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Psychiatric Morbidity Among Adults Living in Private Households, 2000: Technical Report

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Psychiatric Morbidity Among Adults Living in Private Households, 2000: Technical Report Nicola Singleton The report of a survey Alison Lee carried out by Social Howard Meltzer Survey Division of the Office for National Statistics on behalf of the Department of Health, the Scottish Executive and the National Assembly for Wales Psychiatric morbidity among adults living in private households, 2000: Technical Report London: Office for National Statistics © Crown copyright 2002 This report has been produced by the Social Survey Division of Published with the permission of the Controller of Her Majesty’s the Office for National Statistics in accordance with the Official Stationery Office (HMSO). Statistics Code of Practice. ISBN 1 85774 508 6 Applications for reproduction should be submitted to HMSO under HMSO’s Class Licence: www.clickanduse.hmso.gov.uk Alternatively applications can be made in writing to: HMSO Licensing Division St. Clement’s House 2-16 Colegate Norwich NR3 1BQ Contact points For enquiries about this publication, contact Nicola Singleton Tel: 020 7533 5305 E-mail: [email protected] For general enquiries, contact the National Statistics Public Enquiry Service on 0845 601 3034 (minicom: 01633 812399) E-mail: [email protected] Fax: 01633 652747 Letters: Room 1.001, Government Buildings, Cardiff Road, Newport NP10 8XG You can also find National Statistics on the Internet at www.statistics.gov.uk The main report Psychiatric Morbidity among adults living in private households, 2000 is also available on the Internet at www.statistics.gov.uk/products/p8258.asp About the Office for National Statistics The Office for National Statistics (ONS) is the government agency responsible for compiling, analysing and disseminating many of the United Kingdom’s economic, social and demo- graphic statistics, including the retail prices index, trade figures and labour market data, as well as the periodic census of the population and health statistics. The Director of ONS is also the National Statistician and the Registrar General for England and Wales, and the agency that administers the registration of births, marriages and deaths there. Contents Page List of tables v List of figures vi Acknowledgements vii 1. Introduction 1 1.1 Background to the survey 1 1.2 Aims of the survey 1 1.3 Overview of the survey design 2 1.4 Coverage of the survey 2 1.5 Ethical clearance 2 1.6 Coverage of the technical report 2 1.7 Access to the data 3 2. Sample design 4 2.1 Sampling procedures for the initial interview 4 2.1.1 The sampling frame 4 2.1.2 Sampling procedures 4 2.1.3 Multi-household procedures 5 2.1.4 Sampling one person per household 6 2.1.5 Ineligible addresses 6 2.2 Sampling procedures for the second stage interviews 7 3. The questionnaire 8 3.1 Development of the questionnaire and the pilot survey 8 3.2 Assessment of mental disorders 10 3.2.1 Overview of the approach to the assessment of disorder 10 3.2.2 Coverage of disorders 11 3.2.3 Choice of measurement instruments for particular disorders 12 3.2.4 Concepts 16 3.3 Content of the mainstage questionnaire 17 3.3.1 Initial interviews 17 3.3.2 Second-stage interviews 17 4. Fieldwork procedures 19 4.1 Initial interviews 19 4.1.1 Training and supervision of interviewers 19 4.1.2 Fieldwork dates 19 4.1.3 Fieldwork procedures 20 4.1.4 Response rates 20 4.2 Second-stage interviews 22 4.2.1 Training and supervision of interviewers 22 4.2.2 Fieldwork dates 23 4.2.3 Fieldwork procedures 23 4.2.4 Response rates 23 5. Data processing 24 5.1 Data coding and cleaning 24 5.2 Derived variables 24 5.3 Weighting the data 24 5.3.1 Initial interviews 24 5.3.2 Second-stage interviews 26 5.4 Sampling errors and design effects 26 iii Page Appendices 27 A. Psychiatric disorders and their assessment 27 A1 Calculation of CIS-R symptom scores and algorithms to produce ICD-10 classification of neurotic disorder 27 A2 Assessment of probable psychosis 31 A3 Assessment of personality disorder 33 A4 Assessment of alcohol misuse and dependence 36 A5 Calculating a score for drug dependence 37 B. The questionnaire 38 Index 109 C. Fieldwork documents 114 C1 Advance letters 115 C2 Information leaflets 116 C3 Useful Contacts leaflet 117 C4 Show Cards 118 C5 Consent form for flagging NHS 140 D. Coding frames 141 E. Sampling errors and design factors for key survey estimates 164 F. Derived variables used in the main report 244 iv List of tables Page Page Chapter 2 Sample design E.5 Standard errors and 95% confidence intervals for probable psychosis by sex, age, 2.1 Regional stratifiers used and number of ethnicity and region: Main report PSUs selected 5 tables 2.11–2.13 183 2.2 Households eligible for interview 7 E.6 Standard errors and 95% confidence intervals for prevalence of hazardous Chapter 3 The questionnaire drinking by sex, age, ethnicity and region: Main report tables 2.14–2.16 185 3.1 ICD-10 categories of disorder and their E.7 Standard errors and 95% confidence coverage in the survey 11 intervals for CIS-R symptoms by sex, age, 3.2 Instruments used to assess mental disorder ethnicity and region: Main report in the survey 12 tables 2.17–2.19 188 3.3 Time periods used for different sections of E.8 Standard errors and 95% confidence the SCAN interview 16 intervals for lifetime experience of drug use by sex and age: Main report table 2.20 191 Chapter 4 Fieldwork procedures E.9 Standard errors and 95% confidence intervals for drugs used in last year by sex, 4.1 Number of quotas allocated to each month age, ethnicity and region: Main report of fieldwork 19 tables 2.21–2.23 195 4.2 Response of adults at initial interview stage 20 E.10 Standard errors and 95% confidence 4.3 Reasons for refusing to participate 22 intervals for drug dependence by sex, age, 4.4 Reasons for non-contact 22 ethnicity and region: Main report 4.5 Response at the second-stage 23 tables 2.24–2.26 203 E.11 Standard errors and 95% confidence Chapter 5 Data processing intervals for number of disorders by sex, age, ethnicity and region: Main report 5.1 Weights for over-sampling in Scotland 25 tables 2.27–2.29 211 5.2 Results of the post-stratification 25 E.12 Standard errors and 95% confidence intervals for age, ethnicity, marital status Appendix A and family unit type by neurotic disorder and sex: Main report table 4.1 214 A2.1 Alternative estimates of psychosis prevalence 33 E.13 Standard errors and 95% confidence A3.1 Making assessments of probable personality intervals for prevalence of longstanding disorder from the SCID-II self-completion physical complaints by neurotic disorder questionnaire for screening for second-stage and sex: Main report table 4.4 222 interview 34 E.14 Standard errors and 95% confidence intervals for age, ethnicity, marital status Appendix E and family unit type by probable psychotic disorder and sex: Main report table 4.6 225 E.1 Standard errors and 95% confidence E.15 Standard errors and 95% confidence intervals for CIS-R symptoms by sex, age, intervals for qualifications, intellectual ethnicity and region: Main report functioning, social class and employment tables 2.1–2.3 165 status by probable psychotic disorder and E.2 Standard errors and 95% confidence sex: Main report table 4.7 226 intervals for CIS-R scores by sex, age, E.16 Standard errors and 95% confidence ethnicity and region: Main report intervals for housing tenure, number of tables 2.4–2.6 173 accomodation moves and type of locality by E.3 Standard errors and 95% confidence probable psychotic disorder and sex: Main intervals for neurotic disorders by sex, age, report table 4.8 227 ethnicity and region: Main report E.17 Standard errors and 95% confidence tables 2.7–2.9 177 intervals for age, ethnicity, marital status E.4 Standard errors and 95% confidence and family unit type by level of alcohol intervals for personality disorders by sex problem and sex: Main report table 4.10 228 and age: Main report table 2.10 181 v List of tables continued List of figures Page Page E.18 Standard errors and 95% confidence Chapter 3 The questionnaire intervals for age, ethnicity, marital status and family unit type by drug dependence and 3.1 Calculation of symptom score for Anxiety sex: Main report table 4.14 231 from the CIS-R 13 E.19 Standard errors and 95% confidence 3.2 Algorithm for GAD 13 intervals for treatment received for mental or 3.3 Topics covered by AUDIT questionnaire 15 emotional problems by number of neurotic 3.4 Topics included in the assessment of disorders Main report table 5.1 233 drug dependence 16 E.20 Standard errors and 95% confidence intervals for treatment received for mental Chapter 4 Fieldwork procedures and emotional problems by neurotic disorder and sex: Main report table 5.2 234 4.1 Flow chart showing the organisation of the E.21 Standard errors and 95% confidence sampling and interviewing procedures 21 intervals for health care services used for mental or emotional problems by number of neurotic disorders: Main report table 5.6 235 E.22 Standard errors and 95% confidence intervals for health care services used for mental and emotional problems by neurotic disorder and sex: Main report table 5.7 236 E.23 Standard errors and 95% confidence intervals for treatment received for mental or emotional problems by probable psychotic disorder: Main report table 5.11 239 E.24 Standard errors and 95% confidence intervals for health care services used for mental or emotional problems by probable psychotic disorder: Main report table 5.14 239 E.25 Standard errors and 95% confidence intervals for treatment received for mental or emotional problems by level of alcohol problem: Main report table 5.18 240 E.26 Standard errors and 95% confidence intervals for health care services used for mental or emotional problems by level of alcohol problem: Main report table 5.21 241 E.27 Standard errors and 95% confidence intervals for treatment received for mental or emotional problems by drug dependence: Main report table 5.25 242 E.28 Standard errors and 95% confidence intervals for health care services used for mental or emotional problems by drug dependence: Main report table 5.28 243 vi Acknowledgements We would like to thank everybody who contributed The project was steered by a group comprising the to the survey and the production of this report.
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