Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-27T04:20:07.330Z Has data issue: false hasContentIssue false
  • English
  • Français

Single spies and battalions: the clinical epidemiology of mental disorders1

Published online by Cambridge University Press:  09 July 2009

Brian Cooper
Brian Cooper*
Affiliation:
Department of Epidemiological Psychiatry, Central Institute of Mental Health, Mannheim, Germany
*
2Address for correspondence: Dr Brian Cooper, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

Clinical epidemiology, a term that has been variously defined, is used here to refer to a discipline which, commencing with examination and diagnosis of the individual patient who presents in medical practice, proceeds to study the occurrence of similar, possibly connected cases in the local community, and in so doing may provide hypotheses for population-based studies of disease and its risk factors. While the relevance of this discipline to the modern practice of clinical psychiatry remains largely unexplored, its importance in the search for causes of mental disorder is attested by many instances, both historical and more recent, in which the spread or clustering of psychiatric syndromes in populations could be related to nutritional deficiency, infectious disease, the presence of environmental neurotoxins, the social communication of psychopathology or the transmission of abnormal, harmful behaviour patterns within family groups. Observations made in clinical practice have repeatedly served as the starting point for epidemiological investigation of mental disorders, while conversely epidemiological findings have influenced clinical thinking about their classification, diagnosis, prognosis and morbid risk. A review of the relevant literature underlines the need for a keener awareness of environmental risk factors and a fundamentally epidemiological frame of reference in trying to grapple with the aetiological problems of mental disorder.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 4 , November 1993 , pp. 891 - 907
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1

This paper is based on a lecture given at the Annual Congress of the Royal Australian and New Zealand College of Psychiatrists, Canberra, Australia, September 1992.

References

Agate, J. N. & Buckell, M. (1949). Mercury poisoning from fingerprint photography. Lancet ii, 451–454.CrossRefGoogle Scholar
Alarcón, R. de (1969). The spread of heroin abuse in a community. WHO Bulletin on Narcotics 21, 17–22.Google Scholar
Alarcón, R. de & Rathod, N. H. (1968). Prevalence and early detection of heroin abuse. British Medical Journal ii, 549–553.CrossRefGoogle Scholar
Atkinson, J. H., Grant, I., Kennedy, C. J., Richman, D. D., Spector, S. A. & McCutchan, J. A. (1988). Prevalence of psychiatric disorders among men infected with human immunodeficiency virus. Archives of General Psychiatry 45, 859–864.CrossRefGoogle ScholarPubMed
Baghurst, P. A., McMichael, A. J., Wigg, N. R., Vimpani, G. V., Roberts, E. F., Roberts, R. J. & Tong, S.-L. (1992). Environmental exposure to lead and children's intelligence at the age of 7 years: the Port Pirie Cohort Study. New England Journal of Medicine 327, 1279–1284.CrossRefGoogle ScholarPubMed
Baldwin, J. A. (1977). Child abuse: epidemiology and prevention. In Epidemiological Approaches in Child Psychiatry (ed. Graham, P. J.), pp. 55–105. Academic Press: London.Google Scholar
Bebbington, P. E., Brugha, T., MacCarthy, B., Potter, J., Sturt, E., Wykes, T., Katz, R. & McGuffin, P. (1988). The Camberwell Collaborative Depression Study. 1. Depressed probands, adversity and the form of depression. British Journal of Psychiatry 152, 752–765.CrossRefGoogle Scholar
Benaim, S., Horder, J. & Anderson, J. (1973). Hysterical epidemic in a classroom. Psychological Medicine 3, 366–373.CrossRefGoogle Scholar
Berrrios, G. E. & Morley, S. J. (1984). Koro-like symptom in a non-Chinese subject. British Journal of Psychiatry 145, 331–334.CrossRefGoogle Scholar
Bickel, H. (1987). Psychiatric illness and mortality among the elderly: findings of an epidemiological study. In Psychiatric Epidemiology: Progress and Prospects (ed. Cooper, B.), pp. 192–211. Croom Helm: London.Google Scholar
Bickel, H. (1989). Psychogeriatrische Störungen und Mortalität (Old age mental disorders and mortality). Soziale und Präventivmedizin 34, 265–271.CrossRefGoogle Scholar
Brayne, C. & Calloway, P. (1988). Normal ageing, impaired cognitive function and senile dementia of the Alzheimer's type: a continuum? Lancet i, 1265–1266.CrossRefGoogle Scholar
British Medical Journal (1951). Editorial: St. Anthony's fire. British Medical Journal ii, 596.Google Scholar
Brown, G. W. & Davidson, S. (1978). Social class, psychiatric disorder of mother, and accidents to children. Lancet i, 378–380.CrossRefGoogle Scholar
Brown, G. W. & Harris, T. O. (1989). Depression. In Life Events and Illness (ed. Brown, G. W. and Harris, T. O.), pp. 49–93. Unwin Hyman: London.Google Scholar
Brown, G. W., Ni Bhrolcháin, M. & Harris, T. O. (1979). Psychotic and neurotic depression. 3. Aetiological and background factors. Journal of Affective Disorders 1, 195–211.CrossRefGoogle ScholarPubMed
Brown, G. W., Craig, T. K. J. & Harris, T. O. (1985). Depression – distress or disease? Some epidemiological considerations. British Journal of Psychiatry 147, 612–622.CrossRefGoogle ScholarPubMed
Clements, F. W. (1960). The rise and decline of pink disease. Medical Journal of Australia 11 June, 922–925.CrossRefGoogle Scholar
Cooper, B. (1986). Epidemiology and clinical psychiatry. Acta Psychiatrica Belgica 86, 340–348.Google ScholarPubMed
Cooper, B. (ed.) (1987). Psychiatric Epidemiology: Progress and Prospects. Croom Helm: London.Google Scholar
Cooper, B. & Morgan, H. G. (1973). Epidemiological Psychiatry. C. C. Thomas: Springfield, Ill.Google ScholarPubMed
Cooper, B. & Shepherd, M. (1973). Life change, stress and mental disorder: the ecological approach. In Modern Trends in Psychological Medicine, 2 (ed. Price, J. H.), pp. 102–130. Butterworths: London.Google Scholar
Cooper, B., Bickel, H. & Schäufele, M. (1992). Demenzerkrankungen und leichtere kognitive Beeinträchtigungen bei älteren Patienten in der ärztlichen Allgemeinpraxis. (Dementia and cognitive impairment among elderly patients in general medical practice.) Nervenarzt 63, 551–560.Google Scholar
Department of Health and Social Security (1980). Lead and Health. The Report of a DHSS Working Party on Lead in the Environment. HM Stationery Office: London.Google Scholar
Farr, W. (1838). On the Statistics of the English Lunatic Asylums and the Reform of their Public Management. London.Google Scholar
Fletcher, R. H., Fletcher, S. W. & Wagner, E. H. (1982). Clinical Epidemiology: the Essentials. Williams & Wilkins: Baltimore.Google Scholar
Gabbai, Lisbonne & Pourquier, (1951). Ergot poisoning at Pont St. Esprit. British Medical Journal ii, 650–651.CrossRefGoogle Scholar
Hagberg, B., Hagberg, G., Lowerth, A. & Lindberg, U. (1981). Mild mental retardation in Swedish schoolchildren. Acta Paediatrica Scandinavica 70, 441–444.CrossRefGoogle Scholar
Hare, E. H. (1959). The origin and spread of dementia paralytica. Journal of Mental Science 105, 594–626.CrossRefGoogle ScholarPubMed
Holland, W. W. (1991). Clinical epidemiology and the use of words. Journal of Clinical Epidemiology 44, 962–963.CrossRefGoogle ScholarPubMed
Katschnig, H., Pakesch, G. & Egger-Zeidner, E. (1986). Life stress and depressive subtypes: a review of present diagnostic criteria and recent research results. In Life Events and Psychiatric Disorders: Controversial Issues (ed. Katschnig, H.). pp. 201–245. Cambridge University Press: Cambridge.Google Scholar
Kendell, R. E. (1976). The classification of depressions: a review of contemporary confusion. British Journal of Psychiatry 129, 15–28.CrossRefGoogle ScholarPubMed
Klein, D. (1980). Societal influence on childhood accidents. Accident Analysis and Prevention 12, 275–281.CrossRefGoogle Scholar
Koller, H., Richardson, S. A. & Katzs, M. (1984). The prevalence of mild mental retardation in the adult years. Journal of Mental Deficiency Research 28, 101–107.Google ScholarPubMed
Kreitman, N., Smith, P. & Tan, E.-S. (1969). Attempted suicide in social networks. British Journal of Preventive and Social Medicine 23, 116–123.Google ScholarPubMed
Kurland, L. T., Faro, S. N. & Siedler, H. (1960). Minamata disease. World Neurology 1, 370–395.Google ScholarPubMed
Lancet (1951). Editorial: St. Anthony's fire. Lancet ii, 436.Google Scholar
Lancet (1956). Editorial: A new clinical entity?: Lancet i, 789.Google Scholar
Lancet (1966). Editorial: Encephalitis of lethergica type in a mental hospital. Lancet ii, 1014–1015.Google Scholar
Lancet (1987). Editorial: Lyme disease in Europe. Lancet i, 264–265.Google Scholar
Logan, W. P. D. (1949). Mortality from pink disease in 1923–1947. Lancet i, 608–609.CrossRefGoogle Scholar
McEvedy, C. P. & Beard, A. W. (1970). Royal Free epidemic of 1955: a reconsideration. British Medical Journal i, 7–11.CrossRefGoogle Scholar
Mahaffey, K. R. (1992). Editorial: Exposure to lead in childhood – the importance of prevention. New England Journal of Medicine 327, 1308–1309.CrossRefGoogle ScholarPubMed
Markush, R. E. (1973). Mental epidemics: a review of the old to prepare for the new. Public Health Reviews 2, 353–442.Google Scholar
Martyn, C. N. (1992). Neurological clues from environmental neurotoxins. British Medical Journal 295, 346–347.CrossRefGoogle Scholar
Moncrieff, A. A., Konmides, O. P., Clayton, B. E., Patrick, A. D., Rennick, A. G. & Roberts, G. C. (1964). Lead poisoning in children. Archives of Diseases in Childhood 39, 1–13.CrossRefGoogle ScholarPubMed
Morris, J. N. (1975). Uses of Epidemiology, 3rd edn.Churchill Livingstone: Edinburgh.Google Scholar
Nersesian, W. S., Petit, M. R., Shaper, R., Lemieux, D. & Naor, E. (1985). Childhood death and poverty: a study of all childhood deaths in Maine, 1976–1980. Pediatrics 75, 41–50.CrossRefGoogle Scholar
Ngui, P. W. (1969). The koro epidemic in Singapore. Australian and New Zealand Journal of Psychiatry 3, 263–266.Google Scholar
Noguchi, H. & Moore, J. W. (1913). A demonstration of treponema pallidum in the brain in cases of general paralysis. Journal of Experimental Medicine 17, 232–238.CrossRefGoogle ScholarPubMed
Oliver, J. E. & Buchanan, A. H. (1979). Generations of maltreated children and multi-agency care in one kindred. British Journal of Psychiatry 135. 289–303.CrossRefGoogle Scholar
Oliver, J. E. & Taylor, A. (1971). Five generations of ill-treated children in one family. British Journal of Psychiatry 119, 473–480.CrossRefGoogle ScholarPubMed
Orchard, T. J. (1980). Epidemiology in the 1980s – need for a change? Lancet ii, 845–846.CrossRefGoogle Scholar
Paul, J. R. (1958). Clinical Epidemiology. University of Chicago Press: Chicago.Google Scholar
Pearson, K. (1931). On the inheritance of mental disease. Annals of Eugenics (London) 4, 362.CrossRefGoogle Scholar
Pearson, K. & Jaederholm, G. A. (1914). On the Continuity of Mental Defect. Dulau: London.Google Scholar
Roberts, J. A. F., Norman, R. M. & Griffiths, R. (1938). Studies on a child population. IV. The form of the lower end of the frequency distribution of Stanford Binet intelligence quotients and the fall of low intelligence quotients with advancing age. Annals of Eugenics (London) 8, 319–336.CrossRefGoogle Scholar
Roth, M., Huppert, F. A., Tym, E. & Mountjoy, C. Q. (1988). CAMDEX: The Cambridge Examination for Mental Disorders of the Elderly. Cambridge University Press: Cambridge.Google Scholar
Royal Commission on Environmental Pollution (1983). Ninth Report: Lead in the Environment. HM Stationery Office: London.Google Scholar
Rutter, M. (1980). Raised lead levels and impaired cognitive/behavioural functioning. A review of the evidence. Developmental Medicine and Child Neurology 22, (Suppl. 42).Google Scholar
Rutter, M. (1989). Psychiatric risk in parents as a risk for children. In Prevention of Mental Disorders, Alcohol and Other Drug Use in Children and Adolescents. OSAP Prevention Monograph 2 (ed. Shaffer, D., Philips, I. and Enzer, N. B.), pp. 157–189. US Dept. of Health and Human Services: Rockville, MD.Google Scholar
Sackett, D. L., Haynes, R. B. & Tugwell, P. (1985). Clinical Epidemiology: A Basic Science for Clinical Medicine. Little Brown: Boston.Google Scholar
Schlesinger, B. (1970). Multi-Problem Families: A Review and Annotated Bibliography. University of Toronto Press: Toronto.Google Scholar
Selter, P. (1903). Über Trophodermatoneurose. Archiv für Kinderheilkunde 37, 468–469.Google Scholar
Shepherd, M. (1978). Epidemiology and clinical psychiatry. British Journal of Psychiatry 133, 289–298.CrossRefGoogle ScholarPubMed
Spitzer, W. O. (1986). Clinical epidemiology. Journal of Chronic Diseases 39, 411–415.CrossRefGoogle ScholarPubMed
Steenberg, V. (1884). The role played by syphilis in the genesis of general paralysis: discussion. Congrès international des Sciences médicales, 8me Session, Copenhague, 1884. X: Section de Psychiatrie et de Neurologie pp. 80–92.Google Scholar
Strathdee, G. & King, M. (1989). The interface between primary and secondary psychiatric care. In The Scope of Epidemiological Psychiatry (ed. Williams, P., Wilkinson, G. and Rawnsley, K.), pp. 420–433. Routledge: London.Google Scholar
Strömgren, E. (1989). Longitudinal investigations in psychiatric epidemiology. In The Scope of Epidemiological Psychiatry (ed. Williams, P., Wilkinson, G. and Rawnsley, K.), pp. 158–166. Routledge: London.Google Scholar
Suwanlert, S. & Coates, D. (1979). Epidemic Koro in Thailand – clinical and social aspects. Transcultural Psychiatric Research Review 16, 64–66.Google Scholar
Thurnam, J. (1845). Observation and Essays on the Statistics of Insanity. Simpkin Marshall: London.Google Scholar
Tseng, W.-S., Kan-Ming, M.Hsu, J., Li-Shuen, L., Li-Wak, O., Guo-Qian, C. & Da-Wei, J. (1988). A sociocultural study of koro epidemics in Guangdong, China. American Journal of Psychiatry 145, 1538–1543.Google ScholarPubMed
von Economo, C. (1929). Die Encephalitis Lethargica: Ihre Nachkrankenheiten und Hue Behandlung. (Encephalitis Lethargica: its Sequelae and Treatment.) Urban & Schwarzenberg: Berlin.Google Scholar
Warkany, J. (1966). Acrodynia – postmortem of a disease. American Journal of Diseases of Children 112, 147–156.Google ScholarPubMed
Warkany, J. & Hubbard, D. M. (1948). Mercury in the urine of children with acrodynia. Lancet i, 829–830.CrossRefGoogle Scholar
Warkany, J. & Hubbard, D. M. (1951). Adverse mercurial reactions in the form of acrodynia and related conditions. American Journal of Diseases of Children 81, 335–373.Google ScholarPubMed
Williams, P., Wilkinson, G. & Rawnsley, K. (eds.) (1989). The Scope of Epidemiological Psychiatry. Routledge: London.Google Scholar
Yap, P. M. (1965). A culture bound depersonalization syndrome. British Journal of Psychiatry 111, 43–50.CrossRefGoogle ScholarPubMed