Geography of U.S. Psychiatric Disease by MEDLINE Publications, 1990–1997

To the Editor: Thompson (1) recently evaluated the rates of MEDLINE publications from individual states in the United States. When they were normalized by resident populations, he found that several smaller states (Vermont, Washington, Maryland, Massachusetts, and Iowa) outperformed larger states in the number of MEDLINE publications per year per each 100,000 of the population. Benzer et al. (2) showed similar results on an international scale by using EMBASE publications. Curious as to how a subspecialty analysis might compare on a nationwide basis, we evaluated MEDLINE publications on psychiatric disease that were normalized by state populations.

The MEDLINE database was searched through the Internet provider PUBMED during the week of March 10–14, 1999. By means of the advanced search option, the “publication” field was searched for the dates 1990 to 1997. Next, the MSH field was searched for the term “mental disorders.” This was limited to human studies only and combined with a search of the “author affiliation” field for each individual state. Population data were obtained from the Population Estimates Program’s Bureau of the Census Web site.

The map provides a color-coded breakdown of individual states by quintiles. States that appear in the orange group include Maryland, Massachusetts, Vermont, Rhode Island, New York, Washington, and Iowa. States that ranked high in publications dealing with psychiatric disorders that were not ranked high for total biomedical publications included Rhode Island and New York. New York, in particular, had a high number of total psychiatry publications (615 per year) and per population (34 publications per year per each 1 million of the population).

There are obvious limitations to this analysis. Simple publication numbers such as these are crude estimates of the research and scholarship among states. In addition, these data reflect neither the quality nor the usefulness of the published articles. The data do highlight those states that are active in research and scholarship in psychiatric illness.