Henderson A S
NHMRC, Social Psychiatry Research Unit, Australian National University, Canberra.
Aust N Z J Psychiatry. 1996 Feb;30(1):9-19. doi: 10.3109/00048679609076069.
The seven uses of epidemiology identified by Morris all have direct relevance for mental disorders. But psychiatric epidemiology has a number of distinguishing features: it has to depend on a nosology that may lack validity; it depends largely on subjective symptoms for its data; the morbidity it deals with is really a continuum, and not a dichotomy of cases and unaffected persons; the measurement of morbidity using scales or standardised interviews is open to considerable error; and the unbiased assessment of environmental exposures proves to be technically challenging. Some of these features have been the basis of interesting research developments. The main milestones in the progress of psychiatric epidemiology are reviewed, together with some of the current issues of general interest, including activities in Australasia.
莫里斯所确定的流行病学的七种用途都与精神障碍直接相关。但精神科流行病学有一些显著特征:它必须依赖于可能缺乏效度的疾病分类学;其数据在很大程度上依赖于主观症状;它所处理的发病率实际上是一个连续体,而非病例与未患病者的二分法;使用量表或标准化访谈来测量发病率存在相当大的误差;而且对环境暴露进行无偏评估在技术上具有挑战性。其中一些特征一直是有趣的研究进展的基础。本文回顾了精神科流行病学发展进程中的主要里程碑,以及一些当前普遍感兴趣的问题,包括澳大拉西亚地区的相关活动。