Jerome K. Myers

Social adjustment by self-report in a community sample and in psychiatric outpatients.

Data are presented on social functioning derived from a self-report social adjustment scale (SAS-SR) administered to 774 subjects including a community sample and three psychiatric outpatient populations: acute depressives, alcoholics, and schizophrenics. This self-report scale derives from an interview form and was developed and tested on depressed outpatients. Since its publication, it has been used in populations other than depressives including other psychiatric patients, nonpsychiatric patients, and nonpatients.The purpose of this paper is to make data available to other investigators on results of this self-report social adjustment scale in a broad range of subjects and to describe further the psychometric properties, limitations, and utility of the scale. Findings show that the scale has wide applicability in a range of subjects but that certain cautions should be followed in using it with chronically impaired psychiatric populations who may not be involved in the major roles assessed by the scale.

One‐month prevalence of mental disorders in the United States and sociodemographic characteristics: the Epidemiologic Catchment Area study

The associations between the one‐month prevalence rates of mental disorders and sociodemographic characteristics were investigated for 18571 people interviewed in the first‐wave community samples of all 5 sites in the US National Institute of Mental Health (NIMH) Epidemiologic Catchment Area program. Men were found to have a significantly higher rate of cognitive impairment than women after controlling for the effects of age, race or ethnicity, marital status and socioeconomic status. Marital status was one of the most powerful correlates of mental disorder risk: the odds of separated or divorced people having any NIMH Diagnostic Interview Schedule disorder were twice that of married people after controlling for age, gender, race or ethnicity and socioeconomic status. The odds of those in the lowest socioeconomic status group having any Diagnostic Interview Schedule disorder was about 2.5 times that of those in the highest socioeconomic status group, controlling for age, gender, race or ethnicity and marital status. For all disorders except cognitive impairment, race or ethnicity did not remain statistically significant after controlling for age, gender, marital status and socioeconomic status.

The epidemiology of depression: An update on sex differences in rates

Data from the New Haven, CT, Standard Metropolitan Statistical Area, site of the NIMH Epidemiologic Catchment Area (ECA) study, a multi-site collaborative community survey of psychiatric disorders is presented. The 6-month prevalence rates based on the Diagnostic Interview Schedule (DIS) interview and the DSM-III found that major depression was more frequent in women than men (2.4:1). The sex ratios for bipolar disorder were about equal. The sex ratios for major depression were fairly consistent at different time periods retrospectively assessed. There appeared to be a birth cohort effect with cohorts born after 1936 having an earlier age of onset and higher rates of major depression but not a change in sex ratios. These findings must be considered in light of the methodologic limitations of retrospective recall.

Factors affecting the utilization of specialty and general medical mental health services.

This study compares the extent to which need, predisposing, and enabling factors affect the use of mental health services in the specialty and general medical health sectors during a 6-month period. Data are drawn from the first wave of interviews of the Epidemiological Catchment Area (ECA) project at the Yale University site. The results indicate that 1) in the general population, factors affecting use of the two sectors differ; 2) among those using any mental health services, factors affecting use of the two sectors differ; 3) indicators of need have the strongest relationships with utilization; and 4) the effects of predisposing and enabling factors are contingent upon the presence of need.

Contact with health professionals for the treatment of psychiatric and emotional problems

This study focuses on predisposing, enabling, and need factors affecting contact with health professionals for the treatment of psychiatric and emotional problems during a 6-month period. Data are from the first wave of the Yale Epidemiologic Catchment Area (ECA) Project. The study confirms the important relationship of psychopathology to both the likelihood of using mental health related services and the quantity of service contacts. Sex, age, race, education, marital status, usual source of medical care, and attitudes toward mental health services were found to exert independent effects on the likelihood of contact with a health professional after controlling for clinical status. Factors affecting the quality of service contacts among utilizers were psychiatric status, usual source of care, and attitudes.

Life events and mental status: a longitudinal study.

This is a preliminary report on relationships between changes in life events and changes in psychiatric symptomatology in a community sample of 720 adults in New Haven, Connecticut. Over a two-year period it was found that the greater the net change in life events the more likely was the individuals mental status to have changed. A net increase in life events was associated with a worsening of symptoms, while a net decrease resulted in improvement. Similar patterns were found for most of the 64 individual life events for which information was gathered as well as for events categorized according to type of social activity, changes in the respondents social field, and degree of desirability.

Life events and psychiatric impairment.

This is a report on relationships between life crises and psychiatric impairment in a community sample of 938 adults in New Haven, Connecticut.It is part of a longitudinal study of the population of a community mental health center catchment area. The theoretical framework for the paper finds its roots in two bodies of socio-medical literature, namely, stress research and epidemiological field studies of mental illness. The specific research question is to determine whether or not there is a relationship between the occurrence of life events, the patterning of such events and the degree of psychological impairment. As in other field studies, we discovered a significant amount of psychiatric impairment in the community. Eighteen per cent of the adults interviewed were classified as having a high symptom level (very impaired), 47 per cent as a medium symptom level (moderately impaired), and 35 per cent as a low symptom level (unimpaired). More important, we found significant relationships between these scores and the occurrence of life events in the year previous to our interview. First, the greater the degree of impairment the more likely is the individual to have experienced at least one of 62 life events for which we gathered information. Equally important, there is a very strong association between the number of events experienced and the individuals mental status: the greater the number of events reported by respondents, the greater the proportional difference between the percentage of unimpaired and the percentage of very impaired who experienced that number of events. When events are categorized according to type of social activity, changes in the respondents social field and degree of desirability impairment are strongly and positively related to the experiencing of life crises. Finally, similar patterns are found for each of the individual life events with the exception of several biopsychosocial situations associated with the family developmental cycle.Certain cultural and social factors, particularly role expectations and values, are discussed as possible factors helping to account for the relationshipsfound above between life crises and psychiatric impairment.

Rates and risks of depressive symptoms in a United States urban community

The results of a U.S. urban community survey, conducted in 1967 and in 1969, show that 16–18 % of the population have depressive symptoms at any one time. Similar rates are reported in five other studies where self‐report depression symptom scales have been used. The relationship between depressive symptoms and the diagnosis of major depressive disorders still requires investigation since the presence of depressive symptoms does not necessarily indicate the diagnosis of a major or minor depressive disorder.

Recent life events and acute schizophrenic psychosis: a controlled study.

In this case control study, first admission schizophrenic patients were found to report more recent life events overall and more events categorized as undesirable, familial, relocation, and legal than controls. Interpretation of the observations should be ventured cautiously given the small difference schizophrenics and controls, the small number of subjects, the retrospective strategy, and the failure of events “independent of ones control” or events characterized as “threatening” to confirm the positive relationship of recent life events to the occurrence of illness. The present work is part of considerable recent research documenting a relationship between the amount and/or significance of recent life events and the occurrence of psychological symptomatology and major psychiatric syndromes. The overall difference between schizophrenics and normals in reporting events appears to be smaller in magnitude than the difference found between depressives and normals. Further, the significance of events for schizophrenics and for depressives is different. The number, type, severity, and pattern of recent life events reported by schizophrenics suggest a precipitating role of events rather than a formative one. These results are consistent with one other controlled study on schizophrenia and recent life experience.

Psychiatric disorders in a U.S. community THE APPLICATION OF RESEARCH DIAGNOSTIC CRITERIA TO A RESURVEYED COMMUNITY SAMPLE

Point prevalence rates of psychiatric disorders, risk factors, and treatment sought for the disorders are presented, based on a 1975–1976 follow‐up of a community probability sample originally surveyed in 1967. These data, while preliminary because of the limitations of a follow‐up study, demonstrate the first application to a community sample of new psychiatric diagnostic techniques (SADS‐RDC), which are being used with increasing frequency in the United States. The forthcoming DSM‐III will be based on these diagnostic techniques.