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

Published online by Cambridge University Press:  09 July 2009

Paul Williams ,
Alex Tarnopolsky  and
David Hand
Paul Williams*
Affiliation:
General Practice Research Unit, Institute of Psychiatry, London
Alex Tarnopolsky
Affiliation:
General Practice Research Unit, Institute of Psychiatry, London
David Hand
Affiliation:
General Practice Research Unit, Institute of Psychiatry, London
*
1Address for correspondence: Dr Paul Williams, General Practice Research Unit, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF.
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Synopsis

Psychiatric 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.

Type
Research Article
Information
Psychological Medicine , Volume 10 , Issue 1 , February 1980 , pp. 101 - 114
Copyright
Copyright © Cambridge University Press 1980

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