Shepherd, Michael

   (1923–1995)

   The founder of psychiatric epidemiology—and a major figure in social psychiatry—in Britain, Shepherd was born in Bournemouth, England. After reading medicine at Oxford, he qualified in psychological medicine at the Maudsley Hospital in 1949 under Aubrey Lewis. Becoming a Reader in psychiatry at the Institute of Psychiatry, Shepherd began his career with important work in psychopharmacology, helping to pioneer the technique of the randomized clinical trial (RCT).† In a pioneering article in the Lancet in 1955, Shepherd and David Lewis Davies (1911–1983), also of the Maudsley Hospital, performed an RCT on reserpine, finding it of some effectiveness in the treatment of anxious and depressed patients. Later, Shepherd played a role in organizing the British Medical Research Council Clinical Trials committee and served as its secretary and chair for 20 years. In 1968 he, Malcolm Lader (1936–)—professor of psychopharmacology at the Maudsley—and Richard Rodnight wrote Clinical Psychopharmacology, an early text. In the judgment of Shepherd’s obituarist David Healy (1954–), writing in 2004 in Ban, ed., Reflections on Twentieth-Century Psychopharmacology, "This early [epidemiological] work led to a huge literature with which many prominent names have been associated such as . . . Gerald Klerman and Myrna Weissman in the United States. The epidemiological catchment areas studies in the United States were directly descended from the original Shepherd studies" (p. 578).

   Later, as professor of epidemiological psychiatry, Shepherd did significant work on London, ascertaining from a sample of general practices that psychiatric morbidity was really quite common in the population and that the great majority of it never entered the mental-health system. He and co-workers published these findings in a book * Technically, the last drug marketed as an "SSRI" was Lundbeck’s escitalopram (patented in 1990 and launched in the United States in 2002 by Forest as Lexapro). Yet, it is merely an isomer, or mirror-image, of citalopram.

   † The RCT was first proposed by Sir Austin Bradford Hill (1897–1991), professor of medical statistics at the London School of Hygiene and Tropical Medicine, and was carried out by Hill and Marc Daniels in trials on the chemotherapy of pulmonary tuberculosis beginning in 1948, the results of which were described in 1952 in the British Medical Journal. that established psychiatric epidemiology in Britain, Psychiatric Illness in General Practice (1966). To train family doctors better to cope with psychiatric problems, Shepherd helped found at the Maudsley the General Practice Research Unit, which, as his colleague at the Maudsley David Goldberg (1934–) put it, "formed a nursery for a whole generation of young social psychiatrists" (Psychological Medicine, 1995, p. 1110). He cofounded the journal Psychological Medicine and was famously involved in a debate with Mogens Schou about the therapeutic efficacy of lithium, in which Shepherd greatly disbelieved. Sheperd was not the most amiable of men, although undoubtedly brilliant, and David Goldberg later said of the experience of working with him, "Sometimes I simply couldn’t stay awake in his ward rounds because his manner with patients was so unpleasant that I found consciousness was no longer possible. I learnt to stick closely beside him and go into a deep delta sleep during those ward rounds but he never looked at me and so I think I was never discovered."