The International Federation of Psychiatric Epidemiology: its role in psychiatric research

Since the 1980s, molecular genetics has become a new star in biological psychiatry and a major challenge for psychiatric epidemiologists. In a recent article published in Science (1), the authors proposed that complex diseases with the strongest evidence of heritability, low feasibility to be treated or prevented with environmental changes, and high public health impact should have the highest priority for gene hunting; whereas disorders ‘that appears to be highly amendable to environmental modification’ should be given priority for developing effective intervention and studying health-related behaviours. Examples they gave for neuropsychiatric disorders are Alzheimer's disease, schizophrenia and autism for the former and nicotine/alcohol dependence for the latter. While this view does justice to the expensive and laborious molecular genetic research, it may have over-simplified the complex nature–nurture interplay in all common mental disorders by applying a dichotomization, and be excessively optimistic about the identification and preventability of specific genetic and environmental risk factors for specific mental disorders. As has been commented, few specific genetic or environmental causal factors for any specific mental disorder have been established hitherto (2). Moreover, the evidence suggests that ethnic heterogeneity regarding susceptible genes exists, and that culture-specific environmental factors are likely to be present. Meanwhile, findings from a few birth cohort studies indicate that certain environmental factors may be active from a very early stage of life. According to the concept of ‘biological programming’ (3), people may have been exposed to these factors during a critical phase of development before birth and in early childhood with long-term effects throughout later life, modified by adult health habits and the social environment. To elucidate such a complex gene–environment causal relationship over the life span will require inter-disciplinary cooperation in different societies and cultures, a great challenge for psychiatric epidemiologists from different parts of the world to work together. Although the cross-cultural approach is indispensable to this aetiological pursuit, longitudinal studies of mental disorders have largely been conducted in developed countries. Apparently, the lack of manpower, funding, scientific knowledge and skill in conducting psychiatric epidemiological studies is the main hindrance in developing countries, where evaluation of mental health services and clinical epidemiology are still much in need. While manpower and funding are the most difficult to tackle, exchange of scientific ideas and research methodology is much more feasible between the developed and the developing countries. This may involve both the assessment of culture-general and culture-specific environmental factors for mental disorders (4) and cross-cultural validity and reliability of phenotype definition and assessment (5). Among the international organizations devoted to psychiatric epidemiology, the World Psychiatric Association Section of Epidemiology and Public Health (6) and the International Federation of Psychiatric Epidemiology (IFPE) are the two main bodies likely to fulfill this goal. Funded in 1985, IFPE is an international non-governmental, non-profit organization devoted exclusively to promoting psychiatric epidemiology. As stated in its statutes (http://www.sinica.edu.tw/ifpe), the purpose of the Federation is to promote the acquisition, dissemination and application of epidemiological knowledge in the fields of psychiatry and mental health. Its specific aims are: to promote the synthesis of knowledge acquired by epidemiological, clinical, social and biological research; to stimulate the development of epidemiological research methods; to facilitate the exchange of information and contacts between researchers of different nationalities and disciplines; to encourage the preparation and implementation of projects and the dissemination and publication of research findings and to organize international scientific meetings pursuing the above aims. The IFPE has actively organized international and regional scientific meetings in both developed and developing countries. Recent meetings include its eighth international congress in Taipei in 1999, a regional conference in Kuala Lumpur in 2001, its ninth international congress in Edmonton in 2002, a forthcoming tenth congress in Bristol/Bath, England in 2004 (http://www.bristol.ac.uk/psychiatry/IFPE), and a possible future regional conference in Buenos Aries in 2005. At these meetings, junior researchers are encouraged to present their research work to gain useful comments from international colleagues. The eighth congress produced a relevant monograph on its main theme: Gnome and Envirome: their Roles and Interaction in Psychiatric Epidemiology (7). To echo the challenge of international collaboration in searching for the nature of gene–environment interaction of common mental disorders through longitudinal studies, the tenth congress has chosen its main theme as: Life course epidemiology of mental disorders. It is hoped that colleagues from developed and developing countries interested in psychiatric epidemiology will get together during this meeting to find ways to facilitate international collaborations in the enquiry of aetiology throughout life course and effective prevention of common mental disorders.