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Book Forum   |    
Psychiatric Epidemiology
Reviewed by MING TSUANG; BRETT KIA-KEATING
Am J Psychiatry 2007;164:532-532.
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by Ezra Susser, Sharon Schwartz, Alfredo Morabia, and Evelyn J. Bromet. New York, Oxford University Press, 2006, 544 pp., $69.50.

This book presents an accessible discussion of the issues and methods involved in understanding the underlying causes of mental disorders. The authors utilize clear writing and compelling examples to present the material to the reader in a manner that is easily understood, yet interesting. The organization of the book presents the reader with a clear chronological understanding of how the field has developed and how it is continuing to develop. Furthermore, the critical issue of causality is addressed throughout the book, helping the reader to understand the important theoretical and practical difficulties confronting the field.

The book is divided into eight parts: 1) Psychiatric Epidemiology, Then and Now; 2) Risk Factors as Causes of Mental Disorders; 3) Cohort Designs in Psychiatric Epidemiology; 4) Case-Control Designs in Psychiatric Epidemiology; 5) Case-Control Designs in Biologic Psychiatry; 6) Analyzing the Data; 7) The Search for Genetic Causes of Mental Disorders; and 8) Complex Causal Relationships. Each section is then divided into small, easy to understand chapters (37 chapters in all). Despite the many different authors contributing to the various sections and chapters, the book maintains a fairly unified voice throughout.

The first two sections present an introduction into the field and discuss the evolution of epidemiology, as well as the concepts of risk factors and mental disorders. The next four sections present a discussion of conceptual and statistical methods for investigating causal relationships in the epidemiology of mental illness. These methods are then extended and challenged in the next two sections, broadening the analysis into the realm of genetics and discussing the complexities of the issue of causality.

During their discussion of the genesis and evolution of the field in the early chapters, the authors do a nice job of foreshadowing and integrating the future directions of epidemiology, which are covered in the last chapters of the book. This helps to create a cohesive vision of where the science has come from and where it is headed.

The authors not only address the positive aspects of the epidemiology of mental illness, but also discuss disadvantages. For example, they assert that although powerful new strategies for finding causes and improving public health have been found, important methods from previous eras have been neglected. After pointing out methodological challenges and theoretical weaknesses throughout the text, the authors address these issues in discussing what is needed in the future progress of the field of psychiatric genetics.

Although it utilizes several nice examples of psychiatric epidemiology throughout the text, this book is not meant to be a summary of past psychiatric epidemiology. Furthermore, although several sections of this volume present and discuss methods for psychiatric epidemiology, it should not be viewed as an exhaustive book on research design and statistical methods. However, it does provide a solid introduction to important techniques within the field.

Overall, this book presents psychiatric epidemiology in an accessible and engaging manner. The authors present the material in small, easily digestible, yet cohesive chapters and illustrate their points through the use of clear, interesting, and important historical examples. This text could serve as a nice bridge between introductory epidemiology texts and psychiatric epidemiology research. It presents a discussion of the evolution of psychiatric epidemiology as well as an introduction into the theoretical and methodological considerations involved in psychiatric epidemiology research. This book would be appropriate for a wide variety of audiences, but is most suited as an introductory text into the theory and method of psychiatric epidemiology.

Reprints are not available; however, Book Forum reviews can be downloaded at http://ajp.psychiatryonline.org.

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