Psychiatric Epidemiology: Searching for the Causes of Mental Disorders

by Ezra Susser

Overview

Searching for the causes of mental disorders is as exciting as it it complex. The relationship between pathophysiology and its overt manifestations is exceedingly intricate, and often the causes of a disorder are elusive at best. This book is an invaluable resource for anyone trying to track these causes, whether they be clinical researchers, public health practitioners, or psychiatric epidemiologists-in-training. Uniting theory and practice in very clear language, it makes a wonderful contribution to both epidemiologic and psychiatric research. Rather than attempting to review the descriptive epidemiology of mental disorders, this book gives much more dynamic exposition of the thinking and techniques used to establish it.

Starting out by tracing the brief history of psychiatric epidemiology, the book describes the study of risk factors as causes of mental disorders. Subsequent sections discuss approaches to investigation of biologic, genetic, or social causes and the statistical analysis of study results. The book concludes by following some of the problems involved in the search for genetic causes of mental disorders, and more complex casual relationships.

Product Details

ISBN-13:	2900195101811
Publication date:	06/01/2006
Pages:	544
Product dimensions:	6.50(w) x 1.50(h) x 9.50(d)

About the Author

Columbia University

Service d'Epidemiologie clinique, Geneva

SUNY Stony Brook

Table of Contents

PART I. Psychiatric epidemiology, then and now. 1. The burden of mental illness2. The arc of epidemiology3. Searching for the causes of mental disordersPART II. RISK FACTORS AS CAUSES OF MENTAL DISORDERS. 4. What is a cause? 5. Detecting causes6. Study designs7. Relationship among causes8. Measures of associationPART III. COHORT DESIGNS IN PSYCHIATRIC EPIDEMIOLOGY. 9. Prototypical cohort study10. Diversity of cohort studies11. Casual inference: a thought experiment12. Confounding: What it is and what can be done13. Unequal attrition under different types of follow-up14. Differential misclassificationPART IV. CASE CONTROL DESIGNS IN PSYCHIATRIC EPIDEMIOLOGY. 15. Logic of the case control design16. Applications of the case control study17. Choosing controls18. Comparability and the case control studyPART V. CASE CONTROL DESIGNS IN BIOLOGIC PSYCHIATRY. 19. Biologic studies in psychiatry20. Choosing cases in biologic psychiatry21. Choosing controls in biologic psychiatryPART VI. ANALYZING THE DATA. 22. Gauging associations23. Establishing associations24. Planning studies: power and sample size25. Statistical adjustment26. Survival analysis27. Analysis of InteractionPART VII. THE SEARCH FOR GENETIC CAUSES OF MENTAL DISORDERS. 28. Integrating epidemiology with genetics29. Genetic association studies30. Modern family history studies31. Twin studies of heritability32. Genetic linkage studies33. Designs for the genomic eraPART VIII. COMPLEX CASUAL RELATIONSHIPS. 34. Eco-epidemiology35. Casual explanation within a risk factor framework36. Casual explanation outside the black box37. Dependent and dynamic processesAppendix I. Our approach to epidemiologic concepts and methods. Appendix II.(Appendix to Chapter 13) Application of survival analysis to PDSE data. Glossary.

Editorial Reviews

Reviewer: Howard M. Kravitz, DO, MPH (Rush University Medical Center)
Description: This book broadly covers the concepts and methods of epidemiology used to devise strategies to search for the causes of mental disorder. The focus is on theory, methodology, and empirical topics including genetic epidemiology.
Purpose: The purpose is to set out a logical framework that can be applied to studying the causes of mental disorders. This is an ambitious objective, but the editors/authors are senior investigators and teachers who demonstrate throughout the book that they are equal to the task.
Audience: The targeted audience includes public health practitioners and clinicians. Clinical researchers will benefit most from this book, particularly psychiatric epidemiologists. However, both those in training and those who teach it (as I do) will find that the book speaks to them.
Features: The authors provide a "dynamic exposition of the thinking and techniques" used to develop an integrative approach to studying causes of mental disorders. In eight sections (37 chapters) the editors/authors expound on how the scope of epidemiology is advancing beyond the study of risk factors to the study of risk factors as causes of mental disorders. Sections include a brief historical perspective on psychiatric epidemiology and epidemiology in general, risk factors as causes of mental disorders (where the reader is introduced to the concept of the "counterfactual"), cohort and case-control designs (two sections on the latter — one specifically addressing biological psychiatry), analyzing data, genetic causes (my favorite — six lucidly written chapters in a burgeoning area), and complex causal relationships. There are two appendixes — the first elucidates the authors' approach to concepts and methods and the second expands on data first described in chapter 10 (p.124). Concepts and methods are illustrated with thumbnail sketches of studies illustrating the points. What would make this book more complete? Clinical trials are mentioned but require their own section — this is a major focus of psychiatric research and clinical epidemiology. The data analysis section should include a chapter explaining longitudinal models (e.g., random regression, general estimating equations).
Assessment: This book is more about a theory and philosophy of epidemiology than it is about mental disorders. It is not a textbook of psychiatric disorders like Tsuang and Tohen' s Textbook in Psychiatric Epidemiology, 2nd edition (John Wiley & Sons, 2002); instead it provides the tools readers need to comprehend and critique this field's scientific literature and to confidently "search for the causes." Readers will be stimulated to think about the concepts discussed. Although written at a level that should be accessible to first year public health graduate students as well as researchers and teachers, the latter will better appreciate the nuances and subtleties of epidemiologic research that the authors examine. Furthermore, the information and ideas presented here apply to epidemiology in general and are not limited to the authors' special interests — mental disorders. This is a much needed text for psychiatric epidemiologists.

Doody's Review Service

"This is a much needed text for psychiatric epidemiologists."—Doody's

"Overall, this book is an outstanding accomplishment. It fills a gap in the area of psychiatric research where there is a dearth of up-to-date, discipline-specific texts...an excellent text which sets a new benchmark for epidmeiological thinking in mental health research and goes a long way towards making the concepts of the discipline accessible to psychiatric researchers in general."—Psychological Medicine

"If only all textbooks were written like this one. The authors of Psychiatric Epidemiology have assembled a highly cogent examination of the past, present, and possible future of psychiatric epidemiology, doing so in a way that anyone interested in the scientific method—including its limitations—can be immersed."—Psychiatric Times

From the Publisher