The Stirling County Study spans 40 years and draws on a database concerning 4010 adults selected sequentially to represent an area of Atlantic Canada in 1952, 1970, and 1992. The longitudinal design involves repeated cross-sectional surveys combined with cohort follow-up, and the data consist in interviews carried out with subjects and their general physicians. The procedures for psychiatric diagnosis have been consistently applied, are structurally compatible with modern approaches, and were recently updated for changes in the common words used for disturbances of mood. In the final wave of data-gathering, the Diagnostic Interview Schedule, the Modified Mini-Mental Status Examination, and the Structured Clinical Interview for DSM-III-R were also used. Most of the analyses concern the common disorders of depression, anxiety, and alcoholism. The purpose of this proposal is to request funds in order to: 1) continue primary analysis and reporting of findings; 2) prepare a data archive that will be appropriate for use by other scientists and will protect the identity of subjects; and 3) continue to share data with 3 young investigators. Published reports deal with such topics as time-trends in the prevalence and incidence of depression and its relationships to anxiety and cigarette smoking. The topics described in this proposal include: changes in the predictors of mortality with a focus on depression, predictors of cognitive dysfunction, changes in the course of illness among depressed subjects, relationships of obesity and alcoholism to depression, extensions of these topics to anxiety, changes in relationships to socioeconomic status and social roles, changes in the distribution and sequelae of psychiatric disorders as they may relate to health service use, changes in the perceptions of psychiatric disorders by general physicians, and changes in the practices of general physicians regarding use of psychotropic medications. The first half of the study indicated that many types of psychiatric disorders reduce both the quality and quantity of life. This research concerns whether such disorders are changing in their distribution, their correlates and associations, or in their clinical features.
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