National Morbidity Study Research Articles

The College at 60

![][1] I have been a part of the College for 45 of its 60 years. What has it meant for me? On my first visit to Princes Gate, I was introduced to Robin Pinsent and immediately invited to join the morning meeting of the extremely friendly and committed Research Committee. The agenda — basically the Oral Contraceptive study, the late-running results of the last National Morbidity Study and the plans for the next one — was much the same. When I joined the Committee a decade later. So was the camaraderie. Princes Gate was full of London doctors rushing in, changing the world, and rushing out. Those from abroad came for the day (or night); read the papers in the leather sofas, chatted to Margaret Hammond in the library, passed the time of day with James Wood, … [1]: /embed/graphic-1.gif

The effect of the full moon on general practice consultation rates.

The effect of the full moon on human behaviour, the so-called 'Transylvania hypothesis', has fascinated the public and occupied the mind of researchers for centuries. The aim of the present study was to determine whether or not there was any change in general practice consultation patterns around the time of the full moon. We analysed data from the fourth national morbidity study of general practice. The data set was split into two groups and analysed separately: consultations on ordinary weekdays and consultations on weekends and bank holidays. The data were split randomly into two equal sets, one for model building and one for model validation. The lunar cycle effect was assumed to be sinusoidal, on the grounds that any effect would be maximal at the time of the full moon and decline to the new moon, following a cosine curve (with a period of 29.54 days, the mean length of a lunar cycle). There was a statistically significant, but small, effect associated with the lunar cycle of 1.8% of the mean value [95% confidence interval (CI) 0.9-2.7%]. This equates to an average difference between the two extremes during the cycle of 3.6%. For this data set, this accounts for 190 (95% CI 95-285) more consultations on days at the peak of the cycle compared with those at the bottom of the cycle, or, put another way, about three consultations per practice. We can speculate neither as to what the nature of these moon-related problems may be, nor as to the mechanisms underpinning such behaviour. However, we have confirmed that it does not seem to be related to anxiety and depression.

Epidemiology as an investigative paradigm: The College of General Practitioners in the 1950s

This paper focuses upon the research investigations of the College of General Practitioners in Britain in the 1950s. Beginning with a discussion of Michel Foucault's concept of ‘pastoral power’, the paper proceeds to analyse the ways in which the College attempted to set up an epidemiological scrutiny of general practices across Britain; from practice by practice observational studies to the first National Morbidity Study. The paper concludes by arguing that the epidemiological paradigm in general practice was beset by particular internal ‘limits’, and was replaced increasingly from the 1960s by an emphasis upon psychotherapeutic approaches.

Association between consultations for depression and for other conditions in patients aged 45 years and over.

There is little evidence of any association, either positive or negative, between the occurrence of depression and other clinical conditions. It would be particularly useful in general practice to identify any positive association between depression and other illness as this would make depression less likely to be missed in the consultation. Morbidity data recorded in the UK second national morbidity study were analysed, attention being confined to patients aged 45 years and over, who would be more likely to be suffering from chronic illness. During the year December 1971 to November 1972, there were 4 911 patients recorded as having depression who also consulted with other conditions. Morbidity codings were analysed to discover whether any of these conditions was recorded more or less frequently than might have happened by chance in the depressed group. Examples of conditions both positively and negatively associated with depression were revealed, the former being the more highly significant statistically. Validation of these findings should be sought in a similar analysis of the data from the UK third national morbidity survey, soon to be published.

The influence of increasing consultations on general practitioner activity rates in Belgium and United Kingdom

The activities of 100 G.P.s in the U.K. and 44 in Belgium were studied with regard to certain practice events—antibiotic usage, investigation procedures, prescription of psychotropic drugs, referral of patients to hospital and the number of consultations undertaken. Each of these were obtained during a two or four week period as part of a programme of Practice Activity Analysis for educational purposes. The mean activity rates and the range were remarkably similar in both national series. The extent of the range for consultations during the two weeks compares with that obtained in the Second British National Morbidity Study to a degree which provides support for the use of such a limited period. The influence of workload is studied by undertaking linear regression analysis of consultations undertaken versus the activity rates for investigations and prescription of psychotropic drugs. Investigation rates fall slightly as consultation rates increase though the prescribing of psychotropic drugs is not influenced.