Skip to main content
×
×
Home

Definition and prevalence of severe and persistent mental illness

  • Mirella Ruggeri (a1), Morven Leese (a2), Graham Thornicroft (a2), Giulia Bisoffi (a1) and Michele Tansella (a1)...
Abstract
Background

There is little consistency in how severe mental illness (SMI) is defined in practice, and no operational definitions.

Aims

To test two operationalised definitions, based on the National Institute of Mental Health (1987) definition: the first uses three criteria (diagnosis of psychosis; duration of service contact ≥ 2 years; GAF score ≤ 50), the second only the last two.

Method

Annual prevalence rates of SMI in two European catchment areas for each criterion and the criteria combined were calculated.

Results

The first definition produced rates of 2.55 and 1.34/1000 in London and Verona, respectively; the second permitted an additional 0.98/1000 non-psychotic disorders to be included in Verona.

Conclusions

The three-dimensional definition selects a small group of patients with SMI who have psychotic disorders. The two-dimensional approach allows estimates of SMI prevalence rates which include all forms of mental disorder.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Definition and prevalence of severe and persistent mental illness
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Definition and prevalence of severe and persistent mental illness
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Definition and prevalence of severe and persistent mental illness
      Available formats
      ×
Copyright
Corresponding author
Dr Mirella Ruggeri, Dipartimento di Medicina e Sanità’ Pubblica, Sezione di Psichiatria, Università di Verona, 37134 Verona, Italy. Tel: +39-045-8074441; fax: +39-045-585871; e-mail: mruggeri@borgoroma.univr.it
Footnotes
Hide All

Declaration of interest

Funding provided by the University of Verona and the Bethlem and Maudsley NHS Trust.

Footnotes
References
Hide All
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.
Balestrieri M., Micciolo R., De Salvia D., et al (1992) Confronti e prospettive nella utilizzazione dei Registri Psichiatrici dei Casi. Epidemiologica e Psichiatria Sociale, 1, 133148.
Balestrieri M., Bon M. G., Rodriguez-Sacristan A., et al (1994) Pathways to psychiatric care in South Verona, Italy. Psychological Medicine, 24, 641649.
Balestrieri M., Rucci P. & Nicolau S. (1997) Gender specific decline and seasonality of births in operationally defined schizophrenics in Italy. Schizophrenia Research, 27, 7381.
Dunn G., Pickles A., Tansella M., et al (1999) Two-phase epidemiological surveys in psychiatric research. British Journal of Psychiatry, 174, 95100.
House of Commons Health Select Committee (1994) First Report of the Health Committee: Better Off in the Community? The Care of People who are Seriously Mentally Ill. London: HMSO.
Johnson S., Brooks L. & Thornicroft G. (1997) London's Mental Health. London: King's Fund.
Jones S. H., Thornicroft G., Coffey M., et al (1995) A brief mental health outcome scale. Reliability and validity of the Global Assessment of Functioning (GAF). British Journal of Psychiatry, 166, 654659.
McCreadie R. (1982) The Nithsdale schizophrenia survey: I. Psychiatric and social handicaps. British Journal of Psychiatry, 140, 582586.
McGuffin P., Farmer A. & Harvey I. (1991) A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry, 48, 764770.
Meltzer H., Gill B., Petticrew M., et al (1996) OPCS Surveys of Psychiatric Morbidity in Great Britain. London: HMSO.
National Institute of Mental Health (1987) Towards a Model for a Comprehensive Community-Based Mental Health System. Washington, DC: NIMH.
Olfson M. & Klerman G. L. (1992) Depressive symptoms and mental health service utilization in a community sample. Social Psychiatry and Psychiatric Epidemiology, 27, 161167.
Robins L. N. & Regier D. A. (eds) (1991) Psychiatric Disorders in America: the Epidemiologic Catchment Area Study. New York: Free Press.
Roy-Byrne P., Dagadakis C., Unutzer J., et al (1996) Evidence for limited validity of the revised Global Assessment of Functioning Scale. Psychiatric Services, 47, 864866.
Ruggeri M., Biggeri A., Rucci P., et al (1998a) Multivariate analysis of outcome of mental health care using graphical chain models. The South Verona Outcome Project I. Psychological Medicine, 28, 14211431.
Ruggeri M., Riani M., Rucci P., et al (1998b) Multidimensional assessment of outcome in psychiatry: the use of graphical displays. The South Verona Outcome Project 2. International Journal of Methods in Psychiatric Research, 7, 186198.
Schinnar A. P., Rothbard A. B., Kanter R., et al (1990) An empirical literature review of definitions of severe and persistent mental illness. American Journal of Psychiatry, 147, 16021608.
Slade M., Powell R. & Strathdee G. (1996) Current approaches to identifying the severely mentally ill. Social Psychiatry and Psychiatric Epidemiology, 32, 177184.
SPSS (1996) SPSS for Windows: Base System User's Guide. Release 7.0. Chicago, IL: SPSS Inc.
Systema S., Giel R., ten Horn G. H., et al (1989) The reliability of diagnostic coding in psychiatric case registers. Psychological Medicine, 9, 9991006.
Tansella M., Amaddeo F., Burti L., et al (1998) Community-based mental health care in Verona, Italy. In Mental Health in our Future Cities (eds Goldberg D. & Thornicroft G.), pp. 239 262. London: Erlbaum (UK), Taylor & Francis (Psychology Press).
Thornicroft G., Strathdee G., Phelan M., et al (1998) Rationale and design. PRiSM Psychosis Study I. British Journal of Psychiatry, 173, 363370.
World Health Organization (1992a) The Tenth Revision of the International Classification of Diseases and Related Health Problems (ICD–10). Geneva: WHO.
World Health Organization (1992b) Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO.
Zimmermann M. (1994) Diagnosing personality disorders: a review of issues and research methods. Archives of General Psychiatry, 51, 225245.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 3 *
Loading metrics...

Abstract views

Total abstract views: 8 *
Loading metrics...

* Views captured on Cambridge Core between 3rd January 2018 - 19th January 2018. This data will be updated every 24 hours.

Definition and prevalence of severe and persistent mental illness

  • Mirella Ruggeri (a1), Morven Leese (a2), Graham Thornicroft (a2), Giulia Bisoffi (a1) and Michele Tansella (a1)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *