This application should enable WHO to bring to closure its Collaborative Study on Determinants of Outcome of Severe Mental Disorders, a multi-cultural epidemiological and clinical investigation in which a total of 1,531 persons making a first-in-lifetime contact with any """"""""helping agency"""""""" in 13 geographical areas in 10 countries have been identified over a period of two years, and assessed with standardized instruments at intake and at 1-year and 2-year follow-up. Data collection, including on follow-up, has been completed in all research centres, and about 75% of the research schedules have been transferred to WHO Headquarters for processing and analysis (the remainder are expected by the end of May 1985). Basic analyses of the case-finding process, sociodemographic, clinical and diagnostic features of the cohort at initial evaluation, as well as of the age- and sex-specific first-contact incidence of schizophrenia and related disorders, have been performed and a number of preliminary reports prepared. The funds requested should enable WHO to achieve two specific aims: (i) to complete the cleaning, checking and filing of all research data and prepare basic frequency tabulations of all variables; (ii) to carry out most essential data analyses that should enable the completion of a research monograph outlining the major conclusions of the study. Further, to analyses already performed, the outstanding priorities for the period of this grant will be: (a) analyses contributing to a transcultural nosology of schizophrenia (including exploration of factors underlying the differential course and outcome in developing and developed countries); (b) analysis of empirical predictors of course and outcome in schizophrenia; and (c) exploration of culture-related features of the manifestation and course of schizophrenia disorders. The overall strategy of the statistical analysis will be exploratory, but certain specific hypotheses, especially those linked to the question whether multicultural data support the notion of schizophrenia as a group of conditions or favour a single-disease model, will be tested. Statistical analysis will be carried out with preference for simple techniques and log-linear models but multivariate methods will also be applied as appropriate.
