An appraisal of the NIMH Epidemiologic Catchment Area Program.
The Epidemiologic Catchment Area Program was a massive United States community survey of psychiatric illness, dwarfing all prior similar surveys. It has been described as a 'landmark in the development of American contributions to the psychiatric knowledge base'. The results pose a number of challenges to psychiatry. This paper briefly describes the program and appraises it, raising considerable doubts regarding the validity and usefulness of the Diagnostic Interview Schedule as a measuring instrument for the diagnosis of psychiatric illness, especially in the elderly; the use of lay interviewers to measure psychiatric illness; whether it is possible to measure lifetime prevalence of psychiatric illness; some of the reported prevalence rates, especially of phobia; the failure to include generalised anxiety among the 15 psychiatric diagnoses measured; and the failure to compare the results with those reported elsewhere in the literature.
Burvill
P W
PW
University of Western Australia, Royal Perth Hospital, WA 6000.
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009315:National Institute of Mental Health (U.S.); D010698:Phobic Disorders / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D014481:United States; D014482:United States Substance Abuse and Mental Health Services Administration