This study examined the impact of repeated exposure to combat on combat stress reaction (CSR). Sodliers diagnosed with CSR during the Lebanon War (N = 382) were compared with a matched control group of soldiers who fought in the same units but did not manifest symptoms of CSR (N = 334). CSR in the Lebanon War was found to be related to the psychological outcome the soldier experienced in previous wars. The CSR rate in the Lebanon War was higher in soldiers who had experienced an episode of CSR in a previous war than in soldiers with no past combat experience. However, CSR rates were lower among soldiers who had not had an episode of CSR in a previous war than among soldiers with no prior combat experience. High intensity of combat in Lebanon was found to increase both the detrimental and favourable effects of prior combat experience.

The effects on depressive thinking and depressed mood of a brief, standardized distraction procedure were examined. In low endogenous patients (scoring 3 or less on the Newcastle Diagnosis Scale (NDS)), distraction significantly reduced the frequency of depressing thoughts. Consistent with Beck's cognitive model of depression, these patients were significantly less depressed after distraction than after a control procedure. In high endogenous patients (scoring 4 or more on the NDS), distraction produced less marked reductions in frequency of depressing thoughts, and no significant change in depressed mood. It is suggested that the relationship between negative thinking and depressed mood differs in the two patient groups.

Interviews were conducted with 49 men just after they had become unemployed, and with a matched sample of 49 employed men. Follow-up interviews took place 6–8 months later. At follow-up 20 originally unemployed men were still without work, and were significantly more depressed than the employed. Five of these 20, but no employed men, had become clinically depressed. In a multiple regression analysis there was a significant employment × social support interaction which indicated that depression scores at follow-up were higher in those who remained unemployed and who had little social contact with others in the month before losing their jobs. Depression becomes likely when people lose a source of social interaction that is important to their sense of worth, and have no alternative means of experiencing this worth in other relationships.

This study uses methods of latent trait analysis to examine the relationships between psychiatric symptoms that constitute the common psychiatric disorders encountered in primary-care settings. Two highly correlated symptom dimensions of anxiety and depression are shown to underlie these disorders. Neurovegetative sysmptoms of depression are shown to be on the same dimension as psychic symptoms of depression, but to represent a more severe manifestation of depression.

We investigated the nosology of endogenous depression by numerical taxonomy. Five hundred and sixty-nine patients diagnosed as having unipolar major depressive disorder in the NIMH Clinical Research Branch Program on the Psychobiology of Depression – Clnical were studied. Thirty-six symptoms which might distinguish endogenous from non-endogenous depressions were chosen from the literature. Patients' symptom profiles assessed by structured interview were grouped by two methods: a K-means improvement of Ward's method of cluster analysis, and a latent class algorithm. The methods produced very similar groups and several internal validity criteria suggested that the groups were not spurious. Cluster 1, ‘nuclear depression,’ included a nucleus of patients common to multiple definitions of endogenous depression. The non-nuclear group scored as less neurotic than the nuclear group on personality tests administered during the index episode. The groups do not differ in frequency, number or severity of reported life events prior to onset of the index episode. The nuclear group shows a poor prognosis on two-year prospective follow-up, greater disturbance on personality inventories, and increased heritability of depression in siblings.

The Social Behaviour Schedule (SBS) was examined as a measure of disability in a series of 66 chronic psychiatric patients, who were also assessed using the Social Role Performance Schedule (SRP) and the ninth edition of the Present State Examination (PSE). All three schedules have been used in previous studies in their present form. SBS and SRP measures were correlated with each other and neither showed any relationship with subjectively described current PSE symptoms. SBS deficit was associated with a clinical diagnosis of schizophrenia and with problems in supervised occupational activity. Long-term hospital residents showed greater SBS deficit than chronic patients in active rehabilitation programmes, although impaired SRP was the major correlate with the type of supervision provided. SRP measures can be compared with population norms, unlike measures derived from the SBS, which cover more severe ranges of disability.

A two-phase study of psychiatric prevalence has been carried out among the inhabitants (aged 18–64) of a Dutch health area (Nijmegen). In phase 1, a random sample of 3232 persons answered the GHQ–30 (response rate:75%). In phase 2,486 of the respondents were interviewed withthe full PSE within two weeks. The relationship of PSE-‘caseness’ (ID ≥ 5) and GHQ score was expressed in a logistic regression model, the parameters of which showed strong agreement with the Canberra results, for all socio-demographic variables examined, except for urbanization. means of the logistic model the point-prevalence of PSE cases was calculated at 7·3% (range5·5%-9·2%).

Prevalence did not differ significantly in men and women. Higher case rates were found in age category of 55–59 years, among divorced and widowed persons, the lower educational and occupational levels, the unemployed, chronically ill and unable to work, and with city people. This study adds further evidence to a growing body of epidemiological data suggesting similar rates and patterns of psychiatric disorder in populations in industrialized countries.

The Organic Brain Syndrome (OBS) and the Depression (D) scales derived from the Comprehensive Assessment and Referral Evaluation (CARE) were translated into Italian and used in a survey of geriatric institutions in Milan. During the survey validity and reliability tests of the scales were conducted.

Inter-rater reliability (total score weighted kappa) was highly satisfactory for both scales (0·96 for OBS and 0·83 for D scale). Reliability was assessed three times during the survey and showed good stability for both scales, with a slight but significant trend towards reduction over time for the D scale. Reliability of the D scale was significantly lower when the subjects interviewed scored highly on the OBS scale (severe cognitive impairment).

Criterion validity was highly satisfactory both for the OBS scale (cut-off point 4/5: sensitivity 77%, specificity 96%, positive predictive value 91%) and the D scale (cut-off point 10/11: sensitivity 95%, specificity 92%, positive predictive value 84%).

Results are discussed with special reference to longitudinal assessment of reliability, the choice of the cut-off point, and the context-dependent properties of questionnaires.

Two-stage screening for psychiatric disorder was carried out with a sample of 99 male and 95 female outpatients with insulin-dependent diabetes mellitus, using the General Health Questionnaire and the Clinical Interview Schedule. The estimated prevalence of psychiatric disorder in this sample was 18%: only 28% of the psychiatric morbidity so identified was detected by physicians. In contrast, physicians rated 10% of the sample as psychiatric ‘cases’ using a simple 6-point scale.