THE EPIDEMIOLOGY OF PSYCHIATRIC-DISORDERS - PAST, PRESENT, AND FUTURE GENERATIONS

This paper briefly reviews the history of psychiatric epidemiology and the future direction. Five generations of studies are described, beginning in 1885 with a community study in Worchester. The second generation studies began after World War II and emphasized social epidemiology. The third generation incorporated the development of structured diagnostic assessments and led to the Epidemiologic Catchment Area study at five sites in the USA and to a number of epidemiological studies throughout the world using similar methods. The fourth generation included the new comorbidity survey, a national probability sample in the USA, which used an instrument capable of bridging DSM-III and ICD classification. The fifth generation began with the development of methods for a psychiatric epidemiological study of children. Future epidemiological studies need to include assessment of family psychiatry history as a risk factor, and promising biological markers. There needs to be regular monitoring to obtain accurate estimates of temporal changes in rates of psychiatric disorder.