If I were arriving from another galaxy, knew nothing about psychiatric epidemiology, and was handed this book, how would I react?
My first response would be to note that psychiatric epidemiology is a complex field with detailed discussions of method, assessment, major disorders, and special populations. Also, the field is evolving, from risk assessment to examination of the roles of family, community, and institutions in protecting against mental disorder. We may, in fact, be on the cusp of “resilience” and “recovery” epidemiology.
My second response would be to gauge the level of our knowledge. Clearly, the National Comorbidity Survey gives us an excellent overview of the prevalence of disorders. But what about incidence? Should that not be part of our national studies? And what of the problems in assessing annual and lifetime prevalence? Are we not willing to make the financial investment necessary to develop the knowledge needed to prevent psychiatric disorders?
My third response would be to examine how fully the field has embraced the role of genetics in the transmission of disorder. The text includes a good methods paper on psychiatric genetics. But where is this field going? Are we prepared to exploit the exponential expansion in knowledge of genetics? Are psychiatric epidemiologists appropriately trained for this new world?
Returning control to earth for a few minutes, I think Tsuang and Tohen are to be congratulated for undertaking this second edition of Textbook in Psychiatric Epidemiology. It will be very useful to field researchers, students, and interested parties from the policy community. Most leading researchers from the psychiatric epidemiology community are represented. In addition, the text flows logically from approach to content.
Some of the findings, however, are dated (a chronic problem in the mental health statistical community not specific to this text). More needs to be done on the role of technology in conducting community epidemiologic surveys. Very little is said about international work. Moreover, we need to develop data standards for the field so that states and communities can conduct comparable surveys with comparable results.
In my day-to-day work at the Center for Mental Health Services, I am asked one or more questions about psychiatric epidemiology every day. I have the Epidemiologic Catchment Area Study and the National Comorbidity Survey at my side and a picture of Dr. Morton Kramer on my wall. At least twice a week, however, I am asked about topics for which the field does not currently have answers. The topic can be children’s disorders, the relation between prevalence and need, or a host of other important issues.
Now, as I leave for my home galaxy, I will take Tsuang and Tohen with me. I know that this text contains the tools to find the answers that I will need.
