The life course approach to physical health has been modelled in previous publications by Oxford University Press; this is the first book to apply the concept to the theory of the development of psychiatric illness. From the effect of population-wide lead levels on the prevalence of schizophrenia, to the genetic risk factors for starting smoking, this book provides a wide-ranging critical overview of current theories and evidence for the aetiology of common mental disorders. The approach – part epidemiology, part sociology, genetics, public health, psychology, child development, and more – appears to be uniquely suitable when analysing the complex reasons why people develop mental illness.
For example, in chapter 6 the aetiology of schizophrenia is discussed in depth: genetic risk factors are analysed; maternal lifestyle and illness in pregnancy addressed; childhood cognitive development discussed, as well as biological and social factors; and later-life risk factors analysed. Contributing data are critically analysed, and include recently published prospective cohort data and large population-based studies, as well as twin and retrospective studies. A similar approach is taken to each mental illness in turn, in each case thoroughly and clearly presented.
The most involving chapter is the final conclusion, which outlines the few published studies of interventions aimed at the prevention of mental illness in individuals vulnerable to, or even diagnosed with, psychiatric illness. The evidence presented is relatively sparse compared with the large studies described in earlier chapters, but the available data for multi-pronged lifestyle intervention in early life are so positive that we can only agree with the authors when they state that further research is merited.
The authors have produced a successful, comprehensive overview of current data around the multifactorial, ever-changing aetiology of mental illness. The life course approach will be of use to clinicians working in mental health when modelling the factors contributing to mental illness on a population-wide and individual level, and would be a valuable tool for developing new and exciting approaches to tackling mental illness at a local and national level.
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