Community survey data on neurotic symptoms and subjective well-being scales were examined with principal components analysis. The two types of scales were found to load on separate, but negatively correlated, factors. Furthermore, some differential correlates of the two types of scale were found, but the differences were not great. It was concluded that neurotic symptom and well-being scales do largely measure different ends of a single continuum, but well-being scales seem to have an extraversion component not shared by neurotic symptom scales. Subjective well-being measures may be useful in epidemiological surveys where it is desirable to discriminate among low symptom scorers.

One hundred adult male psychiatric patients were investigated concerning their recollections of defined sexual activities occurring with adults before the age of sixteen.

Twenty-three subjects reported such events. The events were remembered as having been mostly distressing at the time but their later significance is unclear.

A two-phase survey of mental disorders uses a screening test to identify possible cases, thereby reducing the resources devoted to interviewing those not having the condition of interest. It is demonstrated using a mathematical model that in situations likely to be encountered in practice a two-phase design may lead to an increase in the efficiency of prevalence rate estimation, and also to an improvement in the efficiency of case detection. However, in certain applications the modest gain in efficiency may not warrant the additional complexity of a two-phase approach to data collection. Data from a survey of mental disorders in Edmonton, Canada, which collected informations on 3258 community residents using the Diagnostic Interview Schedule and the General Health Questionnaire, are used to demonstrate how two-phase methods would have changed the efficiency of an actual survey.

Since the turn of the century and up to about 1980, there have been two generations of epidemiological studies of the true prevalence of psychiatric disorders: a pre-World War II first generation and a post-World War II second generation. With the appearance of DSM-III in 1980 and the changes in epidemiological proceducres coincident with it, it has become meaningful in the US to talk about the beginnings of a new, third generation or studies in psychiatric epidemiology. The purposes of this paper are: first, to briefly summarize the problems of validity with the procedures for case identification and diagnosis in the first-and second-generation studies; second, to consider some of the newer developments with regard to diagnostic instruments that either are or should be influencing third-generation studies; third, to discuss some of the problems of validity in the handful of third-generation studies done so far; and fourth, to describe and illustrate an approach that seems to make sense in the context of gaps in knowledge of aetiology and pathogenesis that leave us still dependent on interviews for case identification and classification.

The present study compares the efficacy of the GHQ-12 and the Chinese Health Questionnaire (CHQ–12) in Cantonese speaking Chinese primary-care patients living in Greater Manchester, using relative operating characteristic (ROC) analysis. We did not find that the Chinese version offered any advantage over the conventional version of the GHQ in this population. Stepwise discriminant analysis however confirmed the value of individual items in the former pertaining to specific somatic symptoms and interpersonal relationships in differentiating cases from non-cases. Information biases, arising from the lack of a reliability study on the second-stage case identifying interview and the unique linguistic characteristics of the Chinese language may have affected the overall validity indices of the questionnaires. The study also examines the effects of using different criteria to define a case, and shows that with increasing levels of severity, there is an improvement in the diagnostic performance of the two questionnaires as reflected by areas under ROC curves and traditional validity indices. Possible explanations of these findings are discussed. The scoring method proposed by Goodchild & Duncan-Jones (1985) when used on these questionnaires had no demonstrable advantage over the conventional scoring method.

Thirty-three patients admitted to hospital with severe early onset puerperal psychiatric disorders were compared with matched normal puerperal controls. Interviews, which were administered after recovery, covered life events in the previous thirteen months and detailed assessment of previous and personal history, pregnancy and labour, other aspects of stress, social support, and marital relationships. No differences, except for previous history of psychiatric disorder, were found between patients and controls or between patients with depressive and with other diagnoses. These findings of absence of social stress contrast with previous studies of milder post-partum depression and of disorders with onset during pregnancy, and suggest that the aetiology of severe post-partum disorders is predominantly biological.

This quasi-prospective study of 2163 women attending breast-screening clinics (and controls), indicates that there is a link between personality factors and breast disease. Certain aspects of Type A behaviour seem to be associated with breast-disease states.

Data are presented from a study of acculturation and psychiatric disorder in 291 Greek Cypriot immigrants from the general population of Camberwell, south London. We hypothesized that ‘pre-acculturation’ would protect against mental disorder, that difficulties in the period immediately after migration would increase the risk of disorder, and that disorder would be least common among those in the middle range of the acculturation spectrum.

Of pre-acculturation factors, only previous knowledge of English was associated with reduced prevalence. Difficulties in the settling-in period were clearly related to current disorder. No relationship was apparent between present acculturation and disorder, but this disguised an interesting but unpredicted gender effect: in males, disorder was most prevalent in the highly acculturated; in females, in the least acculturated.

It is argued that latent trait analysis provides a way of examining the construct validity of diagnostic concepts which are used to categorize common mental illnesses. The present study adds two additional aspects of validity using multiple discriminant analysis applied to two widely used taxonomic systems. Scales of anxiety and depression derived from previous latent trait analyses are applied to individuals reaching criteria for ‘caseness’ on the ID-CATEGO system and the DSM-III system, both at initial diagnosis and six months later. The first multiple discriminant analysis is carried out on the initial scale scores, and the results are interpreted in terms of concurrent validity. The second analysis uses improvement scores on the two scales and relates to predictive validity. It is argued that the ID-CATEGO system provides a better classification for common mental illnesses than the DSM-III system, since it allows a better discrimination to be made between anxiety and depressive disorders.

General practice based psychiatric clinics have increased in number in recent years. Case-note and case-register data examining the nature of the psychiatric disorder of the patients seen in this setting have shown contradictory findings. In this study comparison of 113 patients referred to primary care and hospital out-patient clinics is made using standardized clinical and social measures. Our results show that both groups had similar degrees of physical and social dysfunction and comparable levels of psychiatric morbidity. However, in the primary care population there were more women, and schizophreniform psychoses predominated. In the hospital sample affective illnesses and personality disorders were more common. The majority of patients preferred to consult in the primary care setting.

Controls (N = 45), schizophrenics (N = 20) and alcoholics (N =23) were asked to choose at random a number between 1 and 10, 100 times. The correlation matrices of five different randomization indices were used to study within group variation; these matrices were similar for the normal and alcoholic groups, but very different for the schizophrenic group. The differences between the three groups were studied by canonical analysis and, in terms of the canonical variables, the mean performance of the normal group is clearly discriminated from that of the alcoholic and schizophrenic subjects.

Prevalence of bulimia was estimated from a cross-sectional general population survey of 1498 adults, using the Diagnostic Interview Schedule (DIS) administered by trained lay interviewers. Lifetime prevalence of the DSM-III syndrome in adults aged 18–64 was 1·0% and this was concentrated in young women: in women aged 18–44 lifetime prevalence was 2·6%, and 1·0% currently had the disorder. Based on clinicians' reinterviews of random respondents and identified and marginal cases, the prevalence of current disorder using criteria for draft DSM-III-R bulimia was 0·5%, for DSM-III it was 0·2%, and for Russell's Criteria bulimia nervosa 0·0%. A strong cohort effect was found, with higher lifetime prevalence among younger women, which is consistent with a growing incidence of the disorder among young women in recent years. Although elements of the syndromes were so common as to suggest that dysfunctional attitudes to eating and disturbed behaviour surrounding eating are widespread, there was little evidence of the bulimia syndrome having become an epidemic on the scale suggested by early reports.

We examine published data from 12 studies assessing the capacity of Expressed Emotion (EE) status to predict schizophrenic relapse. Analysis of aggregated data, for 908 subjects, established a 3–7 times greater likelihood of relapse in those categorized as high EE, and a somewhat waning predictive strength EE over the publication interval, 1962–88.

This paper examines the effect of psychiatric morbidity, as measured by the GHQ-60, on the probability of being in contact with a primary care physician, and the socio-demographic factors which influenced this effect. We found that the presence of psychiatric morbidity emerged as a major determinant of primary care utilization in both sexes, and about one-sixth of consultations in men and one-fifth of consultations in women could be attributed to it. Logistic modelling was used to investigate the joint effect on general practitioner consultation of psychiatric morbidity and seven socio-demographic variables. Sex, age, and psychiatric morbidity exerted independent, but not interactive, effects on consultation.