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The Hierarchy Model of Psychiatric Symptomatology: An Investigation Based on Present State Examination Ratings

Published online by Cambridge University Press:  29 January 2018

P. G. Surtees  and
R. E. Kendell
P. G. Surtees
Affiliation:
Medical Research Council Unit for Epidemiological Studies in Psychiatry, University Department of Psychiatry, Royal Edinburgh Hospital, Morningside Park, Edinburgh EH10 5HF, Scotland
R. E. Kendell
Affiliation:
University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, Scotland
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Summary

Psychiatric diagnoses are arranged in a rough hierarchy, generally regarded as a convention to enable patients with a wide range of symptoms to be allocated to single diagnostic categories. Foulds, on the basis of self-report questionnaire responses, claimed that patients with symptoms at the higher levels of this hierarchy not only may but characteristically do exhibit symptoms at all lower levels as well. Foulds’ hierarchy model was tested here, using PSE ratings from two large series of in-patients; at least 75 per cent fulfilled the requirements of the model, but up to 50 per cent of schizophrenic and manic patients failed to do so. Almost two-thirds of all patients with psychotic symptoms establishing them in one of the upper two classes of the hierarchy did not exhibit the neurotic symptoms they required lower in the hierarchy.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 135 , Issue 5 , November 1979 , pp. 438 - 443
Copyright
Copyright © Royal College of Psychiatrists, 1979 

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