Symptom Scales and Diagnostic Schedules in Adult Psychiatry

Abstract

This chapter presents the history of instrumentation for assessing psychiatric phenomena as experienced by adults. Two types of instruments are defined and discussed. One type is known as a ‘scale’. It focuses on dimensions of psychopathy especially in reference to ‘symptoms’. The other type is known as a ‘schedule’. It deals with psychiatric diagnoses especially in terms of ‘syndrome recognition’. Such instruments involve standard questions and uniform categories for responses. All of them are available in published form. Such methods for gathering psychiatric data have been used in epidemiological studies of general populations as well as for investigations of patients in psychiatric specialty settings or primary care. The instruments are grouped in terms of the locales where they were designed and produced (North America and the United Kingdom) or through their sponsorship by the World Health Organization. The history of these methods covers many of the major studies of psychiatric disorders carried out since the World War II. Brief overviews of such studies and some of their findings are given. The chapter ends with discussion of several unresolved issues. These concern, for example, reliability, validity, categorical versus dimensional measurement, focus on the current clinical state versus lifetime history of psychiatric disorders, and the changing view of depression as a chronic rather than an acute disorder.

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