I use the epidemiologic framework to explain the risk factors, natural history, and consequences of major mental disorders. I also take the sociologic approach to understand the occurrence of the subset of bizarre behaviors that generally are labeled as psychiatric disorders. In the area of psychiatric epidemiology, I have conducted research on the incidence and natural history of schizophrenia using data from psychiatric case registers in several locations around the world. Recently this work has focused on the epidemiology of autoimmune diseases and their relationship to risk for autism, schizophrenia, and bipolar disorder. This has led to a current project I am leading: a small randomized controlled trial of gluten withdrawal as treatment for schizophrenia in persons with antibodies to gluten, in collaboration with investigators at the Maryland Psychiatric Research Center.
I have investigated common mental disorders, such as major depressive disorder and the anxiety disorders, in the context of the Baltimore Epidemiologic Catchment Area Followup, a twenty year cohort study. A somewhat surprising finding from that study was the degree to which major depressive disorder was predictive of the new occurrence of important physical conditions such as type 2 diabetes, heart attack, stroke, and breast cancer. The current phase of the ECA project is a collaboration with four ECA sites linking data on mental disorders to the National Death Index, in the largest population-based study of this topic in the United States to date.