title: Protocol and methodology of Study epidemiological mental health in Andalusia: PISMA-ep.
abstract: BACKGROUND
  This is the general methods describing paper of a cross-sectional study that aims to detect the prevalence of major mental disorders in Andalusia (Southern Spain), and their correlates or potential risk factors, using a large representative sample of community-dwelling adults.
  
  
  METHODS
  This is a cross-sectional study. We undertook a multistage sampling using different standard stratification levels and aimed to interview 4,518 randomly selected participants living in all 8 provinces of the Andalusian region utilizing a door-knocking approach. The Spanish version of the MINI International Neuropsychiatric Interview, a valid screening instrument ascertaining ICD-10/DSM-IV compatible mental disorder diagnoses was used as our main diagnostic tool. A large battery of other instruments was used to explore global functionality, medical comorbidity, personality traits, cognitive function and exposure to psychosocial potential risk factors. A saliva sample for DNA extraction was also obtained for a sub-genetic study. The interviews were administered and completed by fully trained interviewers, despite most tools used are compatible with lay interviewer use.
  
  
  RESULTS
  A total of 3,892 (70.8%) of 5,496 initially attempted households had to be substituted for equivalent ones due to either no response (37.7%) or not fulfilling the required participant quota (33%). Thence, out of 5,496 eligible participants finally approached, 4,507 (83.7%) agreed to take part in the study, completed the interview and were finally included in the study (n=4,507) and 4,286 (78%) participants also agreed and consented to provide a saliva sample for DNA study. On the other hand, 989 (16.3%) approached potential participants refused to take part in the study.
  
  
  CONCLUSIONS
  This is the largest mental health epidemiological study developed in the region of Spain (Andalusia). The response rates and representativeness of the sample obtained are fairly high. The method is particularly comprehensive for this sort of studies and includes both, personality and cognitive assessments, as well as a large array of bio-psycho-social risk measures.
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España; Unidad de Salud Mental, Complejo Hospitalario Universitario de Granada, Instituto Biosanitario de Granada, Granada, España. Electronic address: jcervilla@ugr.es.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Cervilla
authors.affiliation: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Escuela Andaluza de Salud Pública, Granada, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Ruiz
authors.affiliation: Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Escuela Andaluza de Salud Pública, Granada, España.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodríguez-Barranco
authors.affiliation: Unidad de Salud Mental, Complejo Hospitalario Universitario de Granada, Instituto Biosanitario de Granada, Granada, España.
authors.forename: Margarita
authors.initials: M
authors.lastname: Rivera
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ibáñez-Casas
authors.affiliation: Departamento de Enfermería, Universidad de Sevilla, Sevilla, España.
authors.forename: Esther
authors.initials: E
authors.lastname: Molina
authors.affiliation: Unidad de Salud Mental, Hospital de Puerto Real, Puerto Real, Cádiz, España.
authors.forename: Eulalio
authors.initials: E
authors.lastname: Valmisa
authors.affiliation: Plan Integral de Salud Mental de Andalucía, Servicio Andaluz de Salud, Sevilla, España.
authors.forename: José
authors.initials: J
authors.lastname: Carmona-Calvo
authors.affiliation: Departamento de Personalidad, Facultad de Psicología, Universidad de Málaga, Málaga, España.
authors.forename: Berta
authors.initials: B
authors.lastname: Moreno-Küstner
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España; Unidad de Salud Mental, Complejo Hospitalario Universitario de Granada, Instituto Biosanitario de Granada, Granada, España.
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Muñoz-Negro
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Ching-López
authors.affiliation: Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, España.
authors.forename: Blanca
authors.initials: B
authors.lastname: Gutiérrez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Cross-setional; Factores de riesgo; Genetics; Genética; Mental disorder; Prevalence; Prevalencia; Risk factors; Transversal; Trastorno mental