RESUMO
Using data from the MECA Study, this report examines the prevalence of Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and various levels of antisocial behavior and their correlates among three ethnic groups: Hispanics, subdivided into Island Puerto Ricans and Mainland Hispanics; African Americans; and Mainland Non-Hispanic, Non-African Americans. Correlates considered include stressful life events, birth defects, low birth weight, learning difficulties, teen mothers, family environment, marital adjustment, social competence, parental monitoring, and family relationships. Logistic regression was used to determine the association of outcomes with individual correlates and of interaction terms with ethnicity. Differences between adjusted rates and observed rates of disorders and levels of antisocial behaviors are compared to estimate the extent to which each correlate explains the group differences in rates. Island Puerto Ricans had a lower prevalence of CD, ODD, and various levels of antisocial behavior than mainland Hispanics, African Americans, and non-Hispanic Whites. The lower prevalence appears to be associated with differences in the extent to which a number of these correlates are found on the island, the most salient being better family relations between the target children and their parents and siblings.
Assuntos
Transtorno da Personalidade Antissocial/etnologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/etnologia , Negro ou Afro-Americano/psicologia , Transtornos do Comportamento Infantil/etnologia , Hispânico ou Latino/psicologia , População Branca/psicologia , Adolescente , Negro ou Afro-Americano/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Incidência , Masculino , Porto Rico/etnologia , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
BACKGROUND: There are few cross-national comparisons of the rates of suicide ideation and attempts across diverse countries. Nine independently conducted epidemiological surveys using similar diagnostic assessment and criteria provided an opportunity to obtain that data. METHODS: Suicide ideation and attempts were assessed on the Diagnostic Interview Schedule in over 40000 subjects drawn from the United States, Canada, Puerto Rico, France, West Germany, Lebanon, Taiwan, Korea and New Zealand. RESULTS: The lifetime prevalence rates/100 for suicide ideation ranged from 2.09 (Beirut) to 18.51 (Christchurch, New Zealand). Lifetime prevalence rates/100 for suicide attempts ranged from 0.72 (Beirut) to 5.93 (Puerto Rico). Females as compared to males had only marginally higher rates of suicidal ideation in most countries, reaching a two-fold increase in Taiwan. Females as compared to males had more consistently higher rates for suicide attempts, reaching a two- to three-fold increase in most countries. Suicide ideation and attempts in most countries were associated with being currently divorced/separated as compared to currently married. CONCLUSIONS: While the rates of suicide ideation varied widely by country, the rates of suicide attempts were more consistent across most countries. The variations were only partly explained by variation in rates of psychiatric disorders, divorce or separation among countries and are probably due to cultural features that we do not, as yet, understand.
Assuntos
Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Canadá/epidemiologia , Comparação Transcultural , Feminino , Seguimentos , França/epidemiologia , Alemanha/epidemiologia , Humanos , Coreia (Geográfico)/epidemiologia , Líbano/epidemiologia , Masculino , Estado Civil , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Porto Rico/epidemiologia , Distribuição por Sexo , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Epidemiological data on panic disorder from community studies from 10 countries around the world are presented to determine the consistency of findings across diverse cultures. METHOD: Data from independently conducted community surveys from 10 countries (the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand), using the Diagnostic Interview Schedule and DSM-III criteria and including over 40,000 subjects, were analyzed with appropriate standardization for age and sex differences among subjects from different countries. RESULTS: The lifetime prevalence rates for panic disorder ranged from 1.4 per 100 in Edmonton, Alberta, to 2.9 per 100 in Florence, Italy, with the exception of that in Taiwan, 0.4 per 100, where rates for most psychiatric disorders are low. Mean age at first onset was usually in early to middle adulthood. The rates were higher in female than male subjects in all countries. Panic disorder was associated with an increased risk of agoraphobia and major depression in all countries. CONCLUSIONS: Panic disorder is relatively consistent, with a few exceptions, in rates and patterns across different countries. It is unclear why the rates of panic and other psychiatric disorders are lower in Taiwan.
Assuntos
Comparação Transcultural , Transtorno de Pânico/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Agorafobia/epidemiologia , Canadá/epidemiologia , Comorbidade , Transtorno Depressivo/epidemiologia , Feminino , Alemanha/epidemiologia , Humanos , Itália/epidemiologia , Coreia (Geográfico)/epidemiologia , Líbano/epidemiologia , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologia , Fatores Sexuais , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To estimate the rates and patterns of major depression and bipolar disorder based on cross-national epidemiologic surveys. DESIGN AND SETTING: Population-based epidemiologic studies using similar methods from 10 countries: the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand. PARTICIPANTS: Approximately 38000 community subjects. OUTCOME MEASURES: Rates, demographics, and age at onset of major depression and bipolar disorder. Symptom profiles, comorbidity, and marital status with major depression. RESULTS: The lifetime rates for major depression vary widely across countries, ranging from 1.5 cases per 100 adults in the sample in Taiwan to 19.0 cases per 100 adults in Beirut. The annual rates ranged from 0.8 cases per 100 adults in Taiwan to 5.8 cases per 100 adults in New Zealand. The mean age at onset shows less variation (range, 24.8-34.8 years). In every country, the rates of major depression were higher for women than men. By contrast, the lifetime rates of bipolar disorder are more consistent across countries (0.3/100 in Taiwan to 1.5/100 in New Zealand); the sex ratios are nearly equal; and the age at first onset is earlier (average, 6 years) than the onset of major depression. Insomnia and loss of energy occurred in most persons with major depression at each site. Persons with major depression were also at increased risk for comorbidity with substance abuse and anxiety disorders at all sites. Persons who were separated or divorced had significantly higher rates of major depression than married persons in most of the countries, and the risk was somewhat greater for divorced or separated men than women in most countries. CONCLUSIONS: There are striking similarities across countries in patterns of major depression and of bipolar disorder. The differences in rates for major depression across countries suggest that cultural differences or different risk factors affect the expression of the disorder.
Assuntos
Transtorno Bipolar/epidemiologia , Transtorno Depressivo/epidemiologia , Adolescente , Adulto , Idade de Início , Idoso , Canadá/epidemiologia , Comorbidade , Comparação Transcultural , Feminino , França/epidemiologia , Alemanha Ocidental/epidemiologia , Humanos , Itália/epidemiologia , Coreia (Geográfico)/epidemiologia , Líbano/epidemiologia , Modelos Logísticos , Masculino , Estado Civil , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Vigilância da População , Porto Rico/epidemiologia , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
We present a preliminary report on cross-national rates, age at onset, comorbidity, suicide attempts and symptom profiles of social phobia. These data are based on epidemiologic community surveys using similar methods from the United States, Canada, Puerto Rico and Korea. The lifetime rate of social phobia (cases per 100 persons) varies by country, from 2.6 in the United States to 0.5 in Korea. Rates are higher in females than in males in all countries. The age of onset for any phobia is mid-teens to early twenties, and social phobia usually has its first onset before other psychiatric disorders. Only a third or fewer cases of social phobia are uncomplicated by another psychiatric disorder. The presence of social phobia increases the risk of suicide attempts in persons with any other psychiatric disorder. Symptom profiles vary by country. Our data indicate consistent patterns but different cultural expressions of social phobia in the countries studied. The early age of onset of social phobia followed subsequently by another psychiatric disorder raises the possibility that early treatment of social phobia could prevent the onset of other psychiatric disorders.
Assuntos
Transtornos Fóbicos/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Canadá/epidemiologia , Feminino , Humanos , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Porto Rico/epidemiologia , Estados Unidos/epidemiologiaRESUMO
Parent and child reports were examined to study how epidemiological researchers can best use the information provided to describe childhood psychopathology. As part of a multisite methodologic study of mental disorders in children, a probability sample (N = 248) of children aged 9 to 17 years from the San Juan metropolitan area was selected. This sample was enriched with 74 clinic cases. Both parents and children were administered the DISC.2. Results showed that prevalence estimates were influenced by the informant. The clinicians' diagnosis is more concordant with children's reports of depression and with parents' reports of disruptive disorders. Parents and children provided unique information when interviewed with a structured psychiatric interview about child psychopathology. Their unique perspectives contributed to the observed discordance that emerged when DISC parent and DISC child results are compared. Combining the two perspectives with a simple "OR" rule at the symptom level did not seem to capture the unique perspectives.
Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Transtorno Depressivo/diagnóstico , Pais , Psiquiatria , Psicometria , Adolescente , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Prevalência , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologiaRESUMO
Data on the epidemiology of psychiatric disorders from different parts of the world using similar methods and diagnostic criteria have previously not been available. This article presents data on lifetime and annual prevalence rates, age at onset, symptom profiles, and comorbidity of obsessive compulsive disorder (OCD), using DSM-III criteria, from community surveys in seven countries: the United States, Canada, Puerto Rico, Germany, Taiwan, Korea, and New Zealand. The OCD annual prevalence rates are remarkably consistent among these countries, ranging from 1.1/100 in Korea and New Zealand to 1.8/100 in Puerto Rico. The only exception is Taiwan (0.4/100), which has the lowest prevalence rates for all psychiatric disorders. The data for age at onset and comorbidity with major depression and the other anxiety disorders are also consistent among countries, but the predominance of obsessions or compulsions varies. These findings suggest the robustness of OCD as a disorder in diverse parts of the world.
Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idade de Início , Idoso , Canadá/epidemiologia , Comorbidade , Comparação Transcultural , Feminino , Alemanha/epidemiologia , Humanos , Cooperação Internacional , Coreia (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologia , Distribuição por Sexo , Taiwan/epidemiologia , Estados Unidos/epidemiologiaRESUMO
This article illustrates a comprehensive cross-cultural adaptation model used to translate into Spanish and to culturally adapt the Diagnostic Interview Schedule for Children (DISC). The process strived to identify similar phenomena to those identified by the original English version in a dissimilar context. To attain cross-cultural equivalency five important dimensions were addressed: semantic, technical, content, criterion and conceptual. To meet this challenge various steps were taken, including bilingual committee, back-translation, reliability and validity testing. The result is an instrument which could be used, not only in Puerto Rico, but also in other Spanish-speaking child and adolescent populations after appropriate cultural adaptations.
Assuntos
Transtornos de Ansiedade/diagnóstico , Transtornos do Comportamento Infantil/diagnóstico , Transtorno Depressivo/diagnóstico , Escalas de Graduação Psiquiátrica , Traduções , Adolescente , Criança , Psiquiatria Infantil , Proteção da Criança , Comparação Transcultural , Feminino , Humanos , Masculino , Porto Rico , Reprodutibilidade dos Testes , SemânticaRESUMO
Compared mental health characteristics of island Puerto Ricans to three groups from the Los Angeles Epidemiologic Catchment Area Study: Mexican American immigrants, U.S.-born Mexican Americans, and Non-Hispanic whites. The Diagnostic Interview Schedule was used to obtain both diagnostic and symptom scale information about affective disorders, alcohol abuse/dependence, somatization, phobic disorder, and psychotic disorder. Mexican American immigrants had the fewest mental health problems of all groups. Puerto Ricans had more somatization disorder, but less affective and alcohol disorders than U.S.-born Mexican Americans or non-Hispanic whites. Results are considered in the light of selection factors, relative disadvantage of groups and methodological problems.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Americanos Mexicanos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Características Culturais , Emigração e Imigração , Feminino , Hispânico ou Latino/psicologia , Humanos , Incidência , Los Angeles/epidemiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Americanos Mexicanos/psicologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Porto Rico/epidemiologia , Porto Rico/etnologia , Classe SocialRESUMO
The advent of the use of structured interview schedules that generate psychiatric diagnoses in epidemiologic studies has promoted an intense interest in its cross-cultural use. However, the valid use of these instruments across cultures requires a careful adaptation process which goes beyond mere language translation. In this article the authors illustrate the application of a comprehensive cross-cultural adaptation model to both the translation into Spanish and the adaptation to the population of Puerto Rico of a widely used psychiatric epidemiologic research instrument: the Diagnostic Interview Schedule (DIS). The process aimed to ensure the development of a research instrument that is not only in correct Spanish and comprehensible for most Spanish-speaking people, but also culturally adapted to Puerto Rico's population. Various steps were taken (including bilingual committee, back-translation, instrument testing and diagnostic comparisons) to address cross-cultural validity in five important dimensions (i.e., semantic, technical, content, criterion and conceptual equivalence). The result is an interview schedule that is not only linguistically and culturally adequate for the targeted population but also includes elements which can contribute to the development of the instrument both in its original English language and in its translated versions.