Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-19T02:54:27.916Z Has data issue: false hasContentIssue false

Do treated psychiatric patients become later community cases?

A prospective cohort study

Published online by Cambridge University Press:  16 April 2020

E.S. Paykel*
Affiliation:
Dept of Psychiatry, Cambridge, University of Cambridge, UK
L. Watters
Affiliation:
St Senan’s Hospital, Enniscorthy, C. Wexford, Republic of Ireland
R. Abbott
Affiliation:
Dept of Psychiatry, Cambridge, University of Cambridge, UK
M. Wadsworth
Affiliation:
MRC National Survey of Health & Development, Department of Epidemiology and Public Health, University College London, UK
*
*Corresponding author. University of Cambridge, Douglas House, 18e Trumpington Road, Cambridge CB2 2AH UK. E-mail address: [email protected] (E.S. Paykel).
Get access

Abstract

Background:

There have been few attempts to link two aspects of psychiatric epidemiology, severe disorder and milder ‘common’ mental disorder, by ascertaining whether subjects who have received psychiatric treatment for major disorders are identified later in epidemiological community surveys.

Methods:

Subjects were from a national birth cohort study and had been followed prospectively from childhood to middle age, with concurrent information on treatment from psychiatric facilities. In two successive prevalence surveys of milder disorder at 36 and 43 years, the association between earlier treatment and being a later community case was examined

Results:

Among 102 subjects who had been treated patients up to age 35 years, 52 (51%) were identified as definite community cases (36, 35%) or subthreshold cases (16, 16%) at either one or both later points. The proportion of community subjects who were previous psychiatric patients increased systematically from community non-cases, through subthreshold cases on one or both occasions, definite cases on one occasion, to definite cases on both occasions.

Conclusions:

About half of subjects who have received treatment from psychiatric facilities remain with persistent symptoms such as to identify them as definite or subthreshold cases of milder common mental disorder some years later.

Type
Original articles

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hotopf, M., Wilson Jones, C., Mayou, R., Wadsworth, M.E.J., Wessely, S.Childhood predictors of adult medically unexplained hospitalisations: results from a national birth cohort. Br. J. Psychiatry 2000;176:273280.CrossRefGoogle ScholarPubMed
Jones, P., Rodgers, B., Murray, R., Marmot, M.Child developmental risk factors for adult schizophrenia in the British 1946 birth cohort. Lancet 1994;344:13981402.CrossRefGoogle ScholarPubMed
Lindelow, M., Hardy, R., Rodgers, B.Development of a scale to measure symptomsof anxiety and depression in the general UK population: the psychiatric symptom frequency scale. Journal Epidemiol. & Comm. Health 1997;51:549557.CrossRefGoogle Scholar
Paykel, E.S., Hayhurst, H., Abbott, R., Wadsworth, M.Stability and change in milder psychiatric disorder over 7 years in a birth cohort. Psychol. Med 2001;31:13731384.CrossRefGoogle Scholar
Richards, M., Hardy, R., Wadsworth, M.The effects of divorce and separation on mental and physical health in a national UK birth cohort. Psychol. Med 1997;27:11211128.CrossRefGoogle Scholar
Rodgers, B., Mann, S.A.The reliability and validity of PSE assessments by lay interviewers: a national population survey. Psychol. Med 1986;16:689700.CrossRefGoogle ScholarPubMed
Rodgers, B.Behaviour and personality in childhood as predictors of adult psychiatric disorder. J. Child Psychol. Psychiatr 1990;31:93414.CrossRefGoogle ScholarPubMed
Rodgers, B.Adult affective disorder and early environment. Br. J. Psychiatry 1990;157:539550.CrossRefGoogle ScholarPubMed
Rodgers, B.Reported parental behaviour and adult affective symptoms 1: associations and moderating factors. Psychol. Med 1996;26:5161.CrossRefGoogle ScholarPubMed
Rodgers, B.Reported parental behaviour and adult affective symptoms 2: mediating factors. Psychol. Med 1996;26:6377.CrossRefGoogle ScholarPubMed
van Os, J., Jones, P., Lewis, G., Wadsworth, M.E.J., Murray, R.Developmental precursors of affective illness in a general population birth cohort. Arch. Gen. Psychiatry 1997;54:625631.CrossRefGoogle Scholar
van Os, J., Jones, P.B.Early risk factors and adult person-enviroment relationships in affective disorder. Psychol. Med 1999;29:10551067.CrossRefGoogle ScholarPubMed
van Os, J., Jones, P.B.Neuroticism as a risk factor for schizophrenia. Psychol. Med 2001;31:11291134.CrossRefGoogle Scholar
Wadsworth, M.E.J.The Imprint of Time: Childhood History and Adult Life. Oxford: Clarendon Press; 1991.Google Scholar
Wadsworth, M.E.J., Mann, S.L., Rodgers, B., Kuh, D.L., Hilder, W.S., Yousef, E.J.Loss and representativeness in a 43 year follow-up of a national birth cohort. J Epidemiol. Comm. Health 1992;46:300304.CrossRefGoogle Scholar
Wing, J.K.A technique for studying psychiatric morbidity in inpatient andoutpatient series and in general population samples. Psychol. Med 1976;6:665671.CrossRefGoogle Scholar
Wing, J.K., Cooper, J.E., Sartorius, N.The measurement and classification of psychiatric symptoms. Cambridge: Cambridge University Press; 1974.Google Scholar
Wing, J.K., Mann, S.A., Leff, J.P., Nixon, J.M.The concept of a ‘case’ in psychiatric population surveys. Psychol. Med 1978;8:203217.CrossRefGoogle ScholarPubMed
Wing, J.K., Bebbington, P., Robins, L.N.What is a case?: the problem of definition in psychiatric community surveys. In: Wing, J., Bebbington, P., Robins, L.What is a Case?. London: Grant McIntyre; 1981. p. 223236.Google Scholar
WHO. The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation; 1992.Google Scholar
Submit a response

Comments

No Comments have been published for this article.