Definition and prevalence of severe and persistent mental illness

RUGGERI, MIRELLA
LEESE, MORVEN
THORNICROFT, GRAHAM
BISOFFI, GIULIA
TANSELLA, MICHELE

MIRELLA RUGGERI, PhD, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona, Ospedale Policlinico, Verona, Italy; MORVEN LEESE, PhD, GRAHAM THORNICROFT, PhD, Section of Community Psychiatry (PRiSM), Institute of Psychiatry, London; GIULIA BISOFFI, Dr Stat, MICHELE TANSELLA, MD, Dipartimento di Medicina e Sanità Pubblica, Sezione di Psichiatria, Università di Verona, Ospedale Policlinico, Verona, Italy

Correspondence: Dr Mirella Ruggeri, Dipartimento di Medicina e Sanita' Pubblica, Sezione di Psichiatria, Università di Verona, 37134 Verona, Italy. Tel: +39-045-8074441; fax: +39-045-585871; e-mail: [email protected]

(First received 14 June 1999, final revision 23 December 1999, accepted 23 December 1999)

British Journal of Psychiatry 177:p 149-155, August 2000.

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 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.

Declaration of interest

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