Ezra Susser, MD, DrPH
, professor of epidemiology at the Mailman School of Public Health and professor of psychiatry at the College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, has been selected to receive the 2011 APHA Rema Lapouse Award. The Rema Lapouse Award, presented annually to an exemplary scientist in the field of psychiatric epidemiology who has made significant contributions to the scientific understandings of the epidemiology and control of mental disorders, is granted by the APHA Mental Health, Biostatistics and Epidemiology Sections. The award will be presented during the APHA Annual Meeting by former Rema Lapouse awardee and Rema Lapouse Awards Committee Chair Dr. C. Hendricks Brown. The APHA Annual Meeting will take place beginning Oct. 29, 2011 through Nov. 2, 2011 in Washington, D.C.
Dr. Susser received his MD and MPH from Columbia University in 1982. He obtained his DrPH a decade later from the same university. One theme in Dr. Susser’s early research was to study the course of psychoses and the potential for partial or full recovery. He contributed to the understanding of ICD-10 Acute and Transient Psychotic Disorders by showing that these conditions had a tenfold higher incidence in developing than developed countries, that they often persisted for 2-4 months before full recovery, and that they differed from other nonaffective psychoses in their subsequent course in both developed and developing countries. These results are being used for revision of Acute and Transient Disorders in ICD-11. A related series of studies pertained to the relationships between homelessness and mental illness and the improvement of services for homeless people with psychotic disorders. Together with Elie Valencia and Sarah Conover, he developed and tested (in a randomized controlled trial) Critical Time Intervention (CTI) for prevention of recurrence of homelessness among people with severe mental illness. CTI is now being adapted for a variety of contexts (e.g. former prisoners returning to the community; new users of services; indigenous peoples), in many locales spanning the United States, Europe, Australia and Latin America. This early work provided the foundation for his long-term and ongoing commitment to global mental health, with a primary (though not exclusive) focus on the care of people with psychoses. Since 1995, he has been involved in supporting programs of community care in Argentina and South Africa. Later this work extended to other countries in Latin America, to Central Asia, and, most recently, to other countries in Africa.
A second theme in his early research was the investigation of prenatal exposures that might influence the development of schizophrenia in adulthood. He discovered a relationship between exposure to famine in early gestation and onset of schizophrenia in adulthood. He is exploring the pathways that might explain this association, including the interplay between genes and this environmental exposure (genetic epidemiology is also a longstanding interest and now extends to epigenetic studies). Currently, he is working together with Norwegian investigators to study neurodevelopmental disorders in a pregnancy cohort of approximately 110,000 births in Norway. This work naturally extended to a more general interest in life course epidemiology, and studies examining several points along the life course and health outcomes in multiple domains. He has also promoted and developed the use of sibling comparisons in epidemiology, which are particularly useful for the investigation of prenatal exposures.
A third theme in his early research was cross-cultural research. This interest is now expressed in three main threads of research. First, he is deeply involved with Dutch investigators who are elucidating the causes of the high incidence of psychosis among certain immigrant/ethnic minority groups in the Hague. Second, he has initiated together with Jonathan Burns (University of Kwazulu-Natal) the groundwork for what they plan to be the first incidence study of psychoses in Africa. Third, cross-cultural work is central to the Global Mental Health Program noted earlier.
During Dr. Susser’s nine year tenure as chair of epidemiology, he was the lead author of the only current (other than edited) textbook on psychiatric epidemiology. In addition, one of his top priorities was to create the capacity in the department to respond to the global HIV/AIDS epidemic. Among other things, he encouraged and recruited faculty and students, fostered the development of global HIV/AIDS programs (led by others) which are now world renowned, and was a steadfast advocate. He also worked on the prevention of HIV/AIDS in people with severe mental illness.
Currently, in addition to co-leading a Global Mental Health Program, Dr. Susser heads the Imprints Center for Genetic and Environmental Lifecourse Studies, which fosters collaborative research and intellectual exchange among investigators studying developmental origins in birth cohorts across the globe. Imprints brings together multiple disciplines, and the seminars are sponsored jointly by the Department of Epidemiology, the Institute of Human Nutrition and the Department of Neurodevelopmental Neuroscience at the Psychiatric Institute. A NIDDK training grant emerged from this process (PIs Debra Wolgemuth, IHN and Ezra Susser). It is designed to train basic scientists and population health researchers in the arena outside their parent discipline (e.g. train basic scientists in population health), to facilitate effective collaboration with investigators in the “other” arena. He is also involved in numerous other training programs, perhaps most notably, as co-Director of the Psychiatric Epidemiology Training Program at Columbia.
Finally, Dr. Susser is president of the American Psychopathological Association in 2012, arguably the professional organization most closely related to psychiatric epidemiology and public mental health (not counting specific sections of larger bodies such as the Mental Health Section of APHA).