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American Journal of Epidemiology Advance Access published online on May 4, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj170
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received February 6, 2006
Accepted February 13, 2006

INVITED COMMENTARY

Invited Commentary: Taking the Search for Causes of Schizophrenia to a Different Level

Dana March 1 and Ezra Susser 2 *

1 Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY; Center for History and Ethics of Public Health, Department of Sociomedical Sciences, Joseph L. Mailman School of Public Health, Columbia University, New York, NY
2 Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY

* To whom correspondence should be addressed.
Ezra Susser, E-mail: ess8{at}columbia.edu


  Abstract

In recent years, epidemiologists have established major variations in the incidence of schizophrenia and have begun to investigate the causes of these variations. The report by Pedersen and Mortensen (Am J Epidemiol 2006;163:000-00) in this issue of the Journal examines the contribution of family-level factors to the urban-rural difference in the incidence of schizophrenia. Their results suggest that familial life in urban environments confers some effect that persists after families move to rural settings. Taking these findings together with those of previous studies, it appears that factors operating at the level of the social context, the family, and the individual may all contribute to the urban-rural difference in schizophrenia incidence. This work exemplifies an integrative, multilevel approach to epidemiologic research that employs principles central to eco-epidemiology and other, similar frameworks.

Keywords: causality; cities; epidemiologic methods; family characteristics; risk factors; schizophrenia; urbanization.
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