Costello E J, Angold A, Burns B J, Stangl D K, Tweed D L, Erkanli A, Worthman C M
Developmental Epidemiology Program, Duke University Medical Center, Durham, NC, USA.
Arch Gen Psychiatry. 1996 Dec;53(12):1129-36. doi: 10.1001/archpsyc.1996.01830120067012.
The Great Smoky Mountains Study of youth focuses on the relationship between the development of psychiatric disorder and the need for and use of mental health services.
A multistage, overlapping cohorts design was used, in which 4500 of the 11758 children aged 9, 11, and 13 years in an 11-county area of the southeastern United States were randomly selected for screening for psychiatric symptoms. Children who scored in the top 25% on the screening questionnaire, together with a 1 in 10 random sample of the rest, were recruited for 4 waves of intensive, annual interviews (n = 1015 at wave 1). In a parallel study, all American Indian children aged 9, 11, and 13 years were recruited (N = 323 at wave 1).
The 3-month prevalence (+/-SE) of any DSM-III-R axis I disorder in the main sample, weighted to reflect population prevalence rates, was 20.3% +/- 1.7%. The most common diagnoses were anxiety disorders (5.7% +/- 1.0%), enuresis (5.1% +/- 1.0%), tic disorders (4.2% +/- 0.9%), conduct disorder (3.3% +/- 0.6%), oppositional defiant disorder (2.7% +/- 0.4%), and hyperactivity (1.9% +/- 0.4%).
The prevalence of psychiatric disorder in this rural sample was similar to rates reported in other recent studies. Poverty was the strongest demographic correlate of diagnosis, in both urban and rural children.
大烟山青少年研究聚焦于精神障碍的发展与心理健康服务的需求及使用之间的关系。
采用多阶段、重叠队列设计，在美国东南部11个县地区的11758名9岁、11岁和13岁儿童中随机抽取4500名进行精神症状筛查。在筛查问卷中得分在前25%的儿童，以及其余儿童中十分之一的随机样本，被招募参加4轮密集的年度访谈（第1轮n = 1015）。在一项平行研究中，招募了所有9岁、11岁和13岁的美国印第安儿童（第1轮N = 323）。
主要样本中任何DSM-III-R轴I障碍的3个月患病率（±SE），经加权以反映总体患病率，为20.3%±1.7%。最常见的诊断是焦虑症（5.7%±1.0%）、遗尿症（5.1%±1.0%）、抽动障碍（4.2%±0.9%）、品行障碍（3.3%±0.6%）、对立违抗障碍（2.7%±0.4%）和多动（1.9%±0.4%）。
这个农村样本中的精神障碍患病率与其他近期研究报告的患病率相似。在城市和农村儿童中，贫困是与诊断最密切相关的人口统计学因素。
