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Programs:

Summary

Epidemiology provides a public health perspective on mental health and mental illness in that it is concerned with psychiatric disorders in the general population. A general hospital is thus a good home for the Psychiatric Epidemiology Unit. The Unit was established in 1985 when Dr. Jane M. Murphy was named its director.

The Unit provides a link between the Harvard Medical School and the Harvard School of Public Health. One of its functions is to provide consultation and training for psychiatric residents and others who wish to include public health in their backgrounds. The main function, however, is research with a focus on the longest ongoing study of psychiatric epidemiology in a general population.

Named the "Stirling County Study", the foundation was laid in the late 1940s and the study now provides more than a 40-year perspective on the prevalence, incidence, course and outcome of the full range of psychiatric disorders but with a primary focus on the common disorders involving depression, anxiety, and alcohol-abuse.

Reports based on the full 40-year perspective indicate that the current prevalence of depression remained stable but in the last quarter of the 20th century a re-distribution occurred based on a two-fold increase among women under 45 years of age with small decreases in the other gender/age groups. Throughout the period of study, depression was almost always accompanied by generalized anxiety. The only change in the relationship between depression and anxiety was that depression began to resemble anxiety as mainly a disorder of women. While it has usually been thought that epidemiologic estimates are unrealistically high, a validity study toward the end of the investigation indicated that clinicians administering the Structured Clinical Interview for Diagnosis suggested that epidemiologic rates may underestimate prevalence. Over the 40 years, the prevalence of cigarette smoking rose and then declined. In the most recent survey, but not earlier, there was a strong relationship between smoking and depression. The prevalence of obesity increased but was not associated with depression although among those with lifetime depression, the obese subjects were much more likely to gain weight during an episode of depression than the non-obese. Other topics for which reports are currently being prepared include mortality risk, the relationship between smoking and alcohol abuse vis-a-vis depression, and trends in the relationship between socioeconomic status and the prevalence and incidence of psychiatric disorders.

Staff

Jane M. Murphy, Ph.D.
Unit Director
Professor of Psychiatry, Harvard Medical School
Professor of Epidemiology, Harvard School of Public Health
Publications by Dr. Murphy

Jack D. Burke Jr., M.D., Professor of Psychiatry, Cambridge Health Alliance, Cambridge Hospital
Nan M. Laird, Ph.D., Professor of Biostatistics, Harvard School of Public Health
Alexander H. Leighton, M.D., Professor of Psychiatry, Professor of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia.
Richard R. Monson, M.D., D.Sc, Professor of Epidemiology, Harvard School of Public Health
Nicholas J. Horton, Sc.D., Assistant Processor, Department of Mathematics, Smith College
Arthur M. Sobol, M.A., Applications Computer Programmer
Barbara J. Burns, B.A., Staff Assistant
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Psychiatric Epidemiology Unit