The epidemiologic catchment area (ECA) study: implications for Australia.

OBJECTIVES: To make clinicians aware of the methods and results of the Epidemiologic Catchment Area (ECA) study, the largest (about 20,000 subjects) undertaken in psychiatric epidemiology, and to explore implications for the management of these conditions in Australia. DATA SOURCES: The main source was the monograph that reports the overall results of the ECA project. Data extraction: Only data that were considered to be of general interest were extracted. DATA SYNTHESIS: The ECA study found that one in every three American adults had experienced one or more of 30 major psychiatric disorders at some time in their lives. One in five had an active disorder at the time of interview. Most conditions were found to have their onset early in life (median age of onset was 16 years) and followed a chronic course. In many cases persons afflicted did not seek or receive appropriate treatment despite using medical services more often. CONCLUSIONS: Psychiatric disorders are a major public health problem. Increased emphasis on their identification and treatment is required, particularly during childhood, adolescence and early adulthood. Paradoxically, these are the age groups more neglected by current services and research.