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During the initial phase of the evolutionary process of becoming a psychiatrist or, for that matter, any mental health professional, a nagging, seemingly unanswerable question always comes to mind. That question is concerned with the prevalence of mental illness in any given population at any given time. Prior to Freud's discoveries at the turn of the century, the field of psychiatry was strictly neurological, that is, biological and phenomenological, in its orientation. No systematic statistical study had ever been done, and prevalence had to be surmised from one's clinical experience. Since research in psychiatry was a basically biological enterprise, the percentage of an offered statistic would have had to be relatively constant through time. With Freud's introduction of a psychodynamic perspective that based the etiology of psychopathology on infantile and early childhood traumas, a concept of statistical prevalence had to be a relative and transient one.
The second half of the 20th century has been characterized by a return to a biological and phenomenological frame of reference. This radical movement of the pendulum of the concept of mental illness appears by now to be very well established. Thus, a statistical study of the prevalence of mental illness has become feasible and practical. Within this frame of reference, the sources of psychopathology must be based on a resonating and reciprocal relationship between innate biological, or genetic, givens and sociodemographic factors that stimulate and intensify the emerging mental disorder.
In 1977, shortly after the inauguration of President Jimmy Carter, his wife, Rosalynn, was authorized to assemble the President's Commission on Mental Health. One of the commission's goals was to undertake an epidemiologic study of the prevalence of mental disorders in the United States. An initial study was