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Mental health epidemiology today: a monitor of distress

Scott Henderson’s lucid editorial, as its title implies, is firmly anchored in the present day. As a yardstick of progress, however, it may be useful to compare his review with one written nearly 50 years ago, which likewise took as its starting point Morris’ list of seven ‘uses of epidemiology’ (Shepherd & Cooper, 1964). Although its authors managed to cite mental health research on each of the seven, their quest took them to the edges of psychiatric practice (e.g. mental handicap, accident-proneness, tension headache and psychosomatic aspects of peptic ulcer). The present editorial, in contrast, can draw upon national prevalence surveys in a score of countries as well as causally oriented research focusing on schizophrenia, affective disorder and other central concerns of today’s clinical specialty. The simple comparison points to an impressive growth in volume and scope of psychiatric epidemiology over the past half century. How far has this expansion been reflected in substantive scientific achievement? In order to address the question, let us consider briefly each in turn of Henderson’s ‘four significant questions’.