NIMH bulletins and redundant publication.
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Duplicate Publications as Topic↗
Biomedical subjects
D A Regier
Publications and source records attributed to D A Regier.
Comparing age at onset of major depression and other psychiatric disorders by birth cohorts in five US community populations.
Using data collected in the National Institute of Mental Health (Rockville, Md) Epidemiologic Catchment Area Program, we examined the proposed hypothesis that there has been a shift in major depression to younger ages at onset, or increased prevalence in younger age periods, for recent birth cohorts. Life-table survival methods were used to examine the hazard rates for major depression as well as for other specific mental disorders. The findings are consistent with a gradual shift to increased rates for major depression between the ages of 15 and 19 years for Epidemiologic Catchment Area respondents born more recently. The findings also suggest a similar shift for drug abuse/dependence; similar but less pronounced changes were found for alcohol abuse/dependence and obsessive-compulsive disorder. However, in this study, bipolar disorder, panic disorder, and phobias did not exhibit a consistent increase in onset at younger ages. Further research is required to determine if the shifts in major depression, drug abuse/dependence, and possibly alcohol abuse/dependence are linked. It is important to note that these shifts to adolescent onset are occurring when nearly half the 31 million Americans without health insurance are aged 24 years or younger.
Adolescent↗
Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.
The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.
Adult↗
Herpesvirus saimiri U RNA sequence variation.
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Base Sequence↗
Age at onset of selected mental disorders in five community populations.
Using data collected in the National Institute of Mental Health Epidemiologic Catchment Area Program, we examined the reported age at onset of selected mental disorders using life table survival methods. The examination of hazard rates suggests that adolescence and young adulthood are important periods for the development of unipolar major depression, bipolar illness, phobias, and drug and alcohol abuse/dependence. Although there are limitations in using cross-sectional data for this purpose, the findings suggest the need for more attention to the development of mental disorders in childhood and adolescence.
Adolescent↗
Phobia: prevalence and risk factors.
This article is the presentation of the main phobia data from the Epidemiologic Catchment Area (ECA) program, with a sample size of n = 18.571. Work on this article was initiated in 1981 at the beginning of the ECA study, but publication has been delayed a decade. Phobias are determined from information from the Diagnostic Interview Schedule (DIS), classified according to DSM III. Phobias are found to be the most common psychiatric disorder in the community, more common than major depression or alcohol abuse or dependence in the month prior to interview. The one month prevalence is between 4.0 and 11.1%, with the estimated prevalence in the United States being 6.2%. There were nine community surveys of the prevalence of phobia that pre-dated the ECA studies, which found a wide range of prevalence rates from 1.2% to 26.1%. By far the strongest risk factor associated with phobias is the presence of another psychiatric disorder. Prevalence rates of simple phobia and agoraphobia are found in the ECA studies to be significantly higher in women; social phobia, which is less prevalent, has no significant sex difference. The prevalence rates are higher in younger age groups, and in those with low socioeconomic status (SES). The onset of phobias occurs primarily in the childhood or teenage years, and they tend to be chronic conditions. Less than a quarter of phobics receive treatment.
Adolescent↗
Depression among Cuban Americans. The Hispanic Health and Nutrition Examination Survey.
This paper presents the findings on depressive symptomatology and major depressive disorder in Cuban American respondents to the Hispanic Health and Nutrition Examination Survey (HHANES). The HHANES represents the first population-based assessment of the mental health status of Cuban Americans. High levels of depression, as measured by a CES-D score of 16 or more, were found in ten percent of the sample. Female gender was independently associated with CES-D caseness. The lifetime, six-month, and one-month prevalence rates of major depressive disorder, as measured by the National Institute of Mental Health Diagnostic Interview Schedule (DIS), were 3.15%, 2.12%, and 1.50%, respectively. An income level of less than ten thousand dollars was independently associated with a lifetime diagnosis of major depression.
Cross-Sectional Studies↗
The epidemiology of anxiety disorders: the Epidemiologic Catchment Area (ECA) experience.
According to the Epidemiologic Catchment Area (ECA) study--one of the largest investigations of the prevalence of mental disorders ever conducted--anxiety disorders affect more than 7% of adults in the United States. Women, individuals under age 45, those who are separated or divorced, and those in low socioeconomic groups all have a higher rate of anxiety than individuals in other groups. This article will present prevalence rates of anxiety disorders based on data from the five ECA sites--New Haven, Conn; Baltimore, Md; St Louis, Mo; Durham, NC; and Los Angeles, Ca.
Adult↗
The complete nucleotide sequence of a pathogenic molecular clone of simian immunodeficiency virus.
The complete nucleotide sequence of an infectious clone of simian immunodeficiency virus of macaques, SIVmac239, has been determined. Virus produced from this molecular clone causes AIDS in rhesus monkeys in a time frame suitable for laboratory investigation. The proviral genome including both long terminal repeats is 10,279 base pairs in length and contains open reading frames for gag, pol, vif, vpr, vpx, tat, rev, and env. The nef gene contains an in-frame premature stop after the 92nd codon. At the nucleotide level, SIVmac239 is closely related to SIVmac251 (98%) and SIVmac142 (96%). It will not be possible to test which features of the viral sequence are critical molecular determinants for the pathogenesis of AIDS.
Amino Acid Sequence↗
Nucleotide sequence of the tzs gene from Agrobacterium rhizogenes strain A4.
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Amino Acid Sequence↗
Nucleotide sequence of the tzs gene from Pseudomonas solanacearum strain K60.
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Base Sequence↗
U.S. and Soviet perspectives on the diagnosis of schizophrenia and associated dangerousness.
During a visit of U.S. senior mental health and forensic experts to the Soviet Union to assess recent changes in Soviet psychiatry, a symposium was held to discuss the U.S. and Soviet concepts of the diagnosis of schizophrenia and dangerousness associated with psychiatric illness. The basic conclusion from this exchange was that significant differences exist between the countries in both areas, as the U.S. conceptualization of schizophrenia and associated dangerousness is considerably narrower than that of Soviet practice. Clearly, future scientific exchange is warranted to examine these conceptual differences in an effort to establish a better empirical basis for assessing the most appropriate medical treatment and legal disposition for patients.
Cross-Cultural Comparison↗
Nucleotide sequence and analysis of the plant-inducible locus pinF from Agrobacterium tumefaciens.
Several loci on the tumor-inducing plasmid from Agrobacterium tumefaciens were transcriptionally activated in the presence of wounded plant tissue or extracts. The inducible virulence loci were required for efficient tumor formation. In contrast, the plant-inducible locus pinF was not observed to be absolutely essential for virulence. Mutants in pinF showed an attenuated virulence on a variety of dicotyledonous hosts, and this attenuation became more pronounced with decreasing numbers of bacterial cells in the inoculum. The DNA sequence of a 5.5-kilobase region which included the pinF locus from the octopine-type tumor-inducing plasmid A6 was determined. Four open reading frames consistent with the observed transcription of pinF were observed. Two of the open reading frames, pinF1 and pinF2, coded for polypeptides with relative molecular weights of 47,519 (pinF1) and 46,740 (pinF2). A comparison of the amino acid sequences of pinF1 and pinF2 indicated that they were similar to each other and to known polypeptide sequences for cytochrome P-450 enzymes.
Amino Acid Sequence↗
One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites.
One-month prevalence results were determined from 18,571 persons interviewed in the first-wave community samples of all five sites that constituted the National Institute of Mental Health Epidemiologic Catchment Area Program. US population estimates, based on combined site data, were that 15.4% of the population 18 years of age and over fulfilled criteria for at least one alcohol, drug abuse, or other mental disorder during the period one month before interview. Higher prevalence rates of most mental disorders were found among younger people (less than age 45 years), with the exception of severe cognitive impairments. Men had higher rates of substance abuse and antisocial personality, whereas women had higher rates of affective, anxiety, and somatization disorders. When restricted to the diagnostic categories covered in international studies based on the Present State Examination, results fell within the range reported for European and Australian studies.
Adolescent↗
The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures.
The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version. The field test is being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and the general populace in different cultures and to provide data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will allow investigators reliably to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.
Cross-Cultural Comparison↗
The NIMH Depression Awareness, Recognition, and Treatment Program: structure, aims, and scientific basis.
Unrecognized, untreated, and undertreated depressive disorders extract an inordinate human and economic cost, despite the availability of an extensive array of effective clinical interventions. To enhance the availability and quality of care, the National Institute of Mental Health launched the Depression Awareness, Recognition, and Treatment Program, a multiphase information and education program designed to alert health professionals and the general public to the fact that depressive disorders are common, serious, and treatable. The authors review the development of this program, describing the professional education efforts it supports in anticipation of increased demand for services, the public education campaign launched in May 1988, and highlights of the scientific advances that make the program feasible and timely.
Catchment Area, Health↗
Epidemiologic evidence for early onset of mental disorders and higher risk of drug abuse in young adults.
Data from the National Institute of Mental Health (NIMH) Epidemiologic Catchment Area Program, an epidemiologic survey of five communities, showed that four major disorders commonly begin in late adolescence or young adulthood. The median age at onset for anxiety disorders is 15 years; for major depressive episode, 24 years; for drug abuse or dependence, 19 years; and for alcohol abuse or dependence, 21 years. Findings also suggest that for respondents 18-30 years old, having a major depressive episode or anxiety disorder doubles the risk for later drug abuse or dependence.
Adolescent↗
Utilization of health and mental health services by Los Angeles Mexican Americans and non-Hispanic whites.
Utilization of general medical and mental health services by respondents in the Los Angeles Epidemiologic Catchment Area (ECA) site was compared with that in three ECA sites studied previously (New Haven, Conn, Baltimore, and St Louis). Within the Los Angeles sample, Mexican-American patterns of utilization were compared with those for non-Hispanic whites. Los Angeles respondents were less likely than those at other ECA sites to make ambulatory health care visits and to be hospitalized for physical or mental health reasons. Mexican Americans were less likely than non-Hispanic whites to report ambulatory health care but were as likely to have been hospitalized. Six percent of Los Angeles respondents reported a recent mental-health-care visit as compared with 6% to 7% of respondents at the other ECA sites. However, among respondents with Diagnostic Interview Schedule DSM-III disorders diagnosed within the six months prior to the interview, a lower proportion made a mental health visit in Los Angeles (14%) compared with the other sites (16% to 20%). Of those who made a mental-health-care visit, Los Angeles respondents with a recently diagnosed disorder were more likely than comparable respondents at the other ECA sites to visit a mental health specialist rather than a general medical care provider. Mexican Americans with a recently diagnosed mental disorder were only half as likely as non-Hispanic whites (11% vs 22%, respectively) to have made a mental health visit. However, when Mexican Americans with Diagnostic Interview Schedule/DSM-III did make a mental health visit, they were as likely as non-Hispanic whites to see a mental health specialist.
Adult↗