The pace of scientific advance

Advances in genetics and in the neurosciences have already increased knowledge of the basic mechanisms of the brain and are beginning to uncover the neurobiological mechanisms involved in psychiatric disorder. Striking progress has been achieved in the understanding of Alzheimer's disease, for example, and there are indications that similar progress will follow in uncovering the causes of mood disorder, schizophrenia, and autism. Knowledge of genetics and the neurosciences is so extensive and the pace of change is so rapid that it is difficult to present a complete account within the limited space available in a textbook of clinical psychiatry. We have selected aspects of these sciences that seem, to us and the authors, to have contributed significantly to psychiatry or to be likely to do so before long.

Psychological and social sciences and epidemiology are essential methods of investigation in psychiatry. Although the pace of advance in these sciences may not be as great as in the neurosciences, the findings generally have a more direct relation to clinical phenomena. Moreover, the mechanisms by which psychological and social factors interact with genetic, biochemical, and structural ones will continue to be important however great the progress in these other sciences. Among the advances in the psychological and social sciences that are relevant to clinical phenomena, we have included accounts of memory, psychological development, research on life events, and the effects of culture. Epidemiological studies continue to be crucial for defining psychiatric disorders, following their course, and identifying their causes.

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