Group Comparison Approaches in Psychiatric Research

  • Ming T. Tsuang
  • Chung-Cheng Hsieh
  • Jerome A. Fleming
Part of the Critical Issues in Psychiatry book series (CIPS)


Comparative population psychiatric research, regardless of the complexity of the methodology, involves studying the relationship between a risk determinant and a health outcome. A risk determinant is also referred to as an “independent variable,” “risk factor,” “exposure,” or “treatment” in a typical comparative study. Simply put, the outcome experience of a group of people who have been exposed to a risk determinant is compared to that of another group who have not been so exposed, and the relation between exposure and outcome is evaluated empirically. In psychiatry, the risk determinant or exposure may be whether the individual has a certain disorder (i.e., schizophrenia or affective disorder) or some combination of psychiatric symptomatology. The outcome might be measured as long-term functioning, mortality rates, morbidity rates, or familial psychopathology.


Affective Disorder Incidence Rate Ratio Psychiatric Research Risk Determinant Candidate Population 
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  1. Anderson, S., Auquier, A., Hauck, W. W., Oakes, D., Vandaele, W., & Weisberg, H. I. (1980). Statistical methods for comparative studies. New York: Wiley.CrossRefGoogle Scholar
  2. Baldessarini, R. J. (1984). Risk rates for depression (letter). Archives of General Psychiatry, 41, 103–104.PubMedCrossRefGoogle Scholar
  3. Berkson, J. (1946). Limitation of the application of fourfold table analysis to hospital data. Biometrics Bulletin, 2, 47–53.PubMedCrossRefGoogle Scholar
  4. Campbell, D. T., & Stanley, J. C. (1963). Experimental and quasi-experimental designs for research. Chicago: Rand McNally.Google Scholar
  5. Chiang, C. L. (1968). Introduction to stochastic processes in biostatistics. New York: Wiley.Google Scholar
  6. Cox, D. R. (1972). Regression models and life tables (with discussion). Journal of the Royal Statistical Society (B), 34, 187–220.Google Scholar
  7. Eaton, W. W., & Kessler, L. E. (1985). The (NIMH) epidemiologic catchment area program. New York: Academic Press.Google Scholar
  8. Eaton, W. W., Holzer, C. E., Von Korff, M., Anthony J. C., Heizer, J. E., George, L., Burnam, M. A., Boyd, J. H., Kessler, L. G., & Locke, B. Z. (1984). The design of the epidemiologic catchment area surveys. Archives of General Psychiatry, 41, 942–948.PubMedCrossRefGoogle Scholar
  9. Elandt-Johnson, R. C. (1975). Definition of rates: Some remarks on their use and misuse. American Journal of Epidemiology, 102, 267–271.PubMedGoogle Scholar
  10. Elwood, J. M. (1988). Causal relationships in medicine: A practical system for critical appraisal. New York: Oxford University Press.Google Scholar
  11. Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G., & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.PubMedCrossRefGoogle Scholar
  12. Gershon, E. S. (1984). Risk rates for depression (letter). Archives of General Psychiatry, 41, 104–105.CrossRefGoogle Scholar
  13. Greenland, S., & Thomas, P. (1982). On the need for the rare disease assumption in case-control studies. American Journal of Epidemiology, 116, 547–53.PubMedGoogle Scholar
  14. Hennekens, C. H., & Buring, J. E. (1987). Epidemiology in medicine. Boston: Little, Brown.Google Scholar
  15. Kramer, M. (1957). A discussion of the concepts of incidence and prevalence as related to epidemiologic studies of mental disorders. American Journal of Public Health, 47, 826–840.PubMedCrossRefGoogle Scholar
  16. Lewis, G., & Pelosi, A. J. (1990). The case-control study in psychiatry. British Journal of Psychiatry, 157, 197–207.PubMedCrossRefGoogle Scholar
  17. Miettinen, O. S. (1976). Estimability and estimation in case-referent studies. American Journal of Epidemiology, 103, 226–35.PubMedGoogle Scholar
  18. Miettinen, O. S. (1985a). Theoretical epidemiology. New York: Wiley.Google Scholar
  19. Miettinen, O. S. (1985b). The “case-control” study: Valid selection of subjects. (with discussions). Journal of Chronic Disease, 38, 543–558.CrossRefGoogle Scholar
  20. Monson, R. R. (1990). Occupational epidemiology (2nd ed.). Boca Raton, FL: CRC Press.Google Scholar
  21. Morrison, J., Clancy, J., Crowe, R., & Winokur, G. (1972). The Iowa 500: I. Diagnostic validity in mania, depression and schizophrenia. Archives of General Psychiatry, 27, 457–461.PubMedCrossRefGoogle Scholar
  22. Regier, D. A., Myers, J. K., Kramer, M., Robins, L. N., Blazer, D. G., Hough, R. L., Eaton, W W., & Locke, B. Z. (1984). The NIMH epidemiologic catchment area (ECA) program: Historical context, major objectives, and study population characteristics. Archives of General Psychiatry, 41, 934–941.PubMedCrossRefGoogle Scholar
  23. Sandercock, P. (1989). The odds ratio: A useful tool in neurosciences. Journal of Neurology, Neurosurgery and Psychiatry, 52, 817–20.CrossRefGoogle Scholar
  24. Schlesselman, J. J. (1982). Case-control studies: Design, conduct, analysis. New York: Oxford University Press.Google Scholar
  25. Schwartz, S., & Link, B. G. (1989). The “well control” artefact in case/control studies of specific psychiatric disorders. Psychological Medicine, 19, 737–742.PubMedCrossRefGoogle Scholar
  26. Tsuang, M. T., & Dempsey, G. M. (1979). Long-term outcome of major psychoses: II. “Schizoaffective” disorder compared with schizophrenia, affective disorders, and a surgical control group. Archives of General Psychiatry, 36, 1302–1304.PubMedCrossRefGoogle Scholar
  27. Tsuang, M. T., Woolson, R. F., & Fleming, J. A. (1979). Long-term outcome of major psychoses: I. Schizophrenia and affective disorders compared with psychiatrically symptom-free surgical conditions. Archives of General Psychiatry, 36, 1295–1301.PubMedCrossRefGoogle Scholar
  28. Tsuang, M. T., Winokur, G., & Crowe, R. R. (1980). Morbidity risks of schizophrenia and affective disorders among first-degree relatives of patients with schizophrenia, mania, depression and surgical conditions. British Journal of Psychiatry, 137, 497–504.PubMedCrossRefGoogle Scholar
  29. Tsuang, M. T., Fleming, J. A., Kendler, K. S., & Gruenberg, A. S. (1988). Selection of controls for family studies: Biases and implications. Archives of General Psychiatry, 45, 1006–1008.PubMedCrossRefGoogle Scholar
  30. Walker, A. M. (1991). Observation and inference. An introduction to the methods of epidemiology. Chestnut Hill: Epidemiology Resources, Inc.Google Scholar
  31. Weissman, M. M., Kidd, K. K., & Prusoff, B. A. (1982). Variability in rates of affective disorders in relatives of depressed and normal proband. Archives of General Psychiatry, 39, 1397–1403.PubMedCrossRefGoogle Scholar
  32. Weissman, M. M., Kidd, K. K., & Prusoff, B. A. (1984). Risk rates for depression [Letter to the editor]. Archives of General Psychiatry, 41, 105–106.CrossRefGoogle Scholar
  33. Woolson, R. T., Tsuang, M. T., & Fleming, J. A. (1980). Utility of the proportional-hazards model for survival analysis of psychiatric data. Journal of Chronic Disease, 33, 183–95.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Ming T. Tsuang
    • 1
    • 2
  • Chung-Cheng Hsieh
    • 1
    • 2
  • Jerome A. Fleming
    • 1
    • 2
  1. 1.Harvard Medical School Department of PsychiatryPsychiatry ServiceBrocktonUSA
  2. 2.West Roxbury Veterans Administration Medical CenterHarvard School of Public Health, Program in Psychiatric EpidemiologyBrocktonUSA

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