The Hopkins Symptom Check List-25 (HSCL-25) is a screening instrument designed to identify common psychiatric symptoms. It has been widely used in different settings outside Sweden and also compared to assessment of psychiatric illness made by general practitioners. The aim of the present study was to validate the HSCL-25 against a psychiatric interview using the Present State Examination (PSE-9) in a Swedish sample of patients in general practice. Validity coefficients of the HSCL-25 were calculated for two different thresholds of caseness, > or = 1.55 and > or = 1.75, respectively. When > or = 1.75 was chosen as a cutoff point, the validity coefficients obtained by the HSCL-25 in this study were comparable to those obtained in other studies.

Males with a severe depression showed a high long-term risk for suicide, around 20%.

The low rates of recurrence and suicide suggest a better prognosis for community samples than for in- and out-patient samples.

The prevalence of mental illness in five different Scandinavian primary care populations was investigated in this study. Patients consecutively consulting their general practitioner a particular week-day were included in the study. Initially the SCL-25 was applied and next the high scores and a sample of the low scores were interviewed by the PSE. In the analysis the screening procedure was first validated. The internal validity of the SCL was tested by means of Rasch latent structure analysis and the external validity tested by ROC/QROC analysis. Based on this, a short 8-item version of the SCL was developed. The prevalence of mental illness in all centres was 0.26 with a minimum of 0.14 in Nacka and a maximum of 0.34 in Turku.

Low attrition rates over 50 years and reasonable diagnostic uniformity make comparisons over time justifiable.