精神疾病流行病学：挑战与机遇
Psychiatric epidemiology: challenges and opportunities.
作者信息
Kessler Ronald C
机构信息
Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.
出版信息
Int Rev Psychiatry. 2007 Oct;19(5):509-21. doi: 10.1080/09540260701564914.
This paper discusses challenges and prospects for increasing the clinical relevance of psychiatric epidemiological research. The discussion begins with a review of the structural determinants of the fact that current psychiatric epidemiological research has less clinical relevance than epidemiological research in other areas of medicine. The discussion then turns to ways in which the focus of psychiatric epidemiological research might be changed to increase its clinical relevance. A review is then presented of recent innovations in community psychiatric epidemiological research that were designed to increase clinical relevance. An argument is then made that the full clinical value of psychiatric epidemiology will only be realized when community epidemiology becomes better integrated with clinical epidemiology and the latter takes on a more prominent role than it currently has in psychiatric research. Existing initiatives to realize an integration of community psychiatric epidemiology with clinical epidemiology are then reviewed. Finally, an agenda is proposed for an expansion of clinical psychiatric epidemiology to include a focus on both naturalistic and quasi-experimental studies of illness course and treatment response in diverse clinical samples.
本文探讨了提高精神科流行病学研究临床相关性所面临的挑战与前景。讨论首先回顾了当前精神科流行病学研究的临床相关性低于其他医学领域流行病学研究这一事实的结构决定因素。接着讨论了改变精神科流行病学研究重点以提高其临床相关性的方法。随后介绍了旨在提高临床相关性的社区精神科流行病学研究的近期创新成果。然后提出一个观点，即只有当社区流行病学与临床流行病学更好地整合，且后者在精神科研究中发挥比目前更突出的作用时，精神科流行病学的全部临床价值才能得以实现。接着回顾了现有的将社区精神科流行病学与临床流行病学整合的举措。最后，提出了一个扩大临床精神科流行病学的议程，包括关注不同临床样本中疾病进程和治疗反应的自然主义和准实验研究。
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