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.
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.