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In the present paper a sample of patients using psychiatric in-patient care only is characterized and analysed with regard to characteristics of the psychiatric services. This paper forms part of the Nordic Comparative Study on Sectorized Psychiatry, designed to investigate contact rates and use of psychiatric care by new patients in 7 catchment areas in 4 Nordic countries during a 1-year follow-up. One-year treated incidence cohorts were used. The logistic regression analysis revealed that the variable 'psychiatric service' was one of the statistically significant determinants of using only in-patient care during the follow-up. The diagnostic groups with the highest probability of using only in-patient care were dependencies and functional psychoses. The following factors were associated with a high risk of using only in-patient care: older age, being referred by another psychiatrist, having received previous psychiatric in-patient care, male sex, being retired, and not living with one's parents or a partner. Patients who used only in-patient care had fewer admissions and days in in-patient care than others during the 1-year follow-up period. Lack of 24-hour emergency services in out-patient care correlated positively with the use of only in-patient care.

After several years of development and testing, the World Health Organization (WHO) has recently completed work on the multiaxial presentation of ICD-10 for use in adult psychiatry. Axis III of the ICD-10 multiaxial system is intended for clinicians' reporting of contextual factors which may influence the diagnosis, treatment or prognosis of mental disorders that are recorded on Axis I. It was tested in two WHO-co-ordinated international field trials and found to be user-friendly, reasonably reliable and useful in routine clinical work, in the training of mental health professionals and in research on mental disorders.

Comparative studies relating characteristics of psychiatric services to rates of treated prevalence are scarce. As part of a Nordic comparative study on sectorized psychiatry, a point-prevalence study was performed in 5 sectorized psychiatric services with comprehensive service facilities for a defined population under responsibility. The rates of treated prevalence on a census day were related to a number of characteristics of the respective services and to accessibility of care. The results showed a great variation in one-day point prevalence in the 5 services, with almost fourfold differences. There were also marked differences in the diagnostic distribution of the cohorts. A positive correlation was found between number of beds and point prevalence, measured both as total point prevalence and impatient prevalence. The rates of beds and psychiatrists were most strongly related to the prevalence of patients with organic disorders and functional psychoses. A closed referral system was associated with a lower level of treated prevalence.

A multiaxial classification system has been developed in which three ICD-8 derived axes of psychiatric syndromes, personality disorders and somatic syndromes, and two DSM-III axes of psychosocial stressors and social functioning have been included. Global assessment scales were annexed the three ICD-8 axes. This DSM-III/ICD-8 system was used for registration of 880 consequetively admitted psychiatric patients in a general hospital setting. The results showed that six psychiatric syndromes (substance use disorders, schizophrenia, manic-depressive psychosis, reactive psychosis, neurosis, and adjustment reactions) were responsible for 80% of the diagnostic variance. Of these syndromes, manic-depressive psychosis had the highest improvement rate both concerning symptoms and social functioning. Manic-depressive psychosis had also the lowest coefficient of variation in the stay in hospital indicating a high degree of homogeneity in accordance to the diagnose-related group system. However, patients within the categories of reactive psychosis and neurosis who received antidepressants also had a low coefficient of variation, although the neurotics were significantly more depressed than the manic-depressives at discharge from hospital.

A study was undertaken concerning prevalence of psychic disorders among 175 5- to 6-year-old, pre-school children randomly selected from the general population in the municipality of Aarhus and the island Samso of Aarhus County, Denmark. Deviant behaviour was arbitrarily defined, with a symptom considered aberrant if it occurred in 10% or less of the children studied. Mental health of the children was assessed by (a) the number of deviant symptoms, (b) opinions of the parents and (c) the personal assessment of the author, who interviewed all the families. Thirty-five probands (20%) showed good adjustment, 113 (65%) were coping well with only minor symptoms, and 27 children (15%) were poorly adjusted. A high prevalence of psychosomatic, behavioural, and emotional symptoms was observed, some of them more frequently among boys than girls. No significant difference was found between urban and rural children. The need for psychiatric help even among supposedly normal, pre-school children is discussed and emphasized.

The use of the psychiatric services in Randers and its neighbouring municipalities with a total population of 114,650 was analyzed by a census on March 1, 1977. 76% of the population (87,108 persons) were at least 15 years old. 716 of these persons were in psychiatric treatment, with 18% in institutionalized outpatient care, 8.4% in non-institutionalized outpatient care, 36.9% in an alcohol clinic, 4.3% in psychiatric day-patient care, 16.1 % in inpatient hospital care, 15.9% in psychiatric nursing homes and 0.1% at psychiatric consultant service. The prevalence of psychiatric treatment of males and females was 8.40 and 8.05 per 1,000, respectively. Peak prevalence for both sexes was found in age group 35–44 years, due mainly to the high number of patients treated as outpatients or at an alcohol clinic. The prevalence of males and females in continuous psychiatric treatment for more than one year was 2.12 and 1.18 per 1,000, respectively (143 patients in all). Of these, 55% of males and 27% of females were treated at an alcohol clinic. Only 41 patients had been long-term inpatients. The presence of psychiatrists in private practice did not reduce the number of patients treated by other services. The private psychiatrist saw mainly the same categories of patients as were seen by psychiatrists at the outpatient clinic, but many patients probably would not have received psychiatric treatment had no private psychiatrists been available.

A nation-wide cohort of all first admitted patients to all Danish psychiatric institutions over a 1 year period and aged 15 years or more was followed for 10 years in the Danish psychiatric register. Revolving door patients were defined as patients with a minimum of four admissions and 1) no admission or discharge period lasting for more than 1/4 of the observation period or 2) at least four admissions over the first 1/4 of the observation period. The revolving door population comprised 1,397 patients with an incidence rate of 0.42 males and 0.32 females per 1,000. Forty-three point five percent belonged to the same diagnostic group at first and last diagnostic assessment ranging from 28.3% in "organic psychosis" to 57.6% in "neurosis". A multiple contingency analysis showed a number of variables at first admission significantly associated with the outcome "revolving door". Many were conditioned by others and the independent variables were "age group", "main diagnosis" and "sex". Patients aged 15-24 years constituted a high risk group among schizophrenics. The 15-24 age group was further at high risk among females with personality disorder or abuse and males with manic depressive and psychogenic psychosis. Living close to a psychiatric institution was in males associated with the outcome independently of age and diagnosis, in females it was restricted to personality disorder. Revolving door patients were significantly younger than others and more likely to suffer from schizophrenia or alcohol/substance abuse.

The prevalence of psychic problems in a random sample of children born in 1968 in the municipality of Aarhus and all children born in the same year on the island of Samso was determined in 1974 and again four years later. Structured interviews of parents were used as the main source of information on the children's problems. A high prevalence of psychosomatic, behavioural and emotional symptoms was observed among the children on both occasions. Several symptoms occurred significantly more frequently in boys than in girls. Deviant behaviour was arbitrarily defined as a symptom that occurred in 10% or less of the children. The mental status of the children was assessed by the number of deviant symptoms, the opinions of the parents and the assessment of the investigator. Demographic and socio-economic variables were analyzed and were related to the childrens’ mental health. Changes as well as persistence of symptoms are discussed.

The present investigation analyzes the characteristics of traffic accidents involving psychiatric patients and comprises all persons who during the period 1970–74 have been admitted to a psychiatric in-patient institution and who during the period 1972–74 have been involved in a traffic accident causing bodily injury. AAccidents with psychiatric patients involved constitute about 5.7 % of all traffic accidents reported in Denmark. Compared with the total group of accidents, they are characterized by an overrepresentation of women and of persons in the age group 25–54 years. Accidents with psychiatric patients are over-represented during the period July-September, and in areas densely built up. The accidents tend to be more complicated, and the psychiatric patients are more likely to get injured and be hospitalized due to the accident. The investigation is based exclusively on routinely collected data. The limitations with which the results are encumbered and the problems concerning methodology and comparison of merent studies are discussed.

— A cohort representing all first-time admissions to Danish psychiatric institutions during the period April 1, 1970 to March 31, 1971 was followed for 10 years in the psychiatric register. The cohort comprised 5,881 males and 6,856 females aged 15 years or above. The revolving door population was delineated as (1) patients with minimum four admissions and no admission or discharge period lasting for more than one fourth of the observation period or (2) patients with minimum four admissions during the first one fourth of the observation period. The incidence rate was 3.14 males and 3.55 females per 1,000. Revolving door patients were younger than others, single or divorced, and lived in larger cities. They were more frequently referred to out-patient aftercare and discharged to their own home. A male diagnostic profile of schizophrenia, demential or organic psychoses, personality disorders and abuse emerged together with a female profile of manic depressive and psychogenic psychosis and neurosis. Twenty-one point nine percent of males and 13.0% of females had more than 10 admissions and 4.5% of males and 3.7% of females spent more than 5 years in hospital. High risk groups were 15–24 years old as 21% and 13% of young males respectively females became revolving door patients, and schizophrenics, as 46% of male and 30% of female schizophrenics became revolving door patients.

The percentage of females among Danish medical graduates has increased from 1% in 1900–10 to 33% in 1980–84. In 1980 women doctors comprised 21% of all Danish medical doctors; the percentage among psychiatrists was 29. The purpose of the study has been to analyse the job-profiles of male and female psychiatrists, and their activities in research, teaching, committees, etc. The job-profiles of males and females differ, females more likely being in less influential positions. Based on an investigation among members of the Danish Psychiatric Association, the working conditions and professional activity of 307 male and female psychiatrists were analysed. Male psychiatrists were found to complete their training at a younger age than females. Among those aged 25–44, 29% of males and 6% of females had reached a position as chief consultant. Males report greater activity in all areas of research, and 35% of females and 17% of males do no research at all. In all age groups and all fields investigated more males take part in organisational activities, while 48% of females and 25% of males report no such activtity. No difference was found regarding teaching experience, but men were relatively more often involved in teaching professional groups and women, nursing staff. A significant preponderance of males had their main interest in biological psychiatry, females in psychotherapy.

The present investigation analyzes the characteristics of traffic accidents involving psychiatric patients and comprises all persons who during the period 1970-74 have been admitted to a psychiatric in-patient institution and who during the period 1972-74 have been involved in a traffic accident causing bodily injury. Accidents with psychiatric patients involved constitute about 5.7 percent of all traffic accidents reported in Denmark. Compared with the total group of accidents, they are characterized by an over-representation of women and of persons in the age group 25-54 years. Accidents with psychiatric patients are over-represented during the period July-September, and in areas densely built up. The accidents tend to be more complicated, and the psychiatric patients are more likely to get injured and be hospitalized due to the accident. The investigation is based exclusively on routinely collected data. The limitations with which the reslts are encumbered and the problems concerning methodology and comparison of different studies are discusses. /Author/