Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-04T20:14:07.718Z Has data issue: false hasContentIssue false
  • English
  • Français

The concept of a ‘case’ in psychiatric population surveys

Published online by Cambridge University Press:  09 July 2009

J. K. Wing ,
S. A. Mann ,
J. P. Leff  and
J. M. Nixon
J. K. Wing*
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry, London
S. A. Mann
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry, London
J. P. Leff
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry, London
J. M. Nixon
Affiliation:
MRC Social Psychiatry Unit, Institute of Psychiatry, London
*
1Address for correspondence: Professor J. K. Wing, MRC Social Psychiatry Unit, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
Get access Rights & Permissions [Opens in a new window]

Synopsis

A series of in-patients, a series of out-patients and a series of women from a general population sample, all aged under 65, and all living in the same area of south-east London, were examined using the ninth edition of the Present State Examination (PSE). An ‘index of definition’ (ID), based on number, type and severity of PSE symptoms, was constructed in order to define a threshold point above which sufficient information was available to allow classification into one of the functional psychoses or neuroses. The index specified 8 levels of definition of disorder; the threshold point for a ‘case’ lying between levels 4 and 5. The identification of ‘cases’ by this means in the general population series was highly concordant with global clinical judgement.

When the 3 series were compared, the in-patient series contained the most definite cases, the out-patient series was intermediate, and the general population series was characterized mainly by below-threshold conditions.

Disorders above the threshold point were classified using the CATEGO program. The clinical severity of the depressive disorders and anxiety states identified in this way in the 3 series was compared on the basis of symptom and syndrome profiles and PSE scores. As expected, the inpatients had the most severe, and the general population ‘cases’ the least severe disorders.

It is suggested that the PSE-ID-CATEGO techniques can be used to help standardize certain aspects of case-finding and case-description in both referred and non-referred populations and thereby make the results of surveys more comparable.

Type
Research Article
Information
Psychological Medicine , Volume 8 , Issue 2 , May 1978 , pp. 203 - 217
Copyright
Copyright © Cambridge University Press 1978

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brown, G. W., Bhrolchain, M. & Harris, T. O. (1975). Social class and psychiatric disturbance among women in an urban population. Sociology 9, 225–254.CrossRefGoogle Scholar
Brown, G. W., Davidson, S., Harris, T., MacLean, U., Pollock, S. & Prudo, R. (1977 a) Psychiatric disorder in London and the outer Hebrides. Social Science and Medicine 11, 367–377.CrossRefGoogle Scholar
Brown, G. W., Harris, T. & Copeland, J. R. M. (1977 b). Depression and loss. British Journal of Psychiatry 130, 1–18.CrossRefGoogle ScholarPubMed
Copeland, J. R. M., Kelleher, M. J., Gourlay, A. J. & Smith, A. M. R. (1975). Influence of psychiatric training, medical qualification, and paramedical training in the rating of abnormal behaviour. Psychological Medicine 5, 89–95.CrossRefGoogle ScholarPubMed
Dohrenwend, B. P., Egri, G. & Mendelsohn, F. S. (1971). Psychiatric disorder in general populations: a study of the problem of clinical judgement. American Journal of Psychiatry 127, 1304–1312.CrossRefGoogle Scholar
Feighner, J. P., Robins, E., Guze, S. B., Woodruff, R. A., Winokur, G. & Munoz, R. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry 26, 57–63.CrossRefGoogle ScholarPubMed
Foulds, G. A. & Bedford, A. (1976). Classification of depressive illness: a re-evaluation. Psychological Medicine 6, 15–19.CrossRefGoogle ScholarPubMed
Gleisner, J., Hewett, S. & Mann, S. (1972). Reasons for admission to hospital. In Evaluating a Community Psychiatric Service (ed. Wing, J. K. and Hailey, A. M.), pp. 199–220. Oxford University Press: London.Google Scholar
Goldberg, D. P. (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Ingham, J. G. & Millar, P. M. (1976). The concept of prevalence applied to psychiatric disorders and symptoms. Psychological Medicine 6, 217–225.CrossRefGoogle ScholarPubMed
Kendell, R. E., Everitt, B., Cooper, J. E., Sartorius, N. & David, M. E. (1968). Reliability of the Present State Examination. Social Psychiatry 3, 123–129.CrossRefGoogle Scholar
Larsson, T. & Sjögren, T. (1954). A Methodological, Psychiatric and Statistical Study of a Large Swedish Rural Population. Munksgaard: Copenhagen.Google ScholarPubMed
Luria, R. E. & McHugh, P. R. (1974). Reliability and clinical utility of the ‘Wing’ Present State Examination. Archives of General Psychiatry 30, 866–871.CrossRefGoogle ScholarPubMed
Srole, L., Langer, T. S., Michael, S. T., Opler, M. K. & Rennie, T. A. C. (1962). Mental Health in the Metropolis: The Midtown Manhattan Study. McGraw-Hill: New York.CrossRefGoogle Scholar
Strömgren, E. (1938). Beiträge zur psychiatrischen Erblehre. Munksgaard: Copenhagen.Google Scholar
Wing, J. K. (1976). A technique for studying psychiatric morbidity in in-patient and out-patient series and in general population samples. Psychological Medicine 6, 665–671.CrossRefGoogle ScholarPubMed
Wing, J. K., Birley, J. L. T., Cooper, J. E., Graham, P. & Isaacs, A. (1967). Reliability of a procedure for measuring and classifying ‘present psychiatric state’. British Journal of Psychiatry 113, 499–515.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). Description and Classification of Psychiatric Symptoms. Cambridge University Press: London.Google Scholar
Wing, J. K., Henderson, S. & Winckle, M. (1977 a). Rating of symptoms by psychiatrists and non-psychiatrists: a study of patients referred from general practice. Psychological Medicine 7, 713–715.CrossRefGoogle Scholar
Wing, J. K., Nixon, J., Mann, S. A. & Leff, J. P. (1977 b). Reliability of the PSE (ninth edition) used in a population survey. Psychological Medicine 7, 505–516.CrossRefGoogle Scholar
World Health Organization (1973). Schizophrenia: Report of an International Pilot Study. WHO. Geneva.Google Scholar
World Health Organization (1974). Glossary of Mental Disorders and Guide to their Classification. WHO: Geneva.Google Scholar