The checkered history of American psychiatric epidemiology.

Publisher: Blackwell Publishers Country of Publication: United States NLM ID: 8607003 Publication Model: Print Cited Medium: Internet ISSN: 1468-0009 (Electronic) Linking ISSN: 0887378X NLM ISO Abbreviation: Milbank Q Subsets: MEDLINE

Publication: Malden, MA : New York, NY : Blackwell Publishers ; Milbank Memorial Fund
Original Publication: New York, NY : Published for the Milbank Memorial Fund by Cambridge University Press, c1986-

Epidemiology/*history ; Mental Disorders/*history ; Mental Health Services/*history ; Psychiatry/*history; Diagnostic and Statistical Manual of Mental Disorders ; History, 19th Century ; History, 20th Century ; History, 21st Century ; Hospitals, Psychiatric/history ; Humans ; Mental Competency/classification ; Mental Disorders/classification ; Mental Disorders/epidemiology ; Mental Health Services/organization & administration ; Psychiatry/standards ; United States

Context: American psychiatry has been fascinated with statistics ever since the specialty was created in the early nineteenth century. Initially, psychiatrists hoped that statistics would reveal the benefits of institutional care. Nevertheless, their fascination with statistics was far removed from the growing importance of epidemiology generally. The impetus to create an epidemiology of mental disorders came from the emerging social sciences, whose members were concerned with developing a scientific understanding of individual and social behavior and applying it to a series of pressing social problems. Beginning in the 1920s, the interest of psychiatric epidemiologists shifted to the ways that social environments contributed to the development of mental disorders. This emphasis dramatically changed after 1980 when the policy focus of psychiatric epidemiology became the early identification and prevention of mental illness in individuals.
Methods: This article reviews the major developments in psychiatric epidemiology over the past century and a half.
Findings: The lack of an adequate classification system for mental illness has precluded the field of psychiatric epidemiology from providing causal understandings that could contribute to more adequate policies to remediate psychiatric disorders. Because of this gap, the policy influence of psychiatric epidemiology has stemmed more from institutional and ideological concerns than from knowledge about the causes of mental disorders.
Conclusion: Most of the problems that have bedeviled psychiatric epidemiology since its inception remain unresolved. In particular, until epidemiologists develop adequate methods to measure mental illnesses in community populations, the policy contributions of this field will not be fully realized.
(© 2011 Milbank Memorial Fund.)

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Date Created: 20111223 Date Completed: 20120209 Latest Revision: 20240318

20240318

PMC3250636

10.1111/j.1468-0009.2011.00645.x

22188350