Background. We sought to develop a clinically useful subtyping system for the non-melancholic depressive disorders, and here we assess one weighted to central aetiological factors.

Methods. We studied 185 patients meeting DSM-III-R and/or clinical criteria for non-melancholic depression. Data were obtained by self-report, interview of patients and from corroborative witnesses. We developed a set of variables for class definition, assessing: (i) ‘P’, disordered personality as a vulnerability factor; (ii) ‘A’, meeting criteria for a lifetime anxiety disorder or positive on probe questions about trait anxiety characteristics, so assessing anxiety as a vulnerability factor; and (iii) ‘L’, psychiatrist and consensually-rated life event stress prior to depression onset.

Results. A latent class analysis generated a four-class solution for the P–A–L variables. Life event stressors had similar item probabilities across all four classes, and did not influence the four-class ‘P–A’ solution when deleted from the analysis, suggesting that life event stress may act more as a general provoking agent, rather than constituting any distinct ‘reactive’ or ‘situational’ depression class. Three classes generated clinically meaningful groupings, reflecting varying contributions of anxiety and disordered personality functioning, and with evidence of differential outcome over the following 12 months.

Conclusions: We suggest that a refined aetiologically-weighted model may assist definition of the non-melancholic depressive disorders, and provide the logic for exploring the comparative utility of differing treatments to identified vulnerability-based classes.

Background. Despite the increasing importance of quality of life in the mental health field, the theoretical conceptualization of the construct remains poorly developed. A proposed mediational model of quality of life, which links subjective quality of life with self-related constructs, is examined with a group of long-term psychiatric hostel residents. The present study aims to develop a measure of quality of life based on the proposed model, to explore the data and their implications for service development and finally to conduct a preliminary analysis of the model's predictions.

Method. A cross-sectional research design was employed. Quality of life interviews, using a modified version of Lehman's Quality of Life Interview, were carried out with 54 psychiatric residents in Greece. The model's predictions were examined by using a series of regression analyses.

Results. The results indicate that perceived improvements in lifestyle, greater autonomy and positive self-concept are significantly and directly associated with better quality of life. In contrast, a direct relationship between objective indicators and subjective quality of life was not found.

Conclusions. The traditional two-part quality of life model that includes objective indicators of life circumstances and subjective indicators is extended to included the constructs of self-concept and perceived autonomy. The present extended mediational model of quality of life for individuals with long-term mental health problems appears to have important implications for the planning and delivery of mental health programmes.

Background. Recent anthropological studies have documented the importance of understanding the relation of culture to the experience of mental illness. The use of interviews that elicit explanatory models has facilitated such research, but currently available interviews are lengthy and impractical for epidemiological studies. This paper is a preliminary report on the development of a brief instrument to elicit explanatory models for use in field work.

Method. The development of the SEMI, a short interview to elicit explanatory models is described. The interview explores the subject's cultural background, nature of presenting problem, help-seeking behaviour, interaction with physician/healer and beliefs related to mental illness.

Results. The SEMI was employed to study the explanatory models of subjects with common mental disorders among Whites, African-Caribbean and Asians living in London and was also used in Harare, Zimbabwe. Data from its use in four different ethnic groups is presented with the aim of demonstrating its capacity to show up differences in these varied settings.

Conclusions. The simplicity and brevity of the SEMI allow for its use in field studies in different cultures, data can be used to provide variables for use in quantitative analysis and provide qualitative descriptions.

Background. The aim of the current study was to evaluate the utility of maternal recall for obtaining history of obstetric complications (OCs) in psychiatric research.

Methods. Obstetric information from in-depth structured maternal interviews and from hospital birth records was compared in 45 mothers of schizophrenic patients and 34 control mothers. Both types of information were blindly and independently scored for OCs using the McNeil-Sjöström OC Scale.

Results. Considerable discrepancies were observed between interviews and records, irrespective of maternal group. No significant differences were found between patient and control mothers in error type (omission, commission, total retrospective error) or recall facility for selected events. More errors of commission were made by mothers of patients with negative family history than mothers of patients with positive family history for psychiatric disorder. Patients had significantly more OCs than controls only when hospital record information was utilized.

Conclusions. OC history obtained by maternal recall has methodological limitations.