Is there a scientifically acceptable alternative to the epidemiological study of familial factors in mental illness?

Birtchnell, John

doi:10.1016/0037-7856(74)90079-1

Cited by 13 publications

(11 citation statements)

References 93 publications

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“…Methodological variation might help explain conflicting findings in prior studies, including the selection of the study sample, the comparison group, and heterogeneity in the operational definitions of early parental death and psychosis [1,11,12,13,14,15,16,17,18,19,20,21]. Study samples have more commonly relied on non-representative clinic patients, e.g., [13,15,16,19,20], and comparison groups have often used clinic patients with other diagnoses or non-randomly recruited controls, e.g., [1,11,13,19,20].…”

Section: Introductionmentioning

confidence: 99%

Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Misra

Gelaye

Koenen

et al. 2019

JCM

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Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child’s age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02–28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10–8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals.

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Section: Introductionmentioning

confidence: 99%

Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Misra

Gelaye

Koenen

et al. 2019

JCM

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“…Is the measurement of symptoms an adequate way to describe a population? Birtchnell (1974), in a related field (the relationship between early family life and adult mental illness), has drawn attention to the shortcomings of traditional epidemiological enquiry, and similar shortcomings may be noted in the area under discussion here. Any method of measurement must be closely related to the purpose of the enquiry; if we are to describe adequately those members of the population who can be thought of as being 'between neurosis and normality', then phenomena other than symptoms must be taken into account, and methods and concepts for the measurement of aspects such as personality and social functioning must be developed.…”

Section: A Proposal For a Multiaxial Model Of Casenessmentioning

confidence: 67%

“…Psychiatric epidemiology faces an even more fundamental problem, namely deciding what 'it' is. The medical epidemiologist is able to make measurements of blood pressure, blood sugar level, etc., but as Birtchnell (1974) points out, 'there is no observable or measureable physical representation of mental illness so that its presence is largely a matter of the psychiatrists' opinion'. Thus, given the present state of knowledge, the criteria for psychiatric caseness must inevitably be derived from clinical experience, and from patients identified in the course of clinical work.…”

Section: Introductionmentioning

confidence: 99%

Case definition and case identification in psychiatric epidemiology: review and assessment

Williams¹,

Tarnopolsky²,

Hand³

1980

Psychol. Med.

127

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SYNOPSISPsychiatric epidemiology has advanced considerably since early studies of hospital populations. The direction of this advance has been away from the study of populations of hospital psychiatric patients towards the study of psychiatric disorder in general practice and the community as a whole. Just as the populations under study have different defining characteristics, so have the individuals who comprise them. Psychosis becomes less and less common at greater distances from the hospital patient, and in the community the epidemiologist is faced with large numbers of respondents who present with fewer, minor and non-specific symptoms.In this review, we present evidence to indicate that concepts of case definition and case identification are insufficiently advanced so far, and are still rooted in ideas derived from hospital psychiatry. Foremost among these is an exclusive preoccupation with diagnosis and symptoms. We suggest that this may be inadequate for the study of non-psychotic disturbance in the community, and discuss other models of case definition, encompassing personality and social functioning as well as psychiatric symptomatology.

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“…Consequently, the propensity for mental ill health within this community sample of family connections was significant. This adds weight to the arguments that support the intergenerational transference of mental illness (Birtchnell, 1974;Repetti, Taylor, & Seeman, 2002), but also to biopsychosocial arguments about mental illness and children's environments having significant effects on developments. For a few parents, their history of abuse not only occurred during childhood, but also continued into adult relationships (for example, domestic violence, and drug and alcohol use).…”

Section: Repeating the Cyclementioning

confidence: 99%

Parents With Mental Illness: The Cycle of Intergenerational Mental Illness

Boursnell¹

2011

Children Australia

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This article provides an insight into the under-explored lives of parents with mental illness. In particular, this article considers the experiences of parents with mental illness who grew up with parents who also had mental illness, or experienced issues related to violence, abuse and neglect during childhood. Due to the dearth of research in this area there is minimal insight into how parents experience mental illness and even less significance is placed on exploring how intergenerational mental illness and backgrounds of violence, abuse and neglect impact on parenthood. This qualitative study generates information about how intergenerational family mental illness, and other issues identified in the course of the study, affected the participants' experiences of being a parent.

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Is there a scientifically acceptable alternative to the epidemiological study of familial factors in mental illness?

Cited by 13 publications

References 93 publications

Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Early Parental Death and Risk of Psychosis in Offspring: A Six-Country Case-Control Study

Case definition and case identification in psychiatric epidemiology: review and assessment

Parents With Mental Illness: The Cycle of Intergenerational Mental Illness

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