consultation and teaching in the long-term care setting. Over 40 months, 473 residents were evaluated by a psychiatric consultation-liaison clinical nurse specialist; 100 of these cases were reviewed in detail. Apparent depression was the most common reason for referral, and depressive and adjustment disorders were the most common diagnostic conclusions of the consultation team. Behavioral complications of dementia were also frequently diagnosed. Treatment recommendations usually included the development of a behavioral management plan, but the institution of psychotropic medications, usually antidepressants, was indicated in about one-fifth of the 100 cases. Treatment interventions were effective in the majority of cases. About one-half of the problems prompting referral were within the expertise of the nurse specialist and did not require the direct involvement of the geropsychiatrist. This nurse-centered consultation model proved effective, well accepted, and easy to implement.

Problem Behavior in International Adoptees: III. Diagnosis of Child Psychiatric Disorders

This study is a clinical extension of two previous epidemiological studies on problem behavior in international adoptees. In depth pictures were obtained by clinical interviews of 132 14-year-old international adoptees and their parents. Children were selected on the basis of previously obtained Child Behavior Checklist (CBCL) scores. Clinical severity ratings and DSM-III-R diagnoses were obtained. The correlations of r = 0.63 and r = 0.45 between clinical severity ratings and CBCL problem and competence scores, respectively, indicated that the results from the authors' extensive epidemiological survey and the clinical evaluation, which took place more than 10 months later, converged. The results showed that the CBCL may be used in epidemiological studies to obtain an estimate of the prevalence of psychiatric disorders in children. The 28% prevalence rate of psychiatric disorders in this sample of 14-year-old international adoptees (22% rate for girls, 36% for boys) was somewhat higher than for general population samples reported in comparable studies. Conduct disorders were elevated in the sample. The behavior of disordered adopted children was characterized by antisocial behaviors, poor relationships, and problems of affect.

Epidemiology and Course of Psychiatric Disorders in School‐Age Children—Results of a Longitudinal Study

In an epidemiological longitudinal study, 356 out of 399 8-yr old children were re-examined at age 13. Prevalence rates for psychiatric disorders of about 16% remained constant during adolescence. The course of emotional disorders proved very promising, while that of conduct disorders was extremely unfavorable. Remission of psychiatric disorders was also influenced by an improved psychosocial environment within the family. Development of disorders in initially healthy children was related to prior learning disabilities and stressful life events. More effective approaches in the treatment of conduct disorders as well as early detection of detrimental familial conditions and learning disabilities are called for.

The impact of diagnostic hierarchies on prevalence estimates for psychiatric disorders

This article presents an algebraic treatment of the impact of diagnostic hierarchies on the estimation of prevalence rates of psychiatric disorders. A method for correcting for this “hierarchy effect” is developed and illustrated. Using the terminology of Boyd et al., when the dominant disorder is common and/or the odds ratio for the dominant and the excluded disorders is high, the observed prevalence of an excluded disorder can substantially underestimate its true prevalence. This “hierarchy effect” can be particularly important in genetic-epidemiologic investigations which compare the prevalence of an excluded disorder in two populations which differ in the prevalence of the dominant disorder. The impact of certain kinds of diagnostic hierarchies can be easily understood and corrected for; with others, particularly those based on etiologic assumptions, a straight-forward interpretation is not always possible.

Psychiatric disorder and poor school performance among welfare children in Ontario.

Parental welfare status was found to be a marker for identifying a group of children with an increased prevalence of psychiatric disorder and poor school performance. The marker was particularly strong for psychiatric disorder in young boys and for poor school performance in young girls. For instance, the prevalence rates of psychiatric disorder, in the 6 to 11 age group, for welfare and non-welfare boys, were 40.0% and 13.9%, respectively; and for poor school performance in welfare and non-welfare girls, 27.8% and 6.1%, respectively. The relationship between different measures of psychosocial disadvantage and these child deficits was examined. Multivariate analyses revealed, for example, that parental welfare status made an independent contribution to the prediction of psychiatric disorder and was a more powerful predictor of poor school performance in girls compared to boys. The implications of these and other results are discussed.

Single parent women. A community study.

While there has been considerable interest in the problems of single parent families, no study has yet determined if the problems are due to increased risk of specific psychiatric disorders in single parents as compared to their married counterparts. Data collected as part of the National Institute of Mental Health Epidemiologic Catchment Area (ECA) Project are presented to compare the psychiatric as well as economic and social functioning of single vs. married parent women ages 18–44, based on a probability sample of members of the greater New Haven community. The major finding between groups is their relative similarity in psychiatric as well as social functioning. The major difference is economic. Single parents, both Black and White, more frequently are less educated and poorer. While many are on welfare, single compared to married female parents are more likely to be working and to report insufficient income to meet their needs. There are no appreciable differences in social contacts, use of health services or six-month prevalence rates of psychiatric disorders including major depression, alcohol or drug abuse. The data suggest that the problems faced by single parent women and their children may be a reflection of poverty and stress in families and not of psychiatric disorders or poor social relations in mothers.

Psychiatric disorders (DSM-III) and cognitive impairment among the elderly in a U.S. urban community.

Results are presented on the current prevalence rates of psychiatric disorder in 2,588 non-institutionalized persons aged 65 and older who were drawn from a probability sample of New Haven, Connecticut, and 12 surrounding towns in South Central Connecticut. Based on the Diagnostic Interview Schedule (DIS), 6.7% of the respondents had a psychiatric diagnosis (DSM-III), and based on the Mini-Mental Status Exam (MMS), 3.4% had severe cognitive impairments during the past 6-month period. Therefore, more than 10% currently had either a psychiatric or a severe cognitive problem. Overall, these rates of psychiatric disorders are lower than those found in adult populations under age 65. As with younger samples, anxiety and affective disorders were among the most common psychiatric problems. The majority of elderly reported themselves in good emotional and physical health and felt they had sufficient finances to meet their needs. The rate of severe cognitive impairment did not increase until after age 79. Among those 80 years and older, cognitive impairments were more common in women than men, probably due to differential survival rates. Since less than 6% of the elderly sample are living in institutions these results among non-institutionalized elderly point to the relative psychiatric well-being of the majority of the elderly. However, in view of the longer life expectancy, the next decade will see an increase in the absolute number of persons with cognitive impairments.

The natural history of behavioural symptoms among severely and profoundly mentally retarded patients.

In a study of the evolution of behavioural symptoms in severely and profoundly mentally retarded adults in hospital over a period of six years, items of abnormal behaviour were found to be remarkably persistent. There is a high prevalence rate of psychiatric disorder in this population, when this disorder is defined in a widely descriptive sense. A substantially improved living environment, and increased staff-patient ratios, are prerequisites for improving disturbed behaviour in these patients.

The prevalence of psychiatric disorder in rural school children.

The multidetermined nature of psychiatric disorder in childhood calls for a detailed assessment of the individual and his family, and often a team approach to treatment. Since this involves contact with the family over a period of time the delivery of this type of service to children living in remote areas under conditions of geographical isolation can present considerable difficulty. A survey of 10- and 11-year-old children from the far West of Queensland showed a prevalence rate for psychiatric disorder of 10% among those whose parents were willing to complete a questionnaire and attend the child's school for interview. Although this is lower than rates obtained for children living in towns on the East coast and in the metropolitan Brisbane it still represents a sizeable group of children who require psychiatric help in areas where presently none is available. A method of family assessment and treatment for country children evolved by the psychiatric unit of a metropolitan children's hospital, shows the remoteness of home need not preclude the disturbed child from psychiatric expertise, although facilities must be augmented if children from an often forgotten sector of the Australian population are to be covered adequately.

A practical method for screening psychiatric disorder in children with speech and language disorders.

Children with speech and language disorders have been found to have a prevalence rate of psychiatric disorder of 50%. The authors sought to develop an efficient screening procedure to distinguish such children who have psychiatric disorder and those who do not. Cutoff scores for easily administered parent and teacher behavior rating questionnaires were investigated in a population of 256 children with speech and language disorders and known presence or absence of psychiatric disorder. It was learned that when the questionnaires are used together, a cutoff score of 31 or greater on either questionnaires are used together, a cutoff score of 31 or greater on either questionnaire has a positive predictive value of 74.1% and a negative predictive value of 76.1%. This screening method shows promise in assisting speech pathologists in comprehensive evaluation and treatment planning for children with speech and language disorders.

Psychiatric disorders in a U.S. community. The application of research diagnostic criteria to a resurveyed community sample.

Point prevalence rates of psychiatric disorders, risk factors, and treatment sought for the disorders are presented, based on a 1975--1976 follow-up of a community probability sample originally surveyed in 1967. These data, while preliminary because of the limitations of a follow-up study, demonstrate the first application to a community sample of new psychiatric diagnostic techniques (SADS-RDC), which are being used with increasing frequency in the United States. The forthcoming DSM-III will be based on these diagnostic techniques. These results, consistent with other reports, show that depression is the most common psychiatric disorder in the community; that schizophrenia and bipolar disorders both have low frequency; and that psychiatric disorders are heterogeneous by age, sex, race, social class, marital status. While persons with a psychiatric disorder tend to use the health care system in the United States, they do not specifically seek help for emotional problems. Since the majority of psychiatric disorders are untreated in the mental health system, prevalence rates of psychiatric disorders based on cases receiving treatment in psychiatric facilities are a gross underestimate.

Psychiatric disturbances during pregnancy in a rural group of African women

One hundred rural African pregnant women, selected at random from antenatal clinic attenders have been screened for conspicuous psychiatric disturbance. Twenty-four per cent of these women were judged to be notably ill in a psychiatric sense. This number is thought to be excessively high, although a control study is required to settle this, but in any case is in excess of the prevalence rate for psychiatric disorder in the East African population generally. Depressive reaction were the most common pattern of disturbance, and this is in keeping with the recent realization that depression is a frequent disorder in the rural African. Unfavourable social, economic and domestic patterns inherent in the present transition between traditional and urbanized patterns of life appear to be significant in precipitating many of these psychiatric disorders. If modern antenatal care is to play a complete role in preventing the hazards of pregnancy, it must take account of the traditional beliefs and anxieties of rural African women, and seek to deal with these as they arise.