Bull World Health Organ. 2000;78(4):413-26.
The International Consortium in Psychiatric Epidemiology (ICPE) was established in 1998 by WHO to carry out cross-national comparative studies of the prevalences and correlates of mental disorders. This article describes the findings of ICPE surveys in seven countries in North America (Canada and USA), Latin America (Brazil and Mexico), and Europe (Germany, Netherlands, and Turkey), using a version of the WHO Composite International Diagnostic Interview (CIDI) to generate diagnoses. The results are reported using DSM-III-R and DSM-IV criteria without diagnostic hierarchy rules for mental disorders and with hierarchy rules for substance-use disorders. Prevalence estimates varied widely--from > 40% lifetime prevalence of any mental disorder in Netherlands and the USA to levels of 12% in Turkey and 20% in Mexico. Comparisons of lifetime versus recent prevalence estimates show that mental disorders were often chronic, although chronicity was consistently higher for anxiety disorders than for mood or substance-use disorders. Retrospective reports suggest that mental disorders typically had early ages of onset, with estimated medians of 15 years for anxiety disorders, 26 years for mood disorders, and 21 years for substance-use disorders. All three classes of disorder were positively related to a number of socioeconomic measures of disadvantage (such as low income and education, unemployed, unmarried). Analysis of retrospective age-of-onset reports suggest that lifetime prevalences had increased in recent cohorts, but the increase was less for anxiety disorders than for mood or substance-use disorders. Delays in seeking professional treatment were widespread, especially among early-onset cases, and only a minority of people with prevailing disorders received any treatment. Mental disorders are among the most burdensome of all classes of disease because of their high prevalence and chronicity, early age of onset, and resulting serious impairment. There is a need for demonstration projects of early outreach and intervention programmes for people with early-onset mental disorders, as well as quality assurance programmes to look into the widespread problem of inadequate treatment.
国际精神疾病流行病学联盟（ICPE）于1998年由世界卫生组织设立，旨在开展精神障碍患病率及其相关因素的跨国比较研究。本文描述了ICPE在北美（加拿大和美国）、拉丁美洲（巴西和墨西哥）以及欧洲（德国、荷兰和土耳其）七个国家的调查结果，采用世界卫生组织复合国际诊断访谈（CIDI）的一个版本来进行诊断。结果依据《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）和第四版（DSM-IV）标准报告，其中精神障碍诊断不采用诊断层级规则，物质使用障碍诊断采用层级规则。患病率估计差异很大——从荷兰和美国任何精神障碍终生患病率超过40%到土耳其的12%以及墨西哥的20%。终生患病率与近期患病率估计值的比较表明，精神障碍通常具有慢性特征，尽管焦虑障碍的慢性特征始终高于心境障碍或物质使用障碍。回顾性报告表明，精神障碍通常发病年龄较早，焦虑障碍估计发病年龄中位数为15岁，心境障碍为26岁，物质使用障碍为21岁。所有这三类障碍均与一些社会经济劣势指标（如低收入、低教育程度、失业、未婚）呈正相关。对回顾性发病年龄报告的分析表明，近期队列人群的终生患病率有所上升，但焦虑障碍的上升幅度小于心境障碍或物质使用障碍。寻求专业治疗的延迟情况普遍存在，尤其是在早发性病例中，只有少数患有现患障碍的人接受了任何治疗。精神障碍因其高患病率、慢性特征、发病年龄早以及导致的严重损害，成为所有疾病类别中负担最重的疾病之一。有必要开展针对早发性精神障碍患者的早期外展和干预项目示范项目，以及质量保证项目，以研究治疗不足这一普遍问题。
