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Textbook of Psychiatric Epidemiology, 3rd Edition

Ming T. Tsuang (Editor), Mauricio Tohen (Editor), Peter Jones (Editor)
ISBN: 978-0-470-69467-1
660 pages
April 2011
Textbook of Psychiatric Epidemiology, 3rd Edition (047069467X) cover image


The new edition of this critically praised textbook continues to provide the most comprehensive overview of the concepts, methods, and research advances in the field; particularly the application of molecular genomics and of neuroimaging. It has been revised and enhanced to capitalize on the strengths of the first and second editions while keeping it up-to-date with the field of psychiatry and epidemiology. This comprehensive publication now includes chapters on experimental epidemiology, gene-environment interactions, the use of case registries, eating disorders, suicide, childhood disorders and immigrant populations, and the epidemiology of a number of childhood disorders.

As in the first and second editions, the objective is to provide a comprehensive, easy to understand overview of research methods for the non-specialist. The book is ideal for students of psychiatric epidemiology, psychiatric residents, general psychiatrists, and other mental health professionals.

The book features a new editor, Peter Jones, from the University of Cambridge, who joins the successful US team of Ming Tsuang and Mauricio Tohen.

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Table of Contents

List of Contributors.

1 Introduction to epidemiologic research methods (Glyn Lewis).

1.1 What is epidemiology?

1.2 Causation in medicine.

1.3 Causal inference.

1.4 The future for psychiatric epidemiology.

2 Analysis of categorical data: The odds ratio as a measure of association and beyond (Garrett M. Fitzmaurice and Caitlin Ravichandran).

2.1 Introduction.

2.2 Inference for a single proportion.

2.3 Analysis of 2 x 2 contingency tables.

2.4 Analysis of sets of 2 x 2 contingency tables.

2.5 Logistic regression.

2.6 Advanced topics.

2.7 Concluding remarks.

2.8 Further reading.

3 Genetic epidemiology (Stephen V. Faraone, Stephen J. Glatt and Ming T. Tsuang).

3.1 Introduction.

3.2 The chain of psychiatric genetic research.

3.3 Psychiatric genetics and psychiatric epidemiology.

4 Examining gene–environment interplay in psychiatric disorders (Judith Allardyce and Jim van Os).

4.1 Introduction.

4.2 The process of genetic epidemiology.

4.3 Gene–environment interplay takes different forms.

4.4 Gene–environment correlation.

4.5 Gene–environment interaction.

4.6 Measurement of genotype, environmental exposure and pathological phenotype.

4.7 Models of GxE.

4.8 Which scale should we use to measure GxE?

4.9 Study designs for the detection of GxE.

4.10 Threats to the validity of epidemiological GxE studies.

4.11 Epigenetic mechanisms.

5 Reliability (Patrick E. Shrout).

5.1 Introduction.

5.2 The reliability coefficient.

5.3 Designs for estimating reliability.

5.4 Statistical remedies for low reliability.

5.5 Reliability theory and binary judgements.

5.6 Reliability statistics: General.

5.7 Other reliability statistics.

5.8 Summary and conclusions.

6 Moderators and mediators: Towards the genetic and environmental bases of psychiatric disorders (Helena Chmura Kraemer).

6.1 Introduction.

6.2 Current methodological barriers.

6.3 Moderation, mediation and other ways in which risk factors 'work together'.

6.4 Extensions.

6.5 Beyond moderators and mediators.

7 Validity: Definitions and applications to psychiatric research (Jill M. Goldstein, Sara Cherkerzian and John C. Simpson).

7.1 Introduction.

7.2 Validity of a construct.

7.3 Validity of the relationships between variables.

7.4 Summary.

8 Use of register data for psychiatric epidemiology in the Nordic countries (Jouko Miettunen, Jaana Suvisaari, Jari Haukka and Matti Isohanni).

8.1 Introduction.

8.2 Registers for use in psychiatric research.

8.3 Register research in Denmark.

8.4 Register research in Finland.

8.5 Register research in Norway.

8.6 Register research in Sweden.

8.7 Discussion.

9 An introduction to mental health services research (Anna Fernandez, Alejandra Pinto-Meza, Antoni Serrano-Blanco, Jordi Alonso and Josep Maria Haro).

9.1 Introduction.

9.2 What is mental health services research?

9.3 A framework for mental health services research.

9.4 Key concepts in mental health services research.

9.5 Examples of mental health services research studies.

9.6 Conclusion.

10 The pharmacoepidemiology of psychiatric medications (Philip S. Wang, Alan M. Brookhart, Christine Ulbricht and Sebastian Schneeweiss).

10.1 Introduction.

10.2 Overview of psychopharmacoepidemiology.

10.3 Sources of data.

10.4 Examples of recent psychopharmacoepidemiologic studies.

10.5 Conclusions.

11 Peering into the future of psychiatric epidemiology (Michaeline Bresnahan, Ezra Susser, Dana March and Bruce Link).

11.1 Introduction.

11.2 Levels of causation: A historical overview.

11.3 Levels of causation.

11.4 Causation over (life) time.

11.5 Examples.

11.6 Framing the future.

12 Studying the natural history of psychopathology (William W. Eaton).

12.1 Introduction.

12.2 Onset.

12.3 Course.

12.4 Outcome.

12.5 Methodological concepts for studying the natural history of psychopathology.

12.6 Conclusion.

13 Symptom scales and diagnostic schedules in adult psychiatry (Jane M. Murphy).

13.1 Introduction.

13.2 North American instruments for epidemiological research.

13.3 North American instruments for psychiatric services and primary care.

13.4 European instruments for psychiatric services and primary care.

13.5 European instruments for epidemiological research.

13.6 Summary.

14 The National Comorbidity Survey (NCS) and its extensions (Ronald C. Kessler).

14.1 Introduction.

14.2 The baseline NCS.

14.3 The NCS follow-up survey (NCS-2).

14.4 The NCS replication survey (NCS-R).

14.5 The NCS-R adolescent supplement (NCS-A).

14.6 The WHO WMH Surveys.

14.7 Overview.

15 Experimental epidemiology (John R. Geddes).

15.1 Introduction.

15.2 Limitations of non-randomised evidence.

15.3 RCTs: The translation of the experimental design into the real world.

15.4 Importance and control of systematic error or bias.

15.5 Importance and control of random error and noise.

15.6 Reporting the results of clinical trials—the CONSORT statement.

15.7 Different clinical questions will prioritise control of different threats to validity and confidence.

15.8 The classification of RCTs.

15.9 Effectiveness trials in schizophrenia.

15.10 Department of Veterans Affairs co-operative study on the cost-effectiveness of Olanzapine (Rosenheck).

15.11 The clinical antipsychotic trials of intervention effectiveness (CATIE) study.

15.12 Cost utility of the latest antipsychotic drugs in schizophrenia study (CUtLASS 1).

15.13 European first-episode schizophrenia trial (EUFEST).

15.14 The size and cost of experimental studies in psychiatry.

15.15 Clinical trials in the future.

16 Epidemiology of Schizophrenia (William W. Eaton, Chuan-Yu Chen and Evelyn J. Bromet).

16.1 Introduction.

16.2 Methods.

16.3 The burden of schizophrenia.

16.4 Natural history.

16.5 Demographic correlates.

16.6 Social risk factors.

16.7 Biological risk factors.

16.8 Prevention.

16.9 Discussion.

17 Epidemiology of depressive disorders (Deborah S. Hasin, Miriam C. Fenton and Myrna M. Weissman).

17.1 Introduction.

17.2 Major depression.

17.3 Dysthymia.

17.4 Summary.

18 Epidemiology of anxiety disorders (Ewald Horwath, Felicia Gould and Myrna M. Weissman).

18.1 Introduction.

18.2 Anxiety disorders.

18.3 Panic disorder.

18.4 Agoraphobia.

18.5 Social phobia.

18.6 Generalised anxiety disorder.

18.7 Obsessive–compulsive disorder.

18.8 Anxiety and affective disorders and mass disasters.

18.9 Future developments.

19 Epidemiology of bipolar disorder in adults and children (Kathleen R. Merikangas and Mauricio Tohen).

19.1 Introduction.

19.2 Epidemiology of bipolar disorder.

19.3 Patterns of comorbidity of bipolar disorder.

19.4 Risk Factors.

19.5 Future directions.

19.6 Summary.

20 Epidemiology of eating disorders (Tracey D. Wade, Anna Keski-Rahkonen and James I. Hudson).

20.1 Introduction.

20.2 Case definition.

20.3 Major prevalence studies.

20.4 Incidence studies.

20.5 Comorbidity.

20.6 Mortality from eating disorders.

20.7 Risk factors.

20.8 Future directions.

21 Epidemiology of alcohol use, abuse and dependence (Deborah A. Dawson, Ralph W. Hingson and Bridget F. Grant).

21.1 Introduction.

21.2 Population estimates of per capita consumption.

21.3 Survey-based estimates of the prevalence of drinking.

21.4 Alcohol-related mortality and morbidity.

21.5 Alcohol and injury.

21.6 Alcohol and chronic disease.

21.7 Diagnostic classification of alcohol use disorders.

21.8 Population estimates, prevalence, incidence and natural course of alcohol use disorders.

21.9 Comorbidity of DSM-IV alcohol use disorders and other psychiatric disorders.

21.10 Summary.

22 Epidemiology of illicit drug use disorders (Wilson M. Compton, Marsha F. Lopez, Kevin P. Conway and Yonette F. Thomas).

22.1 Introduction.

22.2 Drug consumption.

22.3 Definitions.

22.4 Rates of DSM-IV abuse and dependence.

22.5 Global rates of drug use disorders.

22.6 Comorbidities with psychiatric conditions.

22.7 Genetic epidemiology.

22.8 Future opportunities.

22.9 Conclusions.

22.10 Disclaimer.

23 The epidemiology of personality disorders: Findings, methods and concepts (Michael J. Lyons, Beth A. Jerskey and Margo R. Genderson).

23.1 Introduction.

23.2 Substantive findings.

23.3 Course, prognosis and developmental issues.

23.4 Treated prevalence.

23.5 Prevalence of specific personality disorders.

23.6 Antisocial personality disorder.

23.7 Conceptual issues.

23.8 Models of personality disorder.

23.9 Methodological issues.

23.10 Future directions.

24 The epidemiology of depression and anxiety in children and adolescents (Kathleen Ries Merikangas and Erin F. Nakamura).

24.1 Introduction.

24.2 Magnitude of depression and anxiety in children and adolescents.

24.3 Correlates and risk factors.

24.4 Service patterns and impact.

24.5 Summary.

25 Epidemiology of attention deficit hyperactivity disorder (Stephen V. Faraone).

25.1 Introduction.

25.2 Prevalence of ADHD.

25.3 Pharmacoeconomics of ADHD.

25.4 Comorbid psychiatric disorders.

25.5 Demographic risk factors.

25.6 Genetic risk factors.

25.7 Environmental risk factors for ADHD.

25.8 Summary and conclusions.

25.9 Future directions.

26 The epidemiology of autism (Gregory S. Liptak).

26.1 Introduction.

26.2 Background.

26.3 Definition and diagnosis.

26.4 Natural history.

26.5 Prevalence.

26.6 Risk factors.

26.7 Genetic factors.

26.8 Public health impact.

26.9 Associations and causal factors.

26.10 Future directions.

26.11 Summary.

27 Mental illness, women, mothers and their children (Kathryn M. Abel and Vera A. Morgan).

27.1 Introduction.

27.2 The epidemiology of mental illness in women of reproductive age.

27.3 Fertility and fecundity in women with mental illness.

27.4 Maternal mental illness at the time of conception and during pregnancy.

27.5 Gene–environment interactions and offspring outcomes.

27.6 Obstetric complications and risk of adult onset mental disorder in offspring.

27.7 Parental condition.

27.8 Motherhood and perinatal mental illness.

27.9 Designing studies examining the relationship between maternal mental illness and outcomes for their children.

27.10 Conclusions.

28 Epidemiology of suicide and attempted suicide(Dianne Currier and Maria A. Oquendo).

28.1 Introduction.

28.2 Definitions.

28.3 Prevalence of suicide and attempted suicide.

28.4 Risk factors for suicide and attempted suicide.

28.5 Protective factors.

28.6 Conclusions.

29 Epidemiology and geriatric psychiatry (Celia F. Hybels and Dan G. Blazer).

29.1 Introduction.

29.2 Issues of case identification.

29.3 The distribution of cases.

29.4 Aetiological studies.

29.5 Outcome studies.

29.6 Historical trends in the epidemiology of psychiatric disorders in late life.

29.7 Use of health care services.

30 Recent epidemiological studies of psychiatric disorders in Japan (Masayoshi Kawai, Kenji J. Tsuchiya and Nori Takei).

30.1 Introduction.

30.2 Schizophrenia.

30.3 Affective disorders.

30.4 Autism and autism spectrum disorder.

30.5 Summary.

31 Epidemiology of migration and serious mental illness: The example of migrants to Europe (Monica Charalambides, Craig Morgan and Robin M. Murray).

31.1 Introduction.

31.2 Defining the constructs.

31.3 High rates of psychosis in migrants: A genuine finding or methodological artefact?

31.4 Possible explanations.

31.5 Biological considerations.

31.6 Cannabis use.

31.7 Adverse social experiences.

31.8 Mechanisms.

31.9 Implications.

32 Epidemiology of migration substance use disorder in Latin American populations and migration to the United States (Marıa Elena Medina-Mora, Guilherme Borges, Tania Real and Jorge Villatoro).

32.1 Introduction.

32.2 Definitions: What do we understand by migration?

32.3 Countries of origin: Social, political and other reasons that trigger migration.

32.4 Living conditions of migrants in the United States.

32.5 Alcohol and drug use in countries of origin and receiving communities.

32.6 Dependence and treatment rates.

32.7 The process of migrating.

32.8 Migration, substance use and access to services.

32.9 Returning migrants and families left behind.

32.10 Conclusions.

33 Early detection and intervention as approaches for preventing schizophrenia (Ming T. Tsuang, William S. Stone, Margo Genderson and Michael Lyons).

33.1 Introduction.

33.2 Modelling genetic and phenotypic heterogeneity.

33.3 Defining a syndrome of liability using cognitive and clinical characteristics of relatives.

33.4 Gene-based vs. genome-based research.

33.5 Future directions.

33.6 Clinical implications.




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Author Information

Dr. Ming Tsuang is Behavioral Genomics Endowed Chair and University Professor, University of California and Distinguished Professor of Psychiatry and Director, Center for Behavioral Genomics, Department of Psychiatry, University of California, San Diego. He also directs the Harvard Institute of Psychiatric Epidemiology and Genetics. He was Stanley Cobb Professor of Psychiatry and Chairman, Department of Psychiatry, Harvard Medical School at Massachusetts Mental Health Center, where he served as superintendent and president of Massachusetts Mental Health Institute of Psychiatry. He received his M.D. degree from National Taiwan University and his Ph.D. in Psychiatric Genetics and Doctor of Science in Genetics Epidemiology from the University of London. He has been recognized worldwide for his research in schizophrenia, manic-depressive illness and substance abuse.
He is a member of the Institute of Medicine, National Academy of Sciences, and served on the National Advisory Mental Health Council, U.S. Department of Health and Human Services. He has been elected Fellow of the American Psychiatric Association, American College of Psychiatrists, and British Royal Society of Psychiatrists, Fellow and former President of the American Psychopathological Association. He is a Council Member of the Taiwan National Health Research Institute, and Academician, Academia Sinica of Taiwan, the highest academic institution in Taiwan. He is currently the President of the International Society of Psychiatric Genetics.
Dr. Tsuang is the recipient of a myriad of awards for his work, among them: the Rema Lapouse Award for Mental Health Epidemiology, the American Public Health Association; the Stanley Dean Award for Research in Schizophrenia, the American College of Psychiatrists; the National Institute of Mental Health Merit Award; the Noyes Award for Research in Schizophrenia; the National Alliance for Research on Schizophrenia and Depression Distinguished Investigator Award; and the Paul H. Hoch Award, the American Psychopathological Association. Dr. Tsuang also received the Lifetime Achievement Award from the International Society of Psychiatric Genetics, the Taiwanese-American Award for Achievement in Science and Engineering, the Gold Medal Award from the Society of Biological Psychiatry for pioneering contributions in the field of biological psychiatry, and the Award for Research in Psychiatry, the American Psychiatric Association.
He has authored or co-authored over 600 publications, including peer review journal papers, book chapters and books in the areas of psychiatric epidemiology and genetics, including major psychoses and substance abuse and spiritual health. In addition to serving on many editorial boards of scientific journals, he is currently the Senior Editor for Neuropsychiatric Genetics, a section of the American Journal of Medical Genetics.

Dr. Mauricio Tohen obtained his MD degree from the National University of Mexico. He completed a residency in Psychiatry at the University of Toronto and a Fellowship in Psychopharmacology at McLean Hospital, Harvard Medical School. He obtained his doctorate in Epidemiology from the Harvard School of Public Health and an MBA from the University of Indiana. From 1988 to 1997 he was the clinical Director of the Bipolar and Psychotic Disorders Program at McLean Hospital. From 1997 to 2008 he worked at Lilly Research Laboratories in Indianapolis, Indiana where he reached the most senior scientific rank of Distinguished Lilly Scholar. In 2009 he was appointed to the Krus endowed chair in Psychiatry at the University of Texas Health Science Centre at San Antonio. His research has focused on the clinical epidemiology and psychopharmacological treatments of bipolar disorder. Professor Tohen has over 200 original publications and over 500 book chapters and scientific abstracts. He has co-edited Mood Disorders Across the Lifespan and Bipolar Psychopharmacology, and has also edited Comorbidity in Affective Disorders.

Professor Peter Jones is Head of the Department of Psychiatry at the University of Cambridge. His particular clinical interest is in psychotic illness and asking questions about causes and treatment. His research concerns lifecourse influences on adult mental health and illness, and the interface between population-based and biological investigation and explanations.
He is a member of the Wellcome Trust Clinical Epidemiology Research Board and the HTA Commissioning Board.

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"The Textbook of Psychiatric Epidemiology is a timely, up-to-date, and comprehensive book covering all aspects of the science of epidemiology as related to psychiatric disorders. Overall, this is a well written, wel-organized book that I highly recommend to all psychiatrists and neuroscientists who are interested in the underpinning of psychiatric epidemiology." (Journal of Clinical Psychiatry, 2013)

“Overall, this book provides a thorough and understandable introduction to the field of psychiatric epidemiology, suitable for students wishing to become familiar with up-to-date applications and findings in psychiatry as they relate to public health and epidemiology.”  (Doody’s, 6 April 2012)

"This 3rd edition is a welcome return for this informative textbook, which will be of interest to a wide readership through its extensive scope. It covers a range of areas relevant to epidemiology and beyond with what is now the standard format involving expert authors or teams." (Acta Psychiatrica Scandinavica, 2012)

"So I started this review process with a great deal of skepticism. However, during this process I have ended up reading about areas outside my own main research field with much interest, and chapters within my own areas with much pleasure and admiration for the contributions; and, I have found myself recommending individual chapters again and again to students and other people with whom I, during this period, have discussed specific projects. So, much to my own surprise, I end up warmly recommending this book to anyone who has a professional interest in the epidemiology of, and risk factors for psychiatric disorders, and a recurring need for a fast reference to a very comprehensive array of knowledge." Read the full review. (Acta Neuropsychiatrica, 2012)


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