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Epidemiology - National Comorbidity Survey Replication


This application seeks support for continued analysis of the National Comorbidity Survey Replication (NCS-R), a nationally representative household survey of the prevalence and correlates of DSM-IV. The two original NCS-R specific aims were: to investigate time trends in the prevalence and correlates of mental disorders over the decade of the 1990s by comparing results in the results of the baseline NCS;and to expand the assessment of prevalence and correlates beyond the NCS. To these ends, the NCS-R repeated many NCS questions, updated diagnostic assessments to DSM-IV criteria (vs. DSM-III-R in the baseline NCS), expanded the number of disorders assessed, and included many new questions not in the NCS. The current application has four specific aims: (1) to disseminate and support a public use NCS-R dataset;(2) to complete analyses for the NCS-R aim of studying time trends in prevalence, treatment, treatment adequacy, and correlates compared to the baseline NCS;(3) to complete analyses for the NCS-R aim of addressing important substantive and methodological issues that were not covered in the baseline NCS;and (4) to continue our collaboration with NIMH and other colleagues in the larger U01 who are carrying out separate African-American and Latino/Asian-American surveys. The third aim is the most complex of the four, as it has six sub-aims. These include the following: (i) to estimate the prevalence, clinical severity, and correlates of individual DSM-IV disorders, expanding the number and variety of disorders assessed compared to the NCS;(ii) to evaluate disorder-specific nosological issues aimed at guiding revisions of the DSM-V system;(iii) to estimate the comparative effects of individual mental and physical disorders on role functioning and utilities;(iv) to analyze the ways in which comorbidity adds to the impairments associated with individual mental disorders;(v) to analyze the effects of mental vs. physical disorders on family burden;and (vi) to analyze the temporal unfolding of multivariate comorbid disorder profiles over the life course.


Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.