Case definition and case identification in psychiatric epidemiology: review and assessment

Abstract

SYNOPSISPsychiatric epidemiology has advanced considerably since early studies of hospital populations. The direction of this advance has been away from the study of populations of hospital psychiatric patients towards the study of psychiatric disorder in general practice and the community as a whole. Just as the populations under study have different defining characteristics, so have the individuals who comprise them. Psychosis becomes less and less common at greater distances from the hospital patient, and in the community the epidemiologist is faced with large numbers of respondents who present with fewer, minor and non-specific symptoms.In this review, we present evidence to indicate that concepts of case definition and case identification are insufficiently advanced so far, and are still rooted in ideas derived from hospital psychiatry. Foremost among these is an exclusive preoccupation with diagnosis and symptoms. We suggest that this may be inadequate for the study of non-psychotic disturbance in the community, and discuss other models of case definition, encompassing personality and social functioning as well as psychiatric symptomatology.

Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS)

“…HADS, as a screening instrument, applies threshold scores marking these boundaries. 12,39 We found ample reasons to keep the same threshold scores for the Nepali version as those proposed by the original authors of HADS.…”

“…In order to maintain a high level of specificity, 12,39 we recommend maintaining the threshold score of ≥11 to designate caseness for both anxiety and depression. In other words, there is support for keeping the original thresholds and using them in the Nepali version of HADS, which thus can serve as a case-finding instrument among hospital patients as well as in the general population.…”

Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão

“…Essa alternativa tem sido amplamente utilizada em estudos comunitários e em assistência primária 20,26 . Desenvolvida para esse fim, a "Clinical Interview Schedule" (CIS) é uma entrevista psiquiátrica estruturada 5,8 .…”

Dados de epidemiologia descritiva de transtornos mentais em grupos populacionais do Brasil

“…Em qualquer estudo de epidemiologia psiquiátrica, é suprema a importância da conceituação de caso. Os problemas em torno dessa conceituação e as conseqüências da adoção de diferentes critérios de inclusão como sendo caso estão bem descritos no trabalho de Blum 4 e no de Williams e col. 26 , ambos orientados para estudos epidemiológicos em psiquiatria.…”