The Canadian Community Health Survey (CCHS) - Cycle 1.2 >

Contextual information for The Daily release (September 2003)

General information
Definitions

General information

The major objectives of the second cycle of the Canadian Community Health Survey (CCHS) were to determine prevalence rates of selected mental disorders, to assess the burden these illnesses create, and to assess the utilization of mental health services with respect to perceived needs.

For the purpose of developing the CCHS 1.2 questionnaire, mental health was defined to include social, physical, spiritual, economic, and mental aspects of an individual's life. With the support of an expert group and various consultations, Statistics Canada developed this first ever national survey on mental health in response to important data gaps from a research, consumer and policy perspectives.

The content for Cycle 1.2 is partly based on a selection of mental disorders from the WMH-CIDI (World Mental Health – Composite International Diagnostic Interview Instrument). The WMH-CIDI is a lay-administered psychiatric interview that generates a profile of those with a disorder according to the definitions of the Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition (DSM-IV), an international classification system.

To be selected, a mental disorder or problem needed to have an estimated 12-month prevalence of at least 1% (based on regional or comparable national surveys in other countries), be measurable through the use of an already-tested and validated instrument, and amenable to intervention. The impact of the selected instruments on response burden (interview length, clarity of concepts and questions) was also considered during the survey development.

For each covered mental disorder, questions were asked about feelings, symptoms, and their relative frequency, severity, intensity, and impact in daily life. A similar approach was used to profile problems related to substance dependence.

The survey also collected information on well-being and correlates of mental health such as spirituality, physical activity, use of health care resources, and medication use. Socio-demographic information was collected, including age, income, education and family composition.

Definitions

Surveyed mental disorders within the 12-month period prior to the survey:

Major depressive episode — at least one episode of 2 weeks or more with persistent depressed mood and loss of interest or pleasure in normal activities, accompanied by problems such as decreased energy, changes in sleep and appetite, impaired concentration, and feelings of guilt, hopelessness, or suicidal thoughts.

Manic episode (mania) — at least one period of a week or longer with exaggerated feelings of well-being, energy, and confidence or irritable mood during which a person can lose touch with reality. Symptoms of mania include: flight of ideas or racing thoughts; inflated self-esteem; decreased need for sleep; talkativeness; and irritability.

Panic disorder — repeated and unexpected attacks of intense fear and anxiety where at least one of the attacks has been followed by 1 month or more of persistent concern or worry about having another attack or its physiological manifestations such as palpitations, chest pain, feelings of smothering or choking, dizziness, sweating, nausea or abdominal distress, trembling, and hot flushes or chills.

Social phobia — persistent, irrational fear of social or performance situations in which the person may be closely watched and judged by others, as in public speaking, eating, or working. The fear is recognised by the person as excessive or unreasonable. The avoidance, anxious anticipation, or distress in these feared situation(s) interferes significantly with the person’s everyday activities.

Agoraphobia — fear and avoidance of being in places or situations from which escape might be difficult, or in which help may not be available. Feared situations include being outside the home alone, being in a crowd or standing in a line, being on a bridge, and travelling in a bus, train or automobile. The situations are avoided or endured with marked distress or with anxiety about having a panic attack or panic-like symptoms.

Profiled substance dependence within the 12-month period prior to the survey:

Classification as alcohol or illicit drug dependent — based on sets of questions which examine aspects of drug tolerance, (for example, needing more to have an effect), withdrawal, loss of control, and social or physical problems related to alcohol or illicit drug use in daily life. The information collected on these two types of substance dependence provides a profile of behaviours of alcohol and illicit drug use which lead to clinically significant impairment or distress.

Any mental disorder or substance dependence:

Respondents were classified as having “Any mental disorder or substance dependence” if the pattern of answers met the criteria for at least one of the five mental disorders or two substance dependencies covered in the survey (i.e. major depressive episode, manic episode, panic disorder, social phobia, agoraphobia, alcohol dependence, or illicit drug dependence).