Book Review

Textbook in Psychiatric Epidemiology

N Engl J Med 1995; 333:1228November 2, 1995

Article

Textbook in Psychiatric Epidemiology
Edited by Ming T. Tsuang, Mauricio Tohen, and Gwendolyn E.P. Zahner. 483 pp. New York, John Wiley, 1995. $59.95. ISBN: 0-471-59375-3

This book, written in response to requests from graduate students in the Psychiatric Epidemiology Training Program at Harvard, deals with a very important subject. Psychiatric epidemiology attempts to account for the incidence, prevalence, severity, course, outcome, and response to intervention of psychiatric disorders in terms of social, epidemiologic, and demographic factors, including sex, race, age, and level of education. One of the goals of such investigation is to turn up important clues to the cause and pathogenesis of psychiatric disorders. Much has been learned in this field over the past 25 to 30 years, some of which might ultimately provide important clues to causation.

The editors' goal is set forth in the preface:

Our objective has been to provide a comprehensive yet understandable overview of methods and substantive information in psychiatric epidemiology. For purposes of manageability, however, we have limited the focus of this volume to basic research strategies and analytic methods. Not all psychiatric disorders are included, and in particular we have not attempted to cover the rapidly evolving area of child psychiatric epidemiology. Despite these limitations, we hope this textbook will meet the needs of students in the field of psychiatric epidemiology as well as the needs of psychiatric researchers in general.

The book has four sections, covering the history of the field, study designs and methods, assessment, and the epidemiology of major psychiatric disorders. The historical overview is brief and consists of a reprinted paper by Bruce Dohrenwend, presented at the 1988 annual meeting of the American Psychopathological Association, entitled “ `The Problem of Validity in Field Studies of Psychological Disorders' Revisited.” It offers an interesting introduction to field studies and their problems.

The section dealing with study designs and methods includes chapters on research methods, the use of the odds ratio as a measure of association, methods in psychiatric genetics, the Epidemiologic Catchment Area program, the natural history of psychopathology, psychiatric comorbidity, and research on mental health. The section on assessment covers reliability, validity, the selection of diagnostic instruments, diagnostic schedules and rating scales, and the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, and psychiatric epidemiology. The final section presents material on the epidemiologic features of schizophrenia, bipolar disorder, depression and anxiety disorder, alcohol use and abuse, drug dependence, personality disorders, and geriatric problems.

Nearly every chapter is written by at least one nationally or internationally recognized expert. These authors represent a cross section of the leading investigators in psychiatric epidemiology. The book should prove to be a very satisfactory starting point for beginners in the field because of its emphasis on important methodologic and conceptual issues and pitfalls.

Samuel B. Guze, M.D.
Washington University School of Medicine, St. Louis, MO 63110