Towards a philosophy of psychiatric epidemiology

Abstract

Two diametrically opposed approaches to the history of medicine in general, or to a specific area such as the history of psychiatric epidemiology, seem possible. A hagiographic account of a particular health specialization might emphasize how empirical observations have accumulated, how research methods have improved, how causal understanding has expanded and how such developments have contributed to rising levels of health. A critical account of, say, psychiatry epidemiology might on the other hand emphasize how empirical observations are theory-laden and therefore biased, how research methods have been intrusive or inappropriate, how causal understanding is poor and how such developments have contributed to, say, a powerful and profitable medical–industrial complex. Lovell and Oppenheimer argue that theirs is the first volume of historical scholarship addressing psychiatric epidemiology, tracing its historical development and the use of its methods to further social ends. In their introduction they discuss a well-known review by Dohrenwend and Dohrenwend of how psychiatric epidemiology has developed from first-generation investigations of hospital and agency records and informants through to third-generation population studies using structured diagnostic interviews.1 Some may see this as indicative of gradual progress in the field but Lovell and Oppenheimer emphasize instead that over time different constellations of research methods, professional bodies and sociopolitical contexts are apparent.