The World Health Organization International Consorthm in Psychiatric Epidemiology (ICPE): initial work and future directions ‐ the NAPE Lecture 1998a

Abstract

Objective: To provide an overview of the World Health Organization (WHO) International Consortium in Psychiatric Epidemiology (ICPE), to introduce the World Mental Health 2000 (WMH 2000) Initiative and to discuss methodological issues that the ICPE is grappling with in planning the WMH2000 Initiative. Method: We review the history, mission and organization of the ICPE and the rationale behind the WMH2000 Initiative. We review methodological research underlying major design and implementation decisions regarding the WMH2000 surveys. Results: The ICPE is an international consortium created to facilitate cross‐national comparative epidemiological research using the WHO Composite International Diagnostic Interview (CIDI). The first‐phase core TCPE surveys, which we are currently analysing, include over 33 000 interviews in seven countries, with an additional set of over 30000 interviews in seven countries ready to be added to the master file within the next year. The WMH2000 Initiative will include a third series of CIDI surveys that include an anticipated 100000 additional interviews in 10 countries. A series of complex methodological challenges confront us in designing and implementing the WMH2000 surveys. These include issues in the conceptualization and measurement of impairment and disablement, the implementation of standardized quality control procedures across countries, and the blending of epidemiological and clinical interviewing methods to obtain a valid cross‐national characterization of disorder prevalences. Our current plans regarding these issues are discussed. Conclusion: Valid and representative general population epidemiological data on patterns, predictors and adverse consequences of psychiatric disorders are needed as a foundation for public health initiatives. The efforts of the ICPE promise to provide data of this sort for many regions in the world. Formidable methodological and logistical challenges arise in implementing this agenda, but we are confident that these challenges can be met by building on the firm foundation already established in the ongoing ICPE collaboration.