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Epidemiological Psychiatry

Published online by Cambridge University Press:  02 January 2018

Greg Wilkinson  and
Marco Piccinelli
Greg Wilkinson*
Affiliation:
The London Hospital Medical College, London E1 2AD
Marco Piccinelli
Affiliation:
Servizio di Psicologia Medica, Istituto di Psichiatria, Università di Verona, Italia
*
∗Correspondence
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Extract

In 1881 J. M. Machado de Assis published a short novel entitled The Psychiatrist. The main character, Simao Bacamarte, “a physician of noble birth”, devoted himself to “the health of the soul” (as he defined psychopathology) and conceived a new, revolutionary (for the times) hypothesis: “The number of persons suffering from insanity, he believed, was far greater than commonly supposed”. Dr Bacamarte explains: “Till now, madness has been thought a small island in an ocean of sanity. I am beginning to suspect that it is not an island at all but a continent”.

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Information
The British Journal of Psychiatry , Volume 162 , Issue 4 , April 1993 , pp. 576 - 579
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

References

Machado de Assis, J. M. (1881) The Psychiatrist. In The Penguin Book of Latin American Short Stories (ed. Colchie, T.) (1992). London: Viking.Google Scholar
Shepherd, M. (1973) Research report: the General Practice Research Unit at the Institute of Psychiatry. Psychological Medicine, 3, 525–529.Google Scholar
Shepherd, M. (1985) Psychiatric epidemiology and epidemiological psychiatry. American Journal of Public Health, 75, 275–276.CrossRefGoogle ScholarPubMed
Shepherd, M., Cooper, B., Brown, A. C., et al (1966) Psychiatric Illness in General Practice. Oxford: Oxford University Press.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C., & Clare, A. (1981) Psychiatric Illness in General Practice (2nd edn). Oxford: Oxford University Press.Google Scholar
Wilkinson, G. (1989) The General Practice Research Unit at the Institute of Psychiatry. Psychological Medicine, 19, 787–790.Google Scholar
Williams, P., Wilkinson, G. & Rawnsley, K. (1989) The Scope of Epidemiological Psychiatry. London: Routledge.Google Scholar

Further reading

Two journals are devoted to psychiatric epidemiology: Social Psychiatry and Psychiatric Epidemiology and Epi-demiologia e Psichiatria Sociale (in English and Italian). Psychological Medicine has published several key articles and monograph/supplements. Google Scholar
Gruenberg, E. M. (ed.) (1966) Evaluating the effectiveness of mental health services. Milbank Memorial Fund Quarterly, 44(1) Part 2, 1–402. (The extensive round table discussions reported in this volume are based on the studies by four research teams investigating the effectiveness of then new types of comprehensive, integrated local mental health services in Fort Logan (USA), Chichester and district, Plymouth, and Dutchess County (USA). The community mental health services they investigated are described in terms of programmes, resources, organisations and goals. These underlie the evaluators' efforts to identify measurable indices of success and failure.) Google Scholar
Shepherd, M. (1978) Epidemiology and clinical psychiatry. British Journal of Psychiatry, 133, 289–298.CrossRefGoogle ScholarPubMed
Shepherd, M. (1984) The contribution of epidemiology to clinical psychiatry. American Journal of Psychiatry, 144, 1574–1576.Google Scholar
Duncan-Jones, P. Fergusson, D. M., Ormel, J., et al (1990) A model of stability and change in minor psychiatric symptoms: results from three longitudinal studies. In Psychological Medicine (monograph no. 18). Cambridge: Cambridge University Press.Google Scholar
Jenkins, R. (1985) Sex differences in minor psychiatric morbidity. In Psychological Medicine (monograph no. 7). Cambridge: Cambridge University Press.Google Scholar
King, M. B. (1989) Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months. In Psychological Medicine (monograph no. 14). Cambridge: Cambridge University Press.Google Scholar
Mann, A. (1984) Hypertension: psychological aspects and diagnostic impact in a clinical trial. In Psychological Medicine (monograph no. 5). Cambridge: Cambridge University Press.Google Scholar
Sartorius, N., Jablensky, A., Cooper, J. E., et al (1988) Psychiatric classification in an international perspective - with special reference to Chapter V (F) of the 10th revision of the International Classification of Diseases - Mental, Behavioural and Developmental Disorders. British Journal of Psychiatry, 152 (suppl. 1).Google Scholar
Shepherd, M., Watt, D., Falloon, I., et al (1989) The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. In Psychological Medicine (monograph no. 15). Cambridge: Cambridge University Press.Google Scholar
Tansella, M. (ed.) (1991) Community-based psychiatry: long-term patterns of care in South-Verona. In Psychological Medicine (monograph no. 19). Cambridge: Cambridge University Press.Google Scholar
Williams, P., Tarnopolsky, A., Hand, D., et al (1986) Minor psychiatric morbidity and general practice consultation: the west London survey. In Psychological Medicine (monograph no. 9). Cambridge: Cambridge University Press.Google Scholar
Wing, J. K. (ed.) (1982) Long-term community care: experience in a London borough. In Psychological Medicine (monograph no. 2). Cambridge: Cambridge University Press.Google Scholar
Barrett, J. & Rose, R. M. (eds) (1986) Mental Disorders in the Community. Findings from Psychiatric Epidemiology. New York: Guildford Press. (These proceedings of the 75th annual meeting of the American Psychopathological Association deal with the US Epidemiologic Catchment Area Program, the Lundby and Stirling County Studies, treatment and risk factors for schizophrenia, the problem of case identification, and implications of epidemiological findings for policy and program planning.) Google Scholar
Cooper, B. (ed.) (1987) Psychiatric Epidemiology: Progress and Prospects. London: Croom Helm. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry provide an overview of developments over the past 20 years.) Google Scholar
Cooper, B. & Eastwood, R. (eds) (1992) Primary Health Care and Psychiatric Epidemiology. London: Routledge. (This book comprises selected contributions to the first international scientific meeting on primary health care and psychiatric epidemiology, held in Toronto in 1989.) Google Scholar
Cooper, B. & Morgan, H. G. (1973) Epidemiological Psychiatry. Springfield, Illinois: Charles C. Thomas. (This represents the first textbook on the subject.) Google Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. The Pathway to Psychiatric Care. London: Tavistock Publications. (The authors review factors relating to the decision by patients with mental illness to consult GPs, the detection of psychiatric illness by GPs, the referral of patients by GPs to psychiatric out-patient services, and admission to psychiatric facilities. A description is presented of the Goldberg & Huxley model of the above process, consisting of five levels (each representing a different population of subjects) and four ‘filters’ (through which it is necessary to pass in order to move from one level to another). For example, level three consists of patients who are identified by GPs as having mental illness, level four contains patients attending psychiatric outpatient clinics, and the ‘filter’ is the decision by the GP to refer the patient.) Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders. A Biosocial Model. London: Routledge. (Goldberg & Huxley provide a framework for understanding why particular mental disorders develop at particular times and how long an episode of illness may last.) Google Scholar
Gruenberg, E. M. & Huxley, M. (eds) (1961) Causes of Mental Disorders: A Review of Epidemiological Knowledge. New York: Random House.Google Scholar
Hagnell, O., Essen-Moller, E., Lanke, J., et al (1990) The Incidence of Mental Illness over a Quarter of a Century. Stockholm: Almqvist & Wiksell International. (This describes the Lundby longitudinal study of mental illness, in which experienced psychiatrists made home visits and collected basic information on all the 2550 inhabitants of a geographically defined area in the southernmost part of Sweden. The subjects were then followed-up by the investigators after 10 years and 25 years.) Google Scholar
Hare, E. H. & Wing, J. K. (eds) Psychiatric Epidemiology. London: Oxford University Press. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry present reviews of numerous epidemiological studies undertaken in the previous 10 years together with then current and methodological concerns.) Google Scholar
Lin, T. Y. & Standley, C. C. (1962) The scope of epidemiology in psychiatry. World Health Organization Public Health Paper (no. 16). Geneva: WHO.Google Scholar
Reid, D. D. (1960) Epidemiological Methods in the Study of Mental Disorders. Geneva: World Health Organization. (This presents the general principles of the epidemiological approach in medicine, and points out the potential and the practical limitations of its application in psychiatry.) Google Scholar
Tansella, M., De Girolamo, G. & Sartorius, N. (1992) Annotated Bibliography of Psychiatric Epidemiology. London: Gaskell. (A number of the world's experts in psychiatric epidemiology helped to compile a list of the outstanding publications in the field. There are over 200 entries with summaries and comment.) Google Scholar
Weissman, M. M., Myers, J. K. & Ross, C. E. (eds) (1986) Community Surveys of Psychiatric Disorders (series in psychosocial epidemiology, vol. 4). New Brunswick, New Jersey: Rutgers University Press. (Contributors examine methodological issues involved in carrying out community surveys and evaluate a number of influential surveys undertaken over the past few decades. The NIMH Epidemiologic Catchment Area Program is described by Eaton and colleagues, and Assen Jablensky examines psychiatric epidemiology in the 1980s from a World Health Organization perspective. Other volumes in this series are entitled: Studies of Children; Stressful Life Events and Their Contexts; Symptoms, Illness Behavior, and Help-Seeking; Alcohol Patterns and Problems; Studying Drug Abuse; and Ethical Issues in Epidemiologic Research.) Google Scholar
Wing, J. K. (ed.) (1989) Health Services Planning and Research. Contributions from Psychiatric Case Registers. London: Gaskell.Google Scholar
Wing, J. K., Bebbington, P. & Robins, L. N. (eds) (1981) What is a Case? The Problem of Definition in Psychiatric Community Surveys. London: Grant Mclntyre.Google Scholar
Wing, J. K. & Hafner, H. (eds) (1973) Roots of Evaluation. London: Oxford University Press. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry outline the epidemiological basis for planning psychiatric services.) Google Scholar
Two journals are devoted to psychiatric epidemiology: Social Psychiatry and Psychiatric Epidemiology and Epi-demiologia e Psichiatria Sociale (in English and Italian). Psychological Medicine has published several key articles and monograph/supplements. Google Scholar
Gruenberg, E. M. (ed.) (1966) Evaluating the effectiveness of mental health services. Milbank Memorial Fund Quarterly, 44(1) Part 2, 1–402. (The extensive round table discussions reported in this volume are based on the studies by four research teams investigating the effectiveness of then new types of comprehensive, integrated local mental health services in Fort Logan (USA), Chichester and district, Plymouth, and Dutchess County (USA). The community mental health services they investigated are described in terms of programmes, resources, organisations and goals. These underlie the evaluators' efforts to identify measurable indices of success and failure.) Google Scholar
Shepherd, M. (1978) Epidemiology and clinical psychiatry. British Journal of Psychiatry, 133, 289–298.CrossRefGoogle ScholarPubMed
Shepherd, M. (1984) The contribution of epidemiology to clinical psychiatry. American Journal of Psychiatry, 144, 1574–1576.Google Scholar
Duncan-Jones, P. Fergusson, D. M., Ormel, J., et al (1990) A model of stability and change in minor psychiatric symptoms: results from three longitudinal studies. In Psychological Medicine (monograph no. 18). Cambridge: Cambridge University Press.Google Scholar
Jenkins, R. (1985) Sex differences in minor psychiatric morbidity. In Psychological Medicine (monograph no. 7). Cambridge: Cambridge University Press.Google Scholar
King, M. B. (1989) Eating disorders in a general practice population. Prevalence, characteristics and follow-up at 12 to 18 months. In Psychological Medicine (monograph no. 14). Cambridge: Cambridge University Press.Google Scholar
Mann, A. (1984) Hypertension: psychological aspects and diagnostic impact in a clinical trial. In Psychological Medicine (monograph no. 5). Cambridge: Cambridge University Press.Google Scholar
Sartorius, N., Jablensky, A., Cooper, J. E., et al (1988) Psychiatric classification in an international perspective - with special reference to Chapter V (F) of the 10th revision of the International Classification of Diseases - Mental, Behavioural and Developmental Disorders. British Journal of Psychiatry, 152 (suppl. 1).Google Scholar
Shepherd, M., Watt, D., Falloon, I., et al (1989) The natural history of schizophrenia: a five-year follow-up study of outcome and prediction in a representative sample of schizophrenics. In Psychological Medicine (monograph no. 15). Cambridge: Cambridge University Press.Google Scholar
Tansella, M. (ed.) (1991) Community-based psychiatry: long-term patterns of care in South-Verona. In Psychological Medicine (monograph no. 19). Cambridge: Cambridge University Press.Google Scholar
Williams, P., Tarnopolsky, A., Hand, D., et al (1986) Minor psychiatric morbidity and general practice consultation: the west London survey. In Psychological Medicine (monograph no. 9). Cambridge: Cambridge University Press.Google Scholar
Wing, J. K. (ed.) (1982) Long-term community care: experience in a London borough. In Psychological Medicine (monograph no. 2). Cambridge: Cambridge University Press.Google Scholar
Barrett, J. & Rose, R. M. (eds) (1986) Mental Disorders in the Community. Findings from Psychiatric Epidemiology. New York: Guildford Press. (These proceedings of the 75th annual meeting of the American Psychopathological Association deal with the US Epidemiologic Catchment Area Program, the Lundby and Stirling County Studies, treatment and risk factors for schizophrenia, the problem of case identification, and implications of epidemiological findings for policy and program planning.) Google Scholar
Cooper, B. (ed.) (1987) Psychiatric Epidemiology: Progress and Prospects. London: Croom Helm. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry provide an overview of developments over the past 20 years.) Google Scholar
Cooper, B. & Eastwood, R. (eds) (1992) Primary Health Care and Psychiatric Epidemiology. London: Routledge. (This book comprises selected contributions to the first international scientific meeting on primary health care and psychiatric epidemiology, held in Toronto in 1989.) Google Scholar
Cooper, B. & Morgan, H. G. (1973) Epidemiological Psychiatry. Springfield, Illinois: Charles C. Thomas. (This represents the first textbook on the subject.) Google Scholar
Goldberg, D. & Huxley, P. (1980) Mental Illness in the Community. The Pathway to Psychiatric Care. London: Tavistock Publications. (The authors review factors relating to the decision by patients with mental illness to consult GPs, the detection of psychiatric illness by GPs, the referral of patients by GPs to psychiatric out-patient services, and admission to psychiatric facilities. A description is presented of the Goldberg & Huxley model of the above process, consisting of five levels (each representing a different population of subjects) and four ‘filters’ (through which it is necessary to pass in order to move from one level to another). For example, level three consists of patients who are identified by GPs as having mental illness, level four contains patients attending psychiatric outpatient clinics, and the ‘filter’ is the decision by the GP to refer the patient.) Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders. A Biosocial Model. London: Routledge. (Goldberg & Huxley provide a framework for understanding why particular mental disorders develop at particular times and how long an episode of illness may last.) Google Scholar
Gruenberg, E. M. & Huxley, M. (eds) (1961) Causes of Mental Disorders: A Review of Epidemiological Knowledge. New York: Random House.Google Scholar
Hagnell, O., Essen-Moller, E., Lanke, J., et al (1990) The Incidence of Mental Illness over a Quarter of a Century. Stockholm: Almqvist & Wiksell International. (This describes the Lundby longitudinal study of mental illness, in which experienced psychiatrists made home visits and collected basic information on all the 2550 inhabitants of a geographically defined area in the southernmost part of Sweden. The subjects were then followed-up by the investigators after 10 years and 25 years.) Google Scholar
Hare, E. H. & Wing, J. K. (eds) Psychiatric Epidemiology. London: Oxford University Press. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry present reviews of numerous epidemiological studies undertaken in the previous 10 years together with then current and methodological concerns.) Google Scholar
Lin, T. Y. & Standley, C. C. (1962) The scope of epidemiology in psychiatry. World Health Organization Public Health Paper (no. 16). Geneva: WHO.Google Scholar
Reid, D. D. (1960) Epidemiological Methods in the Study of Mental Disorders. Geneva: World Health Organization. (This presents the general principles of the epidemiological approach in medicine, and points out the potential and the practical limitations of its application in psychiatry.) Google Scholar
Tansella, M., De Girolamo, G. & Sartorius, N. (1992) Annotated Bibliography of Psychiatric Epidemiology. London: Gaskell. (A number of the world's experts in psychiatric epidemiology helped to compile a list of the outstanding publications in the field. There are over 200 entries with summaries and comment.) Google Scholar
Weissman, M. M., Myers, J. K. & Ross, C. E. (eds) (1986) Community Surveys of Psychiatric Disorders (series in psychosocial epidemiology, vol. 4). New Brunswick, New Jersey: Rutgers University Press. (Contributors examine methodological issues involved in carrying out community surveys and evaluate a number of influential surveys undertaken over the past few decades. The NIMH Epidemiologic Catchment Area Program is described by Eaton and colleagues, and Assen Jablensky examines psychiatric epidemiology in the 1980s from a World Health Organization perspective. Other volumes in this series are entitled: Studies of Children; Stressful Life Events and Their Contexts; Symptoms, Illness Behavior, and Help-Seeking; Alcohol Patterns and Problems; Studying Drug Abuse; and Ethical Issues in Epidemiologic Research.) Google Scholar
Wing, J. K. (ed.) (1989) Health Services Planning and Research. Contributions from Psychiatric Case Registers. London: Gaskell.Google Scholar
Wing, J. K., Bebbington, P. & Robins, L. N. (eds) (1981) What is a Case? The Problem of Definition in Psychiatric Community Surveys. London: Grant Mclntyre.Google Scholar
Wing, J. K. & Hafner, H. (eds) (1973) Roots of Evaluation. London: Oxford University Press. (These proceedings of an international symposium sponsored by the World Psychiatric Association's Section of Epidemiology and Community Psychiatry outline the epidemiological basis for planning psychiatric services.) Google Scholar
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