SynopsisA random sample of 237 women in a south-east London area were seen by non-medical interviewers, trained to use a standard technique (the Present State Examination) to elicit and record psychiatric symptoms. Ninety-five were interviewed a second time by psychiatrists, who also rated audiotape recordings. The reproducibility of the techniques is adequate though not as high, in some respects, as that obtained from out-patient or in-patient samples. This is true at the level of symptom, syndrome, total score, and index of definition of psychiatric disorder. It is concluded that nonmedical interviewers can obtain as high reproducibility as psychiatrists on most of the non-psychotic sections of the PSE if they have appropriate training. Repeatability is lower than reproducibility, partly due to fluctuations in clinical condition, partly to environmental changes between interviews, and partly to differential responses to medical and non-medical interviewers. Over a short period of time, such as a week, repeatability is satisfactory.

SYNOPSISA 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.

SynopsisStudies employing psychiatric rating instruments administered by lay interviewers need to demonstrate the reliability and validity of subject classification. In a national population study utilizing the short form of the Present State Examination, audiotapes of interviews were used to demonstrate the reliability of ratings. The classification of ‘cases’ was found to be related to self-reports of nervous trouble and help–seeking for such problems. Associations between the rate of psychiatric disorder and demographic factors were similar to those found in previous community surveys. In general, the method of psychiatric assessment was considered to be satisfactory. Recommendations are made for the monitoring of interviews in similar large-scale investigations.

SynopsisFour hundred ‘new’ long-stay patients were studied and assessments of their needs for treatment and accommodation were made. About one third appeared to need further care in hospital. A further third could possibly be discharged if suitable accommodation in the community were available: most of this group were more handicapped than present residents in hostels. The remaining third had diverse needs; many were multiply handicapped – for example, by physical disability or mental retardation in addition to psychiatric disorder. At the moment the psychiatric hospital is virtually the only agency to accept the care of such people.

It is a common experience in the investigation of mental disorders that glycosuria is frequently found, thus indicating a tendency in such cases to a faulty carbohydrate metabolism. With the exception of epilepsy, this occurrence of glycosuria has been noted in most mental conditions. Intermittent glycosuria is met with in general paralysis (Kraepelin) (1); Bond (2) and Strauss (3) note it in about 10 per cent. of their cases. In dementia prócox Schultze and Knauer (4) did not observe glycosuria in the apathetic form of hebephrenia, but often found it to occur with catatonic excitement. With other observers (see Allers (5)) they record the marked association of glycosuria with depressed states, while its occurrence in mania was infrequent except in markedly excited and resistive cases.