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Psychiatrie et épidémiologie

Published online by Cambridge University Press:  28 April 2020

Eric Fombonne  and
Rebecca Fuhrer
Eric Fombonne*
Affiliation:
Psychiatre, Centro Alfred Binet, 76, avenue Edison – 75013 , Paris
Rebecca Fuhrer
Affiliation:
Chargée de Recherche, INSERM Unité, 169, 16, avenue Paul-Vaillant Couturier – 94807 , Villejuif Cédex
*
(adresse pour toute correspondance) (corresponding author)
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Résumé

L’épidémiologie psychiatrique s’est beaucoup développée depuis trente ans. Après avoir rappelé les définitions et méthodes fondamentales en épidémiologie, nous décrivons des progrès accomplis en épidémiologie psychiatrique. Parmi eux, la définition des cas, les techniques d’identification des cas, et la recherche de facteurs de risque sont présentés ici. Pour les illustrer, certaines connaissances actuelles sur les facteurs de risque dans la schizophrénie et la dépression sont brièvement décrits. Ensuite, les travaux en psychiatrie de l’enfant sont brièvement présentés en insistant sur quelques difficultés spécifiques à la recherche en pédopsychiatrie. Finalement, après avoir fait le point de la situation française, quelques opinions communes qui freinent l’essor de la recherche épidémiologique sont passées en revue. Les conclusions soulignent la possibilité et la nécessité de développer cette approche multi-disciplinaire en psychiatrie.

Summary

Summary

During the past thirty years, psychiatric epidemiology has evolved rapidly. We present some introductory concepts of the epidemiologic method that include discussion of the types of measures used, such as incidence and prevalence rates, and relative risks. We briefly introduce the principal study designs (follow-up or cohort studies, case control research) and comment on their advantages and drawbacks. Methodological advances have been achieved, especially with regard to case definition and case finding techniques. Different definitions of a case are reviewed, with special focus on the dichotomy between the dimensional and categorical approaches. Case finding techniques have evolved through the identification of different sources of error in information gathering and clinical reasoning. Research on risk factors is subsequently presented here from a general perspective. Several types of risk factors in psychiatry are enumerated, including genetic, biological factors and psychosocial variables. Then, risk factor research in schizophrenia and depression is briefly described and analyzed. This section highlights the advances which have been achieved in these diagnostic categories. Child psychiatry research issues are considered, and attention is drawn to problems related to the boundary between the normal and the pathological which is confounded by developmental factors. Nevertheless, several good studies have advanced the present State of knowledge and methods in child psychiatry research, and they are presented. The situational specificity of behavioral/ emotional disorders in childhood have led researchers to the conclusion that a two-stage design procedure is the most efficient in child psychiatric epidemiology. The importance of these studies for health Services planning is stressed. Finally, after an overview of the French situation in this field, we comment on frequently expressed opinions which tend to slow down the development of epidemiologic research. We specifically criticize the ideas that: - the epidemiologic approach can only be applied to quantitative and easily measured variables; - research Instruments or results from epidemiologic studies will be used in a negative or questionnable way; - classification and rigorous diagnostic categories are not useful. Conclusions draw attention to the possibility and importance of this multidisciplinary approach to research in psychiatry.

Keywords

Épidémiologie psychiatriqueFacteurs de risqueDéfinition d’un casPsychiatric epidemiologyRisk factorsCase definition
Type
Research Article
Information
Psychiatry and Psychobiology , Volume 1 , Issue 4 , 1986 , pp. 256 - 273
Copyright
Copyright © European Psychiatric Association 1986

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References

Bibliographie/References

Achenbach, T.M., Edelbrock, C.S.- The classification of child psychopathology: a review and analysis of empirical efforts. Psychol Bull 1978; 85: 1275–1301.CrossRefGoogle ScholarPubMed
Achenbach, T.M., Edelbrock, C.S.- Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monogr Soc Res Child Dev 1981; 188.Google ScholarPubMed
American Psychiatric Association - Diagnostic and statistical manual (3rd ed.). Washington DC, 1980.Google Scholar
D’Anthenaise, M., Salbreux, R.- Prévalence de la défi- cience mentale profonde chez l’enfant. Revue de la littérature, étude comparative. Neuropsychiatr Enfance, Adolesc 1979; 27 (1-2): 45–58.Google Scholar
Bailey, V., Graham, P., Boniface, D.- How much child psychiatry does a general practitioner do? J R Coll Gen Pract 1978;28:621–626.Google Scholar
Beck, A.T., Ward, C.H., Mendelson, M., Mock, J.E., Erbaugh, J.K.- Reliability of psychiatric diagnoses: 2. A study of consistency of clinical judgments and ratings. Am J Psychiatry 1962;119:351–357.CrossRefGoogle ScholarPubMed
Belmaker, R.H.- The lessons of platelet monoamine oxidase.psychol Med 1984; 14: 249–253.CrossRefGoogle ScholarPubMed
Boulenger, J.P., Zarifian, E.- Les marqueurs biologiques périphériques en psychiatrie : intérêt des études épidémiologiques? Rev Épidémiol Santé Publique 1985;33:361–367.Google Scholar
Boyd, J.H., Weissman, M.M.- Epidemiology of affective disorders. A reexamination and future directions. Arch Gen Psychiatry 1981 ,38: 1039–1046.CrossRefGoogle ScholarPubMed
Boyd, J.H., Pulver, A.E., Stewart W- Season of birth: schizophrenia and bipolar disorder. Schizophr Bull 1986; 12 (2): 173–186.CrossRefGoogle ScholarPubMed
Boyle, M.H., Jones, S.C.- Selecting measures of emotional and behavioral disorders of childhood for use in general populations. J Child Psychol Psychiatry 1985; 26 (1): 137–160.CrossRefGoogle ScholarPubMed
Brown, G.W., Birley, J.L.T.- Crises and life changes and the onset of schizophrenia. J Health Soc Behav 1968; 9 (3): 203–214.CrossRefGoogle ScholarPubMed
Brown, G.W., Harris, T.O.- Social origins of depression. A study of psychiatric disorder in women. Tavistock Publications, London, 1978.Google Scholar
Colvez, A., Michele Quemada, N.- Les maladies mentales et psycho-sociales dans la pratique libérale. Psychiatrie Française 1979; 1: 13–24.Google Scholar
Cooper, J.E., Kendell, R.E., Gurland, B.J., Sharpe, L., Copeland, J.R.M., Simon, R.- Psychiatric Diagnosis in Newrork and London. (U.S.-U.K. Diagnostic Project). Oxford University Press, London, 1972.Google Scholar
Cooper, J.E., Sartorius, N.- Cultural and temporal variations in schizophrenia: a speculation on the importance of industrializaron. Br J Psychiatry 1977;130:50–55.CrossRefGoogle Scholar
Copeland, J.- What is a ’case’? A case for what? in: Wing J.K., Bebbington P., Robins L.N. eds : What is a case? The problem of definition in psychiatric community surveys. Grant Me Intyre, London, 1981.Google Scholar
Davidson, F., Choquet M Le suicide de l‘adolescent. Étude épidémiologique. ESF, Paris, 1981.Google Scholar
Dohrenwend, B.P., Dohrenwend, B.S.- Social status and psychological disorder: a causal inquiry. John Wiley, New York, 1969.Google Scholar
Dohrenwend, B.S., Dohrenwend, B.P. eds. Stressful life events: their nature and effects. John Wiley, New York, 1974.Google Scholar
Dohrenwend, B.P., Dohrenwend, B.S.- Perspectives on the past and future of psychiatric epidemiology - The 1981 Rema Lapouse Lecture. Am J Public Health 1982; 72 (11): 1271–1279.CrossRefGoogle Scholar
Dohrenwend, B.S., Dohrenwend, B.P.- Life stress and psychopathology. In: Regier, D.A., Allen, G. eds. Risk factor research in the major mental disorders. NIMH, DHHS Pub. N°(ADM) 83-1068. Rockville, Md:the Institute, 1983.Google Scholar
Earls, F.- Prevalence of behavior problems in 3-year children: a cross national replication. Arch Gen Psychiatry 1980; 37: 1153–1157.10.1001/archpsyc.1980.01780230071010CrossRefGoogle ScholarPubMed
Eaton, W.W.- Demographic and social-ecologic risk factors for mental disorders. In: Regier, D.A., Allen, G. eds. Risk factor research in the major mental disorders. NIMH, DHHS Pub. N°(ADM) 83-1068. Rockville, Md: the Institute, 1983.Google Scholar
Eaton, W.W.- Epidemiology of schizophrenia. Epidemiol Rev 1985; 7: 105–126.CrossRefGoogle ScholarPubMed
Fagot-Largeault, A.-L‘homme bioéthique. Maloine, Paris, 1985.Google Scholar
Feighner, J.P., Robins, E., Guze, S.B., Woodruff, R.A., Winokur, G., Munoz, R.- Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 1972;26:57–63.CrossRefGoogle ScholarPubMed
Fombonne, E., Fuhrer, R.- Épidémiologie ct psychiatrie : questions de méthode. Sciences Sociales et Santé 1986; 4 (1): 97–117.CrossRefGoogle Scholar
Freeman, M.- A reliability study of psychiatric diagnosis in childhood and adolescence. J Child Psychol Psychiatry 1971;12:43–54.CrossRefGoogle ScholarPubMed
Fuhrer, R., Rouillon, F., Lemperiere, TH.- Epidemiology of depression among elderly patients seen in general practice. Presented at International Psychogeriatrics Association Workshop, Paris, 1986.Google Scholar
Gershon, E.S.- Genetic vulnerability in psychiatric epidemiology. In: Regier, D.A., Allen, G. eds. Risk factor research in the major mental disorders. NIMH, DHHS Pub. N°(ADM) 83-1068. Rockville, Md:the Institute, 1983.Google Scholar
Goldberg, D., Huxley, P.- Mental illness in the community. The pathway to psychiatric care. Tavistock Publications, London, 1980.Google Scholar
Gould, M.S., Wunsch-Hitzig, R., Dohrenwend, B.- Estimating the prevalence of childhood psychopathology: a critical review. J Am Academy Child Psychiatry 1981; 20:462–476.CrossRefGoogle ScholarPubMed
Graham, P., Rutter, M.- The reliability and validity of the psychiatric assessment of the child. Interview with the parent. Br J Psychiatry 1968;114:581–592.CrossRefGoogle ScholarPubMed
Hagnell, O.- A prospective study of the incidence of mental disorder. The Lundby Report. Svenske Bokförlaget, Norstedts, Stockholm, 1966.Google Scholar
Hollingshead, A.B., Redlich, F.C.-Social class and mental illness: a community study. John Wiley, New York, 1958.10.1037/10645-000CrossRefGoogle Scholar
Hughes, C.C., Tremblay, M., Rapoport, R.N., Leighton, A.H.- People of cove and woodlot. Basic Books, New York, 1960.Google Scholar
Ingham, J -Neurosis: discase or distress?In: Wing, J.K., Bebbington, P., Robins, L.N. eds. What is a case? The problem of definition in psychiatric community surveys. Grant Mc Intyre, London, 1981.Google Scholar
Institut National de la Santé et de la Recherche Médicale. Classification française des troubles mentaux, Paris 1968.Google Scholar
Jablensky, A.- Multicultural study on the nature of schizophrenia. Cambridge University Press, Cambridge, 1986.Google Scholar
Jablensky, A., Sartorius, N., Hirschfeld, R., Pardes, H.- Diagnosis and classification of mental disorders and alcohol -and drug- related problems: a research agenda for the 1980’s. Psychol Med 1983;13:907–921.Google Scholar
Jacobs, S., Myers, J.- Recent life events and acute schizophrenic psychosis: a controlled study. J Nerv Ment Dis 1976 ,162:75–87.CrossRefGoogle ScholarPubMed
Kety, S.S., Wender, P.H., Rosenthal, D.- Genctic relationships within the schizophrenia spectrum: evidence from adoption studics. In: Spitzer, L. et Klein, D.F. Eds. Critical Issues in Psychiatric Diagnoses. Raven Press, New York, 1978.Google Scholar
Langner, T.S., Gersten, J.C., McCarthy, E.D., Eisenberg, J.G.- A screening inventory for assessing psychiatric impairment in children 6 to 18. J Consult Clin Psychol 1976; 44: 286–296.CrossRefGoogle ScholarPubMed
Lapouse, R., Monk, M.A.- An epidemiologic study of behavior characteristics in children. Am J Public Health 1958;48: 1134–1144.CrossRefGoogle ScholarPubMed
Lapouse, R., Monk, M.A.- Fears and worries in a representative sample of children. Am J Orthopsychiatry 1959; 29: 803–818.CrossRefGoogle Scholar
Leighton, D.C., Harding, J.S., Macklin, D.B., Macmillan, A.M., Leighton, A.H.- The character of danger. Basic Books, New York, 1963.Google Scholar
Lemperiere, T., Ades, J.- Problèmes posés au médecin praticien par la dépression. Encéphale 1979; V, 483-490.Google Scholar
Links, P.S.- Community surveys of the prevalence of childhood psychiatric disorders: a review. Child Dev 1983;54:531–548.CrossRefGoogle ScholarPubMed
National Institute of Mental Health - The assessment of psychopathology and behavioral problems in children: A review of scales suitable for epidemiological and clinical research (1967- 1979). Series AN N° 1 - DHHS Publications N (ADM) 83-1037, Washington D.C. 1983.Google Scholar
Nunnally, J.C.-Psychometric theory. Mc Graw Hill, New York, 1978.Google Scholar
Pull, C.B., Pull, M.C., Pichot, P.- L.I.C.E.T.-S : une liste intégrée de critères d’évaluation taxinomiques pour les psychoses non-affectives. Journal de Psychiatrie Biologique et Thérapeutique 1981; 1: 33–37.Google Scholar
Pull, C.B., Pull, M.C., Pichot, P.- L.I.C.E.T.-D : une liste de critères d’évaluation taxinomiques pour les dépressions. Psychologie Médicale 1984; 16:125–131.Google Scholar
Richman, N., Stevenson, J.E., Graham, P.J.- Pre-school to school:a behavioral study. Academic Press, London, 1982.Google Scholar
Richman, N., Stevenson, J.E., Graham, P.J.- Prevalence of behaviour problems in 3-year old children: an epidemiological study in a London borough. J Child Psychol Psychiatry 1975; 16: 277–287.CrossRefGoogle Scholar
Roberts, R.E., Vernon, S.W.- Depression in the community. Prevalence and treatment. Arch Gen Psychiatry 1982; 39:1407–1409.10.1001/archpsyc.1982.04290120041008CrossRefGoogle ScholarPubMed
Robins, L.N., Helzer, J.E., Croughan, J.L., Ratcliff, K.S.- The NIMH Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry 1981; 38:381–389.CrossRefGoogle ScholarPubMed
Robins, L.N.- Psychiatric epidemiology. Arch Gen Psychiatry 1984; 41: 949–958.CrossRefGoogle Scholar
Robins, L.N., Helzer, J.E., Orvaschel, H., Anthony, J.C., Blazer, D.G., Burnam, A., Burke, J.D.-The diagnostic interview schedule. In: Eaton, W.W. et Kessler, L.G. eds. Epidemiologic field methods in psychiatry. The NIMH Epidemiologic Catchment Area Program. Academic Press, London, 1985.Google Scholar
Rothman, K.J.- Modern Epidemiology. Little, Brown and Company, Boston, 1986.Google Scholar
Rutter, M.- Diagnostic validity in child psychiatry. Adv Biol Psychiatry 1978; 2: 2–22.CrossRefGoogle Scholar
Rutter, M.- Epidemiological/longitudinal strategies and causal research in child psychiatry. J Am Academy Child Psychiatry 1981;20:513–544.CrossRefGoogle ScholarPubMed
Rutter, M., Graham, P.- The reliability and validity of the psychiatric assessment of the child: I. Interview with the child. Br J Psychiatry 1968;114:563–579.CrossRefGoogle ScholarPubMed
Rutter, M., Lebovici, S., Eisenberg, L., Sneznevski, A.V., Sadoun, R., Brooke, E., Lin, T.Y.- A tri-axial classification of mental disorders in childhood. An international study. J Child Psychol Psychiatry 1969; 10:41–61.10.1111/j.1469-7610.1969.tb02067.xCrossRefGoogle ScholarPubMed
Rutter, M., Tizard, J., Whitmore, K.- Education. health and behaviour. Longmans, London, 1970.Google Scholar
Rutter, M., Cox, A., Tupling, C., Berger, M., Yule, W.- Attainment and adjustment in two geographical areas: I. The prevalence of psychiatric disorders. Br J Psychiatry 1975a; 126:493–509.CrossRefGoogle Scholar
Rutter, M., Shaffer, D., Shepherd, M.- La classification multi-axiale des troubles psychiatriques de l'enfant. OMS, Genève, 1975b.Google Scholar
Rutter, M., Sandberg, S.- Epidemiology of child psychiatric disorder: methodological issues and some substantive findings. Child Psychiatry Hum Dev 1985; 15 (4): 209–233.CrossRefGoogle ScholarPubMed
Sadoun, R., Quemada, N.- Statistiques médicales des Services psychiatriques. Année 1978. Éditions Inserm, Paris, 1982.Google Scholar
Sartorius, N.- La dépression : épidémiologie et priorités pour les recherches futures. Encéphale 1981; VII: 527–533.Google Scholar
Shepherd, M.. Oppenheim, A.N., Mitchell, S.- Childhood behavior disorders and the child-guidance clinic: an epidemiological study. J Child Psychol Psychiatry 1966; 7: 39–52.CrossRefGoogle Scholar
Shepherd, M.- La découverte de la nature de la pellagre. Le- çons d’une recherche épidémiologique et psychiatrique remarquable. Acta Psychiatr Belg 1983; 83: 295–303.Google Scholar
Spitzer, R.L., Fleiss, J.L.- A re-analysis of thc reliability of Psychiatric diagnosis. Br J Psychiatry 1974;125:341–7.CrossRefGoogle Scholar
Spitzer, R.L., Endicott, J.- A diagnostic interview: the schedule for Affective Disorders and Schizophrenia. Arch Gen Psychiatry 1978;35:837–844.Google Scholar
Spitzer, R.L., Endicott, J., Robins, E.- Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978;35:773–782.CrossRefGoogle ScholarPubMed
Srole, L., Langner, T.S., Michael, S.T., Opler, M.K., Rennie, T.A.C.- Mental health in the metropolis: The Midtown Manhattan study. Mc Graw-Hill, New York, 1962.CrossRefGoogle Scholar
steffenburg, s., gillberg, C.- Autism and autistic-like conditions in Swedish rural and urban areas: A population study. Br J Psychiatry 1986, 149:81–87.CrossRefGoogle Scholar
Tennant, C.- Female vulnerability to depression. Psychol Med 1985; 15:733–737.CrossRefGoogle ScholarPubMed
Teuting, P., Koslow, S.H., Hirschfeld, R.M.A.- Special report on depression research. Science Reports, NIMH, Md, 1981.Google Scholar
Verhulst, FC., Akkerhuis, G.W., Althaus M - Mental Health in Dutch Children: (I) A cross cultural comparison. Acta Psychiatr Scand, Supplementum N°323 Vol 72, 1985a.CrossRefGoogle Scholar
Vhrhulst, F.C., Berden, G.F.M.G., Sanders-Woubstra, J.A.R - Mental Health in Dutch Children: (II) The prevalence of psychiatric disorder and relationship between measures. Acta Psychiatr Scand, Supplementum N°324 Vol 72, 1985b.Google Scholar
Vikan, A.- Psychiatric epidemiology in a sample of 1510 tenyear- old children-I. Prevalence. J Child Psychol Psychiatry 1985 ; 26 (1): 55–75.CrossRefGoogle Scholar
Weissman, M.M.- The myth of involutional melancholia. JAMA 1979a; 242: 742–744.10.1001/jama.1979.03300080040023CrossRefGoogle Scholar
Weissman, M.M.- The psychological treatment of depression: evidence for the efficacy psychotherapy alone, in comparison with, and in combination with pharmacotherapy. Arch Gen Psychiatry 1979b; 36: 1261–1269.CrossRefGoogle Scholar
Weissman, M.M., Klerman, G.L.- Sex differences and the epidemiology of depression. Arch Gen Psychiatry 1977a; 34: 98–111.CrossRefGoogle Scholar
Weissman, M.M., Klerman, G.L.- The chronic depressive in the community: unrecognized and poorly treated. Compr Psychiatry 1977b; 18: 523–532.CrossRefGoogle Scholar
Weissman, M.M., Klerman, G.L.- Epidemiology of mental disorders. Emerging trends in the United States. Arch Gen Psychiatry 1978; 35 : 705–712.CrossRefGoogle ScholarPubMed
Weissman, M.M., Myers, J.K., Thompson, W.D.- Depression and its treatment in a US urban community - 1975-1976. Arch Gen Psychiatry 1981; 38:417–421.CrossRefGoogle Scholar
Weissman, M.M., Leaf, P.J., Holzer, III C.E., Myers, J.K., Tischler, G.L.- The epidemiology of depression. An update on sex differences in rates. J Affective Disord 1984;7:179–188.CrossRefGoogle ScholarPubMed
Werry, J.S.- ICD-9 and DSM III classification for the clinician. J Child Psychol Psychiatry 1985; 26 (1): 1–6.CrossRefGoogle ScholarPubMed
Widlocher, D.- Le psychanalyste devant les problèmes de classification. Confrontations Psychiatriques 1984; 24: 141–156.Google Scholar
Wing, J.K., Cooper, J.E., Sartorius, N.- Measurement and classification of psychiatric symptoms. Cambridge University Press, London, 1974.Google Scholar
Wing, J.K., Mann, S.A., Leff, J.P., Nixon, J.M.- The concept of a ’case’ in psychiatric population surveys. Psychol Med 1978; 8: 203–217.CrossRefGoogle ScholarPubMed
Wing, J.K., Bebbington, P” Robins, L.N.- Theory-testing in psychiatric epidemiology. In: Wing, J.K., Bebbington, P., Robin, L.N. eds : What is a case? The problem of definition in psychiatric community surveys. Grant Mc Intyre, London, 1981.Google Scholar
Wing, J.K., Bebbington, P.- Epidemiology of depressive disorders in the community. J Affective Disord 1982; 4: 331–345.CrossRefGoogle Scholar
Yerushalmy, J.- Statistical problems in assessing methods of medical diagnosis, with special reference to X-ray techniques. Public Health Rep 1947; 62:1432–1449.CrossRefGoogle ScholarPubMed
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