The NBC Study and Television Violence

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73284/1/j.1460-2466.1984.tb02996.x.pd

Diagnosing mental disorders in the community. A difference that matters?: Editorial

Brugha and his colleagues in this issue raise important questions about the validity of standardized diagnostic interviews of mental disorders, such as the Composite International Diagnostic Interview (CIDI) (WHO, 1990). Although their concerns refer predominantly to the use of such instruments in epidemiological research, the authors' conclusions also have significant implications for diagnostic assessments in clinical practice and research. We agree with Brugha et al. that the inflexible approach to questioning used in standardized interviews can lead to an increased risk of invalidity with regard to some diagnoses. We also agree that the use of more semi-structured clinical questions has the potential to address this problem. However, we disagree with Brugha et al. in several other respects

Social fears and social phobia in a community sample of adolescents and young adults: prevalence, risk factors and comorbidity

Background. The paper describes prevalence, impairments, patterns of co-morbidity and other correlates of DSM-IV social phobia in adolescents and young adults, separating generalized and non-generalized social phobics. Methods. Data are derived from the baseline investigation of the Early Developmental Stages of Psychopathology Study (EDSP), a prospective longitudinal community study of 3021 subjects, aged 14–24. Diagnoses were based on the DSM-IV algorithms of an expanded version of the Composite International Diagnostic Interview. Results. Lifetime prevalence of DSM-IV/CIDI social phobia was 9·5% in females and 4·9% in males, with about one-third being classified as generalized social phobics. Twelve-month prevalence was only slightly lower, indicating considerable persistence. Respondents with generalized social phobia reported an earlier age of onset, higher symptom persistence, more co-morbidity, more severe impairments, higher treatment rates and indicated more frequently a parental history of mental disorders than respondents with non-generalized social phobia. Conclusions. History of DSM-IV social phobia was found to be quite prevalent in 14–24 year-olds. The generalized subtype of social phobia was found to have different correlates and to be considerably more persistent, impairing and co-morbid than non-generalized social phobia. Although generalized social phobics are more likely than non-generalized social phobics to receive mental health treatments, the treatment rate in this sample was low despite the fact that mental health services are free in Germany

Accounting for Comorbidity in Assessing the Burden of Epilepsy Among US Adults: Results from the National Comorbidity Survey Replication (NCS-R)

Although epilepsy is associated with substantial role impairment, it is also highly comorbid with other physical and mental disorders, making unclear the extent to which impairments associated with epilepsy are actually due to comorbidities. This issue was explored in the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of 5,692 US adults. Medically-recognized epilepsy was ascertained with self-report, comorbid physical disorders with a chronic conditions checklist, and comorbid DSM-IV mental disorders with the Composite International Diagnostic Interview (CIDI). Lifetime epilepsy prevalence was estimated at 1.8%. Epilepsy was comorbid with numerous neurological and general medical conditions and with a sporadic cluster of mental comorbidities (panic, PTSD, conduct disorder, and substance use disorders). Although comorbid disorders explain part of the significant gross associations of epilepsy with impairment, epilepsy remains significantly associated with work disability, cognitive impairment, and days of role impairment after controlling comorbidities. The net association of epilepsy with days of role impairment after controlling for comorbidities is equivalent to an annualized 89.4 million excess role impairment days among US adults with epilepsy, arguing that role impairment is a major component of the societal costs of epilepsy per se rather than merely due to disorders comorbid with epilepsy. This estimated burden is likely conservative as some parts of the effects of epilepsy are presumably mediated by secondary comorbid disorders

Twelve-month utilization rates and adequacy of treatment for mental health and substance use disorders in Argentina

OBJECTIVE: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). METHODS: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. RESULTS: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. CONCLUSIONS: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.Fil: Cia, Alfredo H.. Centro de Investigaciones Médicas En Ansiedad; ArgentinaFil: Stagnaro, Juan C.. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Aguilar Gaxiola, Sergio. University of California; Estados UnidosFil: Sustas, Sebastián Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Serfaty, Edith. Centro de Estudios Epidemiológicos; ArgentinaFil: Nemirovsky, Martin. Proyecto SUMA; ArgentinaFil: Kessler, Ronald C.. Harvard Medical School; Estados UnidosFil: Benjet, Corina. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz; Méxic

Longitudinal Study of Relapse From AIDS-Preventive Behavior Among Homosexual Men

There is no viable alternative to the control of AIDS besides prevention; factors contributing to relapse from behaviors presumed to reduce risk of that disease were investigated. The authors studied 524 homosexual men who had refrained from or used condoms during receptive or insertive anal sex (RAS and IAS, respectively) for at least 12 months, contacting them at 6-month intervals thereafter to ascertain current practices. They determined, via interviews, personal traits, appraised stress of maintaining safer sex, mental health, life events, and efforts to cope with potential infection. Negative life events, personal control beliefs, problem-solving abilities, and coping via problem-focused (e.g., seeking a monogamous union) rather than emotion-focused (e.g., "when I need a cure, they will have one") behaviors were associated with RAS, but less so with LAS safer sex behaviors. These findings provide a basis for individual and community-level interventions to change behavior and reduce AIDS risk.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66577/2/10.1177_109019819802500509.pd