The truth about psychiatric morbidity?

One task of social psychiatry is to increase our knowledge about true morbidity for mental illness in the community, in order to direct the delivery of psychiatric care. There are, however, several possible sources of error in traditional methods used to estimate morbidity. Changing definitions of mental illness have rendered application and comparison of epidemiological findings of doubtful value. Changes in referral behaviour of general practitioners following changes in intake‐procedure of clinics can affect morbidity estimates. The illness behaviour on the part of the patient and the decision behaviour of the medical professional also can influence estimates of morbidity. Illness behaviour can be viewed from the perspective of the socio‐cultural definition of illness, from the perspective of illness behaviour as a coping response and from the perspective of illness behaviour as “secondary illness gain”. There is some evidence that medical professionals fail to distinguish sufficiently between illness proper, which may be a rather constant factor in the community, and illness behaviour, which appears to be on the increase. The decision‐behavioural problem of the doctor is discussed from Scheff's sociological viewpoint.