Examples of Psychiatric Epidemiologic Studies

Examples of Psychiatric Epidemiologic Studies

Dohrenwend and Dohrenwend (1982) have divided the growth of psychiatric epidemiological research into three periods, or gen-erations. This section describes the key studies and prevalence rates from the most recent of these periods.

Third-generation Studies

The methodology for the third-generation epidemiological studies reflected the view in American psychiatry in the early 1970s that mental illness could be delineated into discrete, op-erational categories. These changes in nosology were exempli-fied in the 1970s with the development of the Feighner criteria at Washington University in St Louis (Robins and Guze, 1970; Feighner et al., 1972) and culminated in the creation of DSM-III a decade later. By operationalizing diagnoses with specific cri-teria, it was possible to create structured diagnostic assessments to elicit the symptoms needed for these categories. Preliminary evidence about the utility of using diagnostic procedures in com-munity samples was obtained in a third-wave follow-up of the New Haven Study noted before. In this study, Weissman and col-leagues (1978) successfully administered the SADS-L in a com-munity population. This and other studies (Bromet et al., 1982) demonstrated that structured diagnostic instruments designed for clinical investigations could produce meaningful findings when administered in population-based studies.

The third-generation studies, thus, are characterized prima-rily by the use of structured diagnostic assessment procedures. In the next sections, we describe two of the largest third-generation studies, the NIMH-sponsored ECA project (Regier et al., 1984, 1985, Robins et al., 1991) and the NCS (Kessler et al., 1994).