This application is for epidemiologic studies of specific mental disorders, use of general and mental health services, and related issues. Data for these studies are being gathered through the Eastern Baltimore Mental Health Survey (EBMHS) based at the Johns Hopkins Medical Institutions, and through other coordinated surveys at NIMH Epidemiologic Catchment Area Program sites at four other U.S. locations. The EBMHS data gathering includes a sequence of interviews and examinations of a probability sample drawn from the 180,000 adult household and institutional residents of three contiguous mental health catchment areas in eastern Baltimore. Three thousand four hundred eighty-one (78 percent) of the sampled household residents and 553 (91 percent) of the sampled institutional residents were interviewed. Initial and one year followup interviews with these respondents include the NIMH Diagnostic Interview Schedule and other sections on mental morbidity, use of health services, and other pertinent characteristics. Research psychiatrists re-examined 810 household respondents, using a standardized clinical examination. Two thousand eight hundred and eighty-nine household respondents were interviewed by telephone, 6 months after initial interview. In addition, there has been a differential diagnosis of dementia cases and assessment of social support provided to aged persons. This proposal calls for collaborative analyses of the core data collected at all ECA sites and site-specific analyses of data unique to EBMHS. These analyses will address topics such as: nature, course, and distribution of specific mental disorders (e.g., panic disorder, substance abuse, dementia) with special atttention to population subgroups (the aged, the unemployed, persons living in differing types of households); use of general and mental health services and treatment need; other factors influencing mental disorder prevalence, psychiatric and methodologic issues of DIS validity, nosology, case finding, reliability of ratings, etc.
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