Psychiatric Epidemiology: Assessment Concepts and Methods.

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Mezzich, Juan E., Jorge, Miguel R., and Salloum, Ihsan M., Eds. Psychiatric Epidemiology: Assessment Concepts and Methods. Baltimore: The Johns Hopkins University Press, 1994. xviii + 612 pp. $86.00.The development of assessment concepts and methodology in psychiatric epidemiology has been propelled greatly in recent years, in large part by the increasing recognition of the importance in improving diagnostic reliability in psychiatric assessment. For example, more objective criteria on which to base diagnostic assessments have been incorporated into recent revisions of both the Diagnostic and Statistical Manual for Mental Disorders (DSM), published by the American Psychiatric Association, and the chapter on mental and behavioral disorders in the International Classification of Diseases (ICD), published by the World Health Organization. Improved diagnostic reliability helps to strengthen the case for validity of psychiatric diagnoses. This effort, in turn, facilitates building a firm scientific base for the broad range of issues encompassing the study of mental and behavioral disorders-their natural history, the search for their causes, and the evaluation of methods for successful intervention. This publication represents a very commendable effort to bring together some of the most important contributions on assessment concepts and methods in one volume to provide a broad overview of recent progress.The editors state that this book grew out of a desire to teach a graduate-level course on assessment in psychiatric epidemiology. The book has 32 chapters, and 28 of them are essentially reproductions of articles published earlier. A comprehensive range of topics is covered, including chapters on case definition, the history and conceptual basis of diagnostic systems, design issues, reliability and validity, structured and unstructured diagnostic assessment procedures, psychopathological rating scales, and assessments of biological factors. The authors of the various chapters represent a broad spectrum of international expertise with contributors from a number of different countries. This internationally representative authorship enhances the breadth of coverage for the assessment issues addressed. Each chapter concludes with a brief annotated set of references for further consideration.The chapters dealing with the historical and conceptual bases of diagnostic systems provide an excellent reminder of the substantial progress made over time. On the other hand, the chapters on the current classification systems, the ICD-10 and the DSM-IV, also reveal how limited our collective understanding of psychopathology remains, and our continuing need for more insightful assessment concepts and better assessment methods. Several chapters on assessment methods provide an excellent summary of the complexities involved in measuring psychopathology, biological factors, levels of functioning, and use of mental health services.Special issues relating to children, adolescents, the elderly, and cross-cultural issues are especially timely as the interest in and need for cross-cultural assessments and cross-cultural comparisons increase. Both the recently published DSM-IV and ICD-10 focus more attention on these issues as well.For serious students of assessment issues in psychiatric epidemiology, the book provides a thorough overview of the field for initial study, and a ready reference source for future inquiry. Those who have already had a grounding in these topics will find this book to be a useful update of the substantial progress being made in these areas. The editors have been successful in providing in one volume some of the best current thinking about assessment concepts and methods available for the study of psychiatric epidemiology.Charles T. Kaelber, M.D., Dr.P.H.

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