Relationships of psychopathology to age, sex, ethnicity, education and marital status in state hospital patients

Abstract

THE INCREASING use of symptom and behavior rating scales in clinical research during the past two decades has created a renewed respectability for descriptive psychiatry. This has led us back to a concern for directly observable manifestations, the phenomenology of mental illness.l-3 Rating scales such as the BPRS (Brief Psychiatric Rating Scale)4 and the IMPS (Inpatient Multidimensional Psychiatric Scale)5 have proven very useful in the field of psychopharmacology. Not only have they permitted quantitative evaluation of symptom change, but they have also provided a basis for description and classification of patients.6 The classification of patients solely on the basis of current symptom manifestations is a radical departure from usual psychiatric diagnostic practice in which history, etiology and sociocultural information enter into classificatory decisions. Although phenomenological description and classification have advantages, we must also recognize a growing body of evidence indicating that phenomenological differences are substantially related to personal, social and cultural variables.’ The significance of observed psychopathology may depend on the context of background factors within which it occurs. It is important that symptom rating scales, rather than clinical diagnoses, be used in evaluating the psychiatric relevance of background variables. Clinical diagnostic classification involves consideration of historical and sociocultural factors; thus certain built-in relationships are to be expected, whereas the use of quantitive rating scale profiles to describe psychopathology avoids most of this problem. In addition, well known problems related to the absence of clearly defined diagnostic criteria and consequent unreliability of clinical diagnoses are avoided. Although numerous variables are potentially interesting with respect to implications for manifest psychopathology, a relatively small number are almost universally considered