Medical and Psychiatric Comorbidity Over the Course of Life
Life course epidemiology is a field that looks at the coexistence of two or more conditions, including both medical and psychiatric illness, over the course of an individual's life. Looking at comorbidity can lead to clues about the etiology or pathogenesis of a disease, its natural history, and even possible treatments or disease prevention. In Medical and Psychiatric Comorbidity Over the Course of Life , William Eaton, chair of the Department of Mental Health at Johns Hopkins Bloomberg School of Public Health, has selected presentations from the 2004 American Psychopathological Association annual meeting to educate the reader on recent advances in the study of psychiatric epidemiology.
Sections from the book on epidemiology, risk factors, mood disorders, emotions and health, and schizophrenia use specific examples from presentations to illustrate how understanding of psychopathology can be enhanced by looking at it from an etiological perspective. To give an example of the breadth of topics covered, a study of fetal origins of schizophrenia is used to discuss different types of cohort studies. The idea that genes may produce different diseases at distinct stages in life is explored in a study that used genome scans to test the hypothesis that there may be a phenotype of panic disorder associated with interstitial cystitis. The use of databases such as the Danish Psychiatric Case Register is examined in looking at medical illness and mortality in schizophrenia.
Readers of Medical and Psychiatric Comorbidity Over the Course of Life will find chapters written by experts at the top of their fields about current research. Background information is provided on the study of life course comorbidity. Although two conditions may occur at different times in an individual's life, there may be a relationship between them; the practical scientific work behind clarifying the specifics of these often complicated relationships is the work of comorbidity studies. Important epidemiological topics are introduced, such as the etiologically relevant period when risk factors for diseases have appeared but diagnoses have not yet been made. Several clear and concisely written chapters review well-studied areas of medical psychiatry, such as the association between mood disorders and heart disease, and suggest new avenues of investigation that may clarify the relationship of disorders to one another, such as the relationship of depression to osteoporosis.
Although it uses examples from current areas of research to illustrate principles of life course epidemiology, this book does not try to be a comprehensive textbook on epidemiology or on medical psychiatry. At times the book seems fragmented, lacking cohesion between concepts and chapters. I found myself wishing for a clearer objective across the length of the book. Although many of the concepts introduced in the book piqued my interest, I felt frustrated that I was not going to receive more than a taste of each individual topic.
Overall, this is an informative and thought-provoking book which would be enjoyed by psychiatrists, psychologists, and mental health professionals with an interest in public health, psychosomatic medicine, or behavioral medicine.
