Translating Epidemiology In Psychiatry: The Future Is Here

Scott Henderson, among the leading psychiatric epidemiology thinkers, has re-evaluated the contribution of epidemiology to understanding psychiatric disorders over the last 50 years. Beginning with Morris's use of epidemiology, he reviews contributions in classification as well as the understanding of morbidity, comorbidity and rates and the identification of pathogenic environmental exposures. He notes the new possibility of linking epidemiology to understanding biological pathways using molecular genetics and neurobiology. He also notes that the flat and featureless epidemiologic horizon has begun to show attractive contours and that we may be entering a new phase in the evolution. I would propose that this future is already here. In June 2011, we published a review called Translational Epidemiology in Psychiatry, Linking Population to Clinical and Basic Sciences (Weissman et al. Reference Weissman, Brown and Talati 2011). In the article, we noted that translational research generally refers to the application of knowledge generated by advances in basic science research, translated into new approaches for diagnosis, prevention and treatment of disease. This direction is called bench-to-bedside. Psychiatry has similarly emphasized the basic sciences as the starting point of translational research. We introduced the term translational epidemiology in psychiatry as a bidirectional concept, in which the knowledge generated from the bedside or the population can also be translated to the benches of laboratory science. Epidemiologic studies are primarily observational but they can generate representative samples, novel designs and hypotheses that can be translated into more tractable experimental approaches in the clinical and basic science laboratories. This bedside or population-to-bench concept has not been explicated in psychiatry, although there are an increasing number of examples in the research literature. Henderson notes that linkages with neurosciences will bring further progress in understanding the causes of psychiatric disorder. We agree and in the article describe epidemiologic designs, providing examples and opportunities for translational research from community surveys, as well as prospective, birth cohort and family-based designs which can further this effort