IJE vol.34 no.1 © International Epidemiological Association 2005; all rights reserved.
Editor's Choice |
Epidemiological Freudianism
Over the last few years the IJE has shown considerable interest in the early-life origins of adult disease.1–19 Our historical reprint in this issue—a fascinating reflection on the long-term imprint of early environmental influences by the great humanist and biologist Rene Dubos—was given the intriguing title ‘Biological Freudianism’ to relate its speculations to those of Sigmund Freud who, in the psychological sphere, postulated the particular importance of early-life influences.20 Our commentators grasp the challenge of relating Dubos' work to the extensive subsequent literature,21–23 but other papers in this issue could be said to reflect epidemiological, rather than biological, Freudianism.
Freud famously thought that the oral stage—from birth to 18 months—was one during which too much or too little gratification could result in oral fixation or oral personality, with a tendency towards smoking, drinking alcohol, and overeating. This familiar triad of lifestyle naughtiness—the stuff of health promoters' nightmares—receives perhaps less coverage than is often the case in issues of the IJE, but poor diet is related both to higher subsequent cancer risk24 and is seen as an outcome of some marital transitions.25 Richard Doll and colleagues offer some comfort for those of us stuck in the oral stage, with evidence that at least some of the apparent protective effect of alcohol against disease is causal.26
The popular view of Freud's writings as being sex obsessed has lead to the London Freud Museum posting a denial that all his theories were about sex.27 Epidemiologists have traditionally been much more interested in other behaviours, but in this issue of the IJE we document the possible sexual transmission of Hepatitis C between spouses in Egypt,28 the evidence that a sexually transmitted infection may increase the risk of prostate cancer29 and the consequences of HIV infection.30,31
Regression was a popular term in Freud's system, relating to a tendency to retreat into the mental and social habits of an earlier developmental stage, usually in response to stressful situations. In epidemiology regression usually refers to the less exciting topic of a statistical technique, but Barnett et al.32 provide an excellent introduction to regression to the mean and its potential influence on epidemiological findings. Some readers, their eyes attracted to Richard Hugo's ‘Degrees of Gray in Philipsburg’,33 may regress in a different way and their memories retreat to their last good kiss.
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References
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2 Phillips DIW. Twins, low birthweight and type 2 diabetes. Int J Epidemiol 2004;33:953–54.
3 McNeill G, Tuya C, Smith WCS. The role of genetic and environmental factors in the association between birthweight and blood pressure: evidence from meta-analysis of twin studies. Int J Epidemiol 2004;33:995–1001.
4 Kramer MS. Maternal nutrition, body proportions at birth, and adult chronic disease. Int J Epidemiol 2004;33:837–38.
5 Kristensen P, Bjerkedal T, Irgens LM. Birthweight and work participation in adulthood. Int J Epidemiol 2004;33:849–56.
6 Cheung YB. Fetal origins of social situations? Medicalization of social life? Int J Epidemiol 2004;33:856–57.
7 Kuh D, Richardus M, Hardy R, Butterworth S, Wadsworth MEJ. Childhood cognitivie ability and deaths up until middle age: a post-war birth cohort study. Int J Epidemiol 2004;33:408–13.
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9 Kumar R, Bandyopadhyay S, Aggarwal AK, Khullar M. Relation between birthweight and blood pressure among 7–8 year old rural children in India. Int J Epidemiol 2004;33:87–91.
10 Andersen A-MN, Osler M. Birth dimensions, parental mortality, and mortality in early adult age: a cohort study of Danish men born in 1953. Int J Epidemiol 2004;33:92–99.
11 Hardy R, Wadsworth MEJ, Langenberg C, Kuh D. Birthweight, childhood growth, and blood pressure at 43 years in a British birth cohort. Int J Epidemiol 2004;33:121–29.
12 Simondon KB, Elguero E, Marra A, Diallo A, Aaby P, Simondon F. Season of birth is not associated with risk of early adult death in rural Senegal. Int J Epidemiol 2004;33:130–36.
13 Moore SE, Fulford AJC, Streatfield PK, Persson LA, Prentice AM. Comparative analysis of patterns of survival by season of birth in rural Bangladeshi and Gambian populations. Int J Epidemiol 2004;33:137–43.
14 Lawlor DA. The art and science of epidemiology: governed by the seasons? Int J Epidemiol 2004;33:144–46.
15 Te Velde SJ, Ferreira I, Twisk JWR, Stehouwer CDA, van Mechelen W, Kemper HCG. Birthweight and arterial stiffness and blood pressure in adulthood—Results from the Amsterdam Growth and Health Longitudinal Study. Int J Epidemiol 2004;33:154–61.
16 Wilkinson IB, Cockcroft JR. Birthweight arterial stiffness and blood pressure: in search of a unifying hypothesis. Int J Epidemiol 2004;33:161–62.
17 Laurén L, Järvelin M-R, Elliott P et al. the EURO-BLCS Study Group, Sovio U, Spellman A, McCarthy M, Emmett P, Rogers I, Hartkiainen A-L, Pouta A, Hardy R, Wadsworth M, Helmsdal G, Olsen S, Bakoula C, Lekea V, Millwood I. Relationship between birthweight and blood lipid concentrations in later life: evidence from the existing literature. Int J Epidemiol 2004;32:862–76.
18 Barker DJP. Developmental origins of raised serum cholesterol. Int J Epidemiol 2004;32:876–77.
19 Lagiou P, Hsieh C-C, Trichopoulos D et al. Birthweight differences between USA and China and their relevance to breast cancer aetiology. Int J Epidemiol 2003;32:193–98.
20 Dubos R, Savage D, Schaedler R. Biological Freudianism. Lasting effects of early environmental influences. Pediatr 1966;38:789–800. Reprinted Int J Epidemiol 2005;34:5–12.
21 Tannock GW. Remembrance of microbes past. Int J Epidemiol 2005;34:13–15.
22 Waterland RA. The global relevance of ‘biological Freudianism’. Int J Epidemiol 2005;34:15–17.
23 Moore V. Biological Freudianism and the quest for understanding of the social origins of health. Int J Epidemiol 2005;34:18–20.
24 Mai V, Kant AK, Flood A. Lacey JV, Schairer C, Schatzkin A. Diet quality and subsequent cancer incidence and mortality in a prospective cohort of women. Int J Epidemiol 2005;34:54–60.
25 Lee S, Cho E, Grodstein F, Kawachi I, Hu F, Colditz G. Effects of marital transitions on changes in dietary and other health behaviours in US women. Int J Epidemiol 2005;34:69–78.
26 Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to alcohol consumption: a prospective study among male British doctors. Int J Epidemiol 2005;34:199–204.
27 Are Freud's theories all about sex? Available at: http://www.freud.org.uk/about5.html
28 Magder L, Fix AD, Mikhail NNH et al. Estimation of the risk of transmission of hepatitis C between spouses in Egypt based on seroprevalence data. Int J Epidemiol 2005;34:160–65.
29 Fernández L, Galán Y, Jiménez R et al. Sexual behaviour, history of sexually transmitted diseases, and the risk of prostate cancer: a case-control study in Cuba. Int J Epidemiol 2005;34:193–97.
30 Villamor E, Misegades L, Fataki MR, Mbise RL, Fawzi WW. Child mortality in relation to HIV infection, nutritional status, and socio-economic background. Int J Epidemiol 2005;34:61–68.
31 Lewden C, Salmon D, Morlat P et al. Causes of death among human immunodeficiency virus (HIV)-infected adults in the era of potent antiretroviral therapy: emerging role of hepatitis and cancers, persistent role of AIDS. Int J Epidemiol 2005;34:121–30.
32 Barnett A, van der Pols JC, Dobson AJ. Regression to the mean: what it is and how to deal with it. Int J Epidemiol 2005;34:215–20.
33 Hugo R. Degrees of Gray in Philipsburg. Int J Epidemiol 2005;34:35.
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