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The Decade of the Patient
Author(s) -
Akiskal Hagop Souren
Publication year - 1999
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.1999.tb10841.x
Subject(s) - biography , citation , dementia , psychology , depression (economics) , library science , psychoanalysis , psychiatry , medicine , art history , history , disease , computer science , macroeconomics , pathology , economics
I ‘discovered’ Acta Psychiatrica Scandinavica as a medical student in 1966, when conducting a search for systematic longitudinal investigations of affective disorders. Of course, emphasis on longitudinal course is a legacy from Kraepelin, but the Scandinavian longitudinal studies published for many years in this journal are also Meyerian in the most positive sense of that orientation. They examine in great detail social, demographic and psychological attributes as they relate to the origin and course of these mental disorders. Although most of these studies are on clinical cohorts with all of their inherent limitations, they can be regarded as the beginning of epidemiological studies in psychiatry. The Danish Psychiatric Register has taken the methodology of prospective observation one step further, to include all national cases with a given diagnosis. This database has hitherto contributed much valuable knowledge about various mental conditions (1). The best known of these world-wide are the studies on schizophrenia by Fini Schulsinger and his colleagues. They have used an ingenious approach, examining the psychiatric outcome of adopted-away children vs. children raised with their biological parents, to tease apart the relative contributions of genetic and environmental factors in the origin of schizophrenia. Another noteworthy area of study just to highlight some of the fascinating things that one can learn from the Danish Registry ~ has demonstrated that the mentally ill are no more likely to be the cause of traffic accidents than individuals without such illness. This study provides a solid basis for arguing against the discriminatory practices which exist in various countries when individuals with a psychiatric history apply for a driving licence. This database had not yet been widely used in investigations of affective disorders. The article in the present issue of Actu Psychiatric Scandinavica by Kessing et al. (2) represents an important step in this direction. The authors report that patients discharged from psychiatric hospitals in the early 1970s with a diagnosis of affective disorder (both