Mini-Mental State findings from an age 60+ random community sample (N = 1681) indicate that score is related to education, age and race (but not sex) and to functional status, but not to selected aspects of physical or mental health. Adjustment for demographic characteristics, particularly education, is recommended lest cognitive impairment be overestimated.

Less educated elderly people are commonly found to perform more poorly on the Mini-Mental State Examination (MMSE). This educational level difference has been attributed by some research workers to test bias. To assess whether the MMSE is biased against the poorly educated, its validity was assessed separately in the more- and less-educated members of a community sample. No evidence was found to indicate that the test is a biased measure of cognitive impairment.

In a defined population of 112000, an attempt was made to discover every patient with multiple sclerosis. Using strict diagnostic criteria, 91 patients were identified. A search of psychiatric records for the same population revealed that 15 (16%) of these patients were referred to psychiatrists between the onset of their symptoms and the diagnosis of multiple sclerosis. Ten (11 %) were seen with symptoms attributable to multiple sclerosis. These symptoms were recognized as neurological in only two cases, while the other eight patients received a variety of psychiatric diagnoses.

Possible reasons for diagnostic error included the subjective nature of many early symptoms, histrionic behaviour, and psychiatric disturbance which drew attention away from physical symptoms. The results underline the caution needed when patients with physical symptoms are referred for psychiatric assessment.

This paper describes the development, validation and use of a computerized assessment for minor psychiatric disorder based on the Clinical Interview Schedule (CIS; Goldberg et al. 1970). There was good agreement between the computerized assessment and the CIS administered by psychiatrists, both in assessing overall severity and in defining ‘cases’ of psychiatric disorder. Individual symptoms elicited by the computer and the CIS were compared, and the levels of agreement found were similar to those from inter-observer studies of standardized interviews. Subjects from a variety of non-psychiatric settings regarded the assessment as acceptable, accurate and easy to use. It is concluded that this computerized assessment of neurotic symptoms is valid and reliable. It eliminates observer bias, it is an efficient use of research resources and it may have clinical applications in primary care.

Evidence is summarized suggesting that existing self-report questionnaires for the assessment of Type A behaviour pattern suffer from major methodological shortcomings. Type A individuals may be unwilling or unable to accurately self-report. The female spouse of the male patient can potentially provide a more objective, accurate ‘trait’ description less contaminated by ‘state’ variables such as diagnosis of illness or medication. The development of a spouse-report questionnaire is described and pilot data from 41 couples are presented, including comparison of the self-report and spouse-report responses on 46 questionnaire items and five scales. Unexpectedly high levels of agreement were found between self and spouse reports. Possible explanations of such agreement are critically examined.

The rate of DSM-III schizotypal personality traits was evaluated in three groups of adolescent offspring (ages 15–21), defined by the psychiatric diagnosis of their parents. Parental diagnoses included schizophrenic disorder (40 adolescents), affective disorder (35 adolescents), and ‘no psychiatric disorder’ (normal controls) parents (82 adolescents). The presence of the eight component features of schizotypal personality disorder was assessed from video-taped semi-structured psychiatric interviews, subsequently rated by trained psychiatrists, blind to the parental psychiatric status of the subjects. The effect of age, sex, and social class on the pattern of prevalence results was examined.

The expected specificity of DSM-III schizotypal personality traits to schizophrenia was not supported by the prevalence pattern of the traits. Rates of 2 or more, 3 or more, and 4 or more schizotypal personality features were highest in the parental psychiatric groups. The rates of schizotypal personality traits in adolescent offspring of affective disorder parents were as high as those previously reported for relatives of schizophrenic disorder probands.