W3-T1 Epidemiology of Mental Disorder Flashcards
define epidemiology
the branch of medicine that deals with the incidence and transmission of disease in populations, especially with the aim of controlling it (Oxford English Dictionary)
the study (scientific, systematic) of the distribution (frequency) and determinants (causes, risk factors) of health-related states (not only disease) or events in specified populations (community), and the application (discipline within public health) of this study to the control of health problems (Dictionary of Epidemiology)
–> not only related to disease, but road traffic accidents can also be one too. as long as related to the major public health problems
what epidemiology involves
– defining disorder
– counting and mapping disorder in place and time
– link the occurrence of disorder to potential causative factors
– identify appropriate public health intervention
define descriptive epidemiology
prevalence
incidence
variation between populations
comorbidities
burden of disorder
define analytical epidemiology
causes
what was the story of John Snow and the Broad
Street pump illustrated
epidemiological thinking (descriptive perspective)
define the finding from a study by Doll and Hill in regard to death rates from lung cancer amongst doctors
using analytical perspective method
they found a straight-line relationship between the number of cigarettes and cancer deaths, which proved a very strong argument for something in cigarettes causing lung cancer.
define psychiatric epidemiology
a branch of epidemiology that looks at the distribution of mental disorders in the population
understand the onset, cause, and outcomes of mental disorders,
measure the burden on society
identify causal mechanisms
describe basic concepts in psychiatric epidemiology
caseness – define the presence of a mental disorder as defined by operational criteria
incidence – transition to caseness over a defined time period
prevalence – the proportion of people who are cases at the time
how epidemiology is defined from descriptive perspective?
By identifying the population
By sampling the case
By having structured interviews
Most of the mental disorder case use DSM as the structure including conducting the interview
Diagnostic criteria are reliable but have contested validity
How epidemiology is defined from analytical perspective
Break the population down in a structured fashion
Identify variables to be measured
Apply methodology
(may involve a variety of different methodologies, from a population-based survey, to case-control studies, where we compare identified cases with non-cases for the presence of a variable of interest
what are the limitations of the classic US epidemiology of mental disorder studies?
Epidemiological Catchment Area Studies (1980)
National Comorbidity Study (1990)
National Comorbidity Study Replication (2000)
they don’t tell us anything useful about low-prevalence disorders like schizophrenia
missed out on mental disorders in the elderly, which are a very important source of societal burden in advanced countries
despite their limitations, the studies have been seminal (influential) and are very important.
what are the findings from the recent National Comorbidity Study Replication (NCSR)
mental disorders are common (no less than 26% lifetime prevalence, 27% shows 12 months period prevalence)
are of early onset (75% began at age 24)
serious or moderate severity
comorbidity (disease/condition) is common
access to treatment is limited
what prevalence data has to include to make it comprehensive
population-based surveys
administrative data
define the study and finding from Wittchen and Jacobi in relation to mental disorders in Europe
Study method: widened the range and scope of disorders
result:
– 27% of the adult EU population affected by mental disorder in the past 12 months
– little evidence for considerable cultural or county variation
most frequent: anxiety, depression, , somatoform, and substance dependent disorders
what Wittchen and Jacobi conclude from disability and treatment
association of all mental disorders with a considerable disability burden in terms of the number
of work days lost
generally low utilisation and treatment rates (only 26% consult with professional)
