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Single spies and battalions: the clinical epidemiology of mental disorders1

Published online by Cambridge University Press:  09 July 2009

Brian Cooper
Brian Cooper*
Affiliation:
Department of Epidemiological Psychiatry, Central Institute of Mental Health, Mannheim, Germany
*
2Address for correspondence: Dr Brian Cooper, Section of Old Age Psychiatry, Institute of Psychiatry, De Crespigny Park, London SE5 8AF.
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Synopsis

Clinical epidemiology, a term that has been variously defined, is used here to refer to a discipline which, commencing with examination and diagnosis of the individual patient who presents in medical practice, proceeds to study the occurrence of similar, possibly connected cases in the local community, and in so doing may provide hypotheses for population-based studies of disease and its risk factors. While the relevance of this discipline to the modern practice of clinical psychiatry remains largely unexplored, its importance in the search for causes of mental disorder is attested by many instances, both historical and more recent, in which the spread or clustering of psychiatric syndromes in populations could be related to nutritional deficiency, infectious disease, the presence of environmental neurotoxins, the social communication of psychopathology or the transmission of abnormal, harmful behaviour patterns within family groups. Observations made in clinical practice have repeatedly served as the starting point for epidemiological investigation of mental disorders, while conversely epidemiological findings have influenced clinical thinking about their classification, diagnosis, prognosis and morbid risk. A review of the relevant literature underlines the need for a keener awareness of environmental risk factors and a fundamentally epidemiological frame of reference in trying to grapple with the aetiological problems of mental disorder.

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 4 , November 1993 , pp. 891 - 907
Copyright
Copyright © Cambridge University Press 1993

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Footnotes

1

This paper is based on a lecture given at the Annual Congress of the Royal Australian and New Zealand College of Psychiatrists, Canberra, Australia, September 1992.

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