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一项纵向研究中失访的精神科及社会人口学预测因素:荷兰心理健康调查与发病率研究(NEMESIS)

Psychiatric and sociodemographic predictors of attrition in a longitudinal study: The Netherlands Mental Health Survey and Incidence Study (NEMESIS).

作者信息

de Graaf R, Bijl R V, Smit F, Ravelli A, Vollebergh W A

机构信息

Netherlands Institute of Mental Health and Addiction, Utrecht.

出版信息

Am J Epidemiol. 2000 Dec 1;152(11):1039-47. doi: 10.1093/aje/152.11.1039.

Abstract

This article discusses the effects of sociodemographics and the presence of psychiatric disorders diagnosed in the 12 months before the first interview by using the Diagnostic and Statistical Manual of Mental Disorders: DSM-III-R, third edition, revised, on three types of attrition (failure to locate, refusal to participate, morbidity/mortality) in the second wave (1997-1998) of the Netherlands Mental Health Survey and Incidence Study, a longitudinal, general population survey of psychopathology among 7,076 subjects aged 18-64 years. Compared with those reinterviewed successfully, persons not located at the 1-year follow-up (n = 219) were more often younger, poorly educated, urban, not cohabiting with a steady partner, and born outside the Netherlands. Refusers (n = 923) had a lower educational level. Morbidity/mortality (n = 72) was associated with higher age, lower educational level, not being employed, and somatic disorders. After adjustment for sociodemographics, none of the disorders was positively associated with refusal. Failure to locate was linked to agoraphobia, alcohol abuse, and the categories of mood, substance use, and eating disorders. Morbidity/mortality was linked to dysthymia, agoraphobia, simple phobia, obsessive-compulsive disorder, and the category of anxiety disorders. Overall attrition was only slightly higher among respondents with one or more disorders (odds ratio = 1.20, 95% confidence interval: 1.04, 1.38). Thus, psychopathology has only weak-to-moderate effects on attrition and is mainly related to failure to locate and morbidity/mortality but not to refusal.

摘要

本文探讨了社会人口统计学因素以及在首次访谈前12个月内根据《精神疾病诊断与统计手册:第三版,修订本》(DSM-III-R)诊断出的精神疾病对荷兰心理健康调查与发病率研究第二轮(1997 - 1998年)中三种失访类型(无法找到、拒绝参与、发病/死亡)的影响。该研究是一项针对7076名年龄在18 - 64岁的普通人群进行的关于精神病理学的纵向调查。与成功接受再次访谈的人相比,在1年随访时未找到的人(n = 219)更常为年轻人、受教育程度低、居住在城市、未与稳定伴侣同居且出生在荷兰境外。拒绝参与的人(n = 923)教育水平较低。发病/死亡(n = 72)与年龄较大、教育水平较低、未就业以及躯体疾病有关。在对社会人口统计学因素进行调整后,没有一种疾病与拒绝参与呈正相关。无法找到与广场恐惧症、酒精滥用以及情绪、物质使用和饮食失调类别有关。发病/死亡与心境恶劣、广场恐惧症、单纯恐惧症、强迫症以及焦虑症类别有关。总体而言,患有一种或多种疾病的受访者的失访率仅略高(优势比 = 1.20,95%置信区间:1.04,1.38)。因此,精神病理学对失访的影响仅为弱到中度,主要与无法找到和发病/死亡有关,而与拒绝参与无关。

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