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Biomedical subjects

D S Rae

Publications and source records attributed to D S Rae.

36 records · Page 2Linked to original sources
PubMed1990

Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.

The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.

Adult↗
PubMed1990

Age at onset of selected mental disorders in five community populations.

Using data collected in the National Institute of Mental Health Epidemiologic Catchment Area Program, we examined the reported age at onset of selected mental disorders using life table survival methods. The examination of hazard rates suggests that adolescence and young adulthood are important periods for the development of unipolar major depression, bipolar illness, phobias, and drug and alcohol abuse/dependence. Although there are limitations in using cross-sectional data for this purpose, the findings suggest the need for more attention to the development of mental disorders in childhood and adolescence.

Adolescent↗
PubMed1990

Phobia: prevalence and risk factors.

This article is the presentation of the main phobia data from the Epidemiologic Catchment Area (ECA) program, with a sample size of n = 18.571. Work on this article was initiated in 1981 at the beginning of the ECA study, but publication has been delayed a decade. Phobias are determined from information from the Diagnostic Interview Schedule (DIS), classified according to DSM III. Phobias are found to be the most common psychiatric disorder in the community, more common than major depression or alcohol abuse or dependence in the month prior to interview. The one month prevalence is between 4.0 and 11.1%, with the estimated prevalence in the United States being 6.2%. There were nine community surveys of the prevalence of phobia that pre-dated the ECA studies, which found a wide range of prevalence rates from 1.2% to 26.1%. By far the strongest risk factor associated with phobias is the presence of another psychiatric disorder. Prevalence rates of simple phobia and agoraphobia are found in the ECA studies to be significantly higher in women; social phobia, which is less prevalent, has no significant sex difference. The prevalence rates are higher in younger age groups, and in those with low socioeconomic status (SES). The onset of phobias occurs primarily in the childhood or teenage years, and they tend to be chronic conditions. Less than a quarter of phobics receive treatment.

Adolescent↗
PubMed1990

Depression among Cuban Americans. The Hispanic Health and Nutrition Examination Survey.

This paper presents the findings on depressive symptomatology and major depressive disorder in Cuban American respondents to the Hispanic Health and Nutrition Examination Survey (HHANES). The HHANES represents the first population-based assessment of the mental health status of Cuban Americans. High levels of depression, as measured by a CES-D score of 16 or more, were found in ten percent of the sample. Female gender was independently associated with CES-D caseness. The lifetime, six-month, and one-month prevalence rates of major depressive disorder, as measured by the National Institute of Mental Health Diagnostic Interview Schedule (DIS), were 3.15%, 2.12%, and 1.50%, respectively. An income level of less than ten thousand dollars was independently associated with a lifetime diagnosis of major depression.

Cross-Sectional Studies↗
PubMed1990

The epidemiology of anxiety disorders: the Epidemiologic Catchment Area (ECA) experience.

According to the Epidemiologic Catchment Area (ECA) study--one of the largest investigations of the prevalence of mental disorders ever conducted--anxiety disorders affect more than 7% of adults in the United States. Women, individuals under age 45, those who are separated or divorced, and those in low socioeconomic groups all have a higher rate of anxiety than individuals in other groups. This article will present prevalence rates of anxiety disorders based on data from the five ECA sites--New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Ca.

Adult↗
PubMed1990

Racial congruity as a contextual correlate of mental disorder.

The effects of exposure to racially dissonant residential environments on depressive psychopathology are explored. Epidemiological survey data are shown to support the hypothesis that an inverse relationship exists between racial congruity and depression. Limitations of the analysis are discussed, as are the social implications of the findings.

Adjustment Disorders↗
PubMed1990

Violent crime arrest rates of White House Case subjects and matched control subjects.

White House Case subjects typically are schizophrenic patients who have been psychotically preoccupied with a prominent political figure. The authors report the arrest rates for murder, aggravated assault, other assault, and robbery among 192 male White House Case subjects 20-59 years old who were discharged from civil commitments in the early 1970s. These rates were compared with those for the same crimes in a random matched sample of arrested subjects and with the general population arrest rates. When rates were covaried for prior violent crime arrests, White House Case subjects with prior arrests had a significantly higher rate of total posthospitalization violent crime arrests than the matched control sample.

Adult↗
PubMed1989

Depressive symptoms among Mexican Americans: the Hispanic Health and Nutrition Examination Survey.

This paper presents findings on depressive symptomatology among 3,118 Mexican-American adults who participated in the Hispanic Health and Nutrition Examination Survey (HHANES). In 1982-1984, the National Institute of Mental Health Center for Epidemiologic Studies Depression Scale was administered to Mexican Americans aged 20-74 years as part of the HHANES examination component. Respondents reported in either English or Spanish on both the presence and persistence of depressive symptoms during the week prior to the interview. The caseness rate (high levels of depressive symptoms) was 13.3%. Factors associated with increased risk of high levels of depressive symptoms were female sex, low educational achievement, low income, and US birth combined with Anglo-oriented acculturation. There were no significant differences by language. The relatively low prevalence rate and the increased risk associated with US birth/Anglo-oriented acculturation indicate the need for more multifactor studies and the investigation of possible additional factors that may contribute to the mental health of Mexican Americans.

Acculturation↗
PubMed1989

Murder and assault arrests of White House cases: clinical and demographic correlates of violence subsequent to civil commitment.

The authors studied arrest records and clinical data on 217 persons formerly hospitalized as "White House Cases" because they were psychotically preoccupied with prominent political figures. Prior arrest for violent crime was the variable most strongly associated with arrest for violent crime after hospital discharge. Male gender and a history of weapons possession were also correlated with future violence. For those with prior violent crime arrests, hospital incidents requiring seclusion were also associated with later violence. For those without prior arrests, subsequent violence was associated with threats, living outside Washington, and command hallucinations. For those previously arrested for nonviolent crimes, only persecutory delusions were associated with later violence.

Commitment of Persons with Psychiatric Disorders↗
PubMed1988

One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites.

One-month prevalence results were determined from 18,571 persons interviewed in the first-wave community samples of all five sites that constituted the National Institute of Mental Health Epidemiologic Catchment Area Program. US population estimates, based on combined site data, were that 15.4% of the population 18 years of age and over fulfilled criteria for at least one alcohol, drug abuse, or other mental disorder during the period one month before interview. Higher prevalence rates of most mental disorders were found among younger people (less than age 45 years), with the exception of severe cognitive impairments. Men had higher rates of substance abuse and antisocial personality, whereas women had higher rates of affective, anxiety, and somatization disorders. When restricted to the diagnostic categories covered in international studies based on the Present State Examination, results fell within the range reported for European and Australian studies.

Adolescent↗
PubMed1988

Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults.

Data from the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area Program, an epidemiologic survey of five communities, showed that four major disorders commonly begin in late adolescence or young adulthood. The median age at onset for anxiety disorders is 15 years; for major depressive episode, 24 years; for drug abuse or dependence, 19 years; and for alcohol abuse or dependence, 21 years. Findings also suggest that for respondents 18-30 years old, having a major depressive episode or anxiety disorder doubles the risk for later drug abuse or dependence.

Adolescent↗
PubMed1984

Exclusion criteria of DSM-III. A study of co-occurrence of hierarchy-free syndromes.

The diagnostic criteria of the third edition of the DSM-III often state that one diagnosis cannot be made if it is "due to" another disorder. Using data from the National Institute of Mental Health Diagnostic Interview Schedule, with a sample of 11,519 subjects from a community population, we found that if two disorders were related to each other according to the DSM-III exclusion criteria, then the presence of a dominant disorder greatly increased the odds of having the excluded disorder. We also found that disorders, which DSM-III says are related to each other, were more strongly associated than disorders, which DSM-III says are unrelated. However, we also found there was a general tendency toward co-occurrence, so that the presence of any disorder increased the odds of having almost any other disorder, even if DSM-III does not list it as a related disorder. We concluded that empirical studies are needed to study the assumptions underlying the use of a diagnostic hierarchy.

Adult↗
PubMedDate not supplied

Estimating the prevalence of mental disorders in U.S. adults from the Epidemiologic Catchment Area Survey.

The National Institute of Mental Health Epidemiologic Catchment Area Survey is a comprehensive, community-based survey of mental disorders and use of services by adults, ages 18 and older. Diagnoses are based on the criteria in the "Diagnostic and Statistical Manual of Mental Disorders," third edition, and were obtained in five communities in the United States through lay-interviewer administration of the National Institute of Mental Health Diagnostic Interview Schedule. Results from the survey provide the public health field with data on the prevalence and incidence of specific mental disorders in the community, unbiased by the treatment status of the sample. The population with disorders is estimated, and the survey findings that respond to some of the most common requests for information about the epidemiology of mental disorders in the United States are highlighted briefly. Based on the survey, it is estimated that one of every five persons in the United States suffers from a mental disorder in any 6-month period, and that one of every three persons suffers a disorder in his or her lifetime. Fewer than 20 percent of those with a recent mental disorder seek help for their problem, according to the survey. High rates of comorbid substance abuse and mental disorders were found, particularly among those who had sought treatment for their disorders.

Ambulatory Care Facilities↗
PubMedDate not supplied

Suicide attempts in the Epidemiologic Catchment Area Study.

This study examines risk factors for attempted suicide in the general community. Data from the five-site NIMH Epidemiologic Catchment Area (ECA) Study were used to estimate lifetime prevalence and identify risk factors for suicide attempts. Occurrence of suicide attempts and lifetime diagnosis of psychiatric disorder were ascertained, using the NIMH Diagnostic Interview Schedule (DIS). Of 18,571 adult respondents aged 18 and over, 2.9 percent reported that they had attempted suicide at some time in their lives. A weighted logistic regression model was constructed to ascertain significant (p less than .0028 with Bonferroni correction) risk factors for attempted suicide. Persons who had a lifetime diagnosis of a psychiatric disorder had the highest risk of attempted suicide (odds ratio [OR] = 8.4). Females (OR = 3.3), separated or divorced persons (OR = 2.5), Whites (OR = 1.7), persons in the two lowest socioeconomic quartiles (ORs = 2.2, 2.3), and respondents from the Los Angeles ECA (OR = 1.8) were also more likely to have attempted suicide. These findings contribute to an understanding of suicide and suicidal behavior in general populations, outside the clinical setting.

Adolescent↗