The concept of psychiatric illness – a core problem in psychiatric epidemiology
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ABSTRACT:
The basic problem in psychiatric epidemiology is the ontology, to establish what the nature of psychiatric
illness, disease or disorder is. Psychiatric epidemiology operates with two main concepts of psychiatric
illness: the overload concept and the criterological concept. From these two different ideas of what a
psychiatric illness is, follow varying consequences for studies, clinical work and administrative purposes.
Differences between screening instruments and diagnostic tools in their concepts and operationalisations
result in different research results, such as varying gender differences. The screener and the diagnostic
instrument should both be tested against other illness indicators. A continuous screener can be interesting
as a measure of level of symptoms, but not a good measure of the probability for diagnosis. We need in
fact several definitions of psychiatric disorders; for clinical intervention use, for different types of research
and for administrative/bureaucratic purposes. The importance of classification depends on the purpose.
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