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Plasma levels of total and free tryptophan were measured in patients with depressive neurosis and depressive psychosis, before and after recovery. No significant differences were found in total or free plasma tryptophan levels between 'neurotic' and 'psychotic' groups, and no change in these levels was found on recovery from depressive illness.

Objective: Migrants migrate for a number of reasons and varying duration. The objective in this paper is to review the findings to ascertain whether rates of depression among migrants are higher compared with the non-migrant populations. Method: We used the published data to review the theoretical background for migration and to study the existing literature on rates of depression in various migrant and ethnic groups. Results: The rates of depressive neurosis vary according to migrant status. Migrants in some groups are less likely to report symptoms of depression. Using fluency in language as a proxy measure of acculturation it appears that acculturated individuals are more likely to be depressed. Conclusion: The impact of migration on depression is not as clear and straightforward as for other psychiatric conditions. More work needs to be carried out in understanding the impact of migration on depression.

Emotional estimation of short fragments of classical music was analyzed in healthy subjects and patients with depressive neurosis and retarded depression (the depressive phase of maniac-depressive psychosis). The values and stability of point estimates varied between the studied groups. Narrowing of the range of emotional estimates was found in depressed patients. Standard deviation of estimates was related to musical key and tempo in normal subjects and patients with retarded depression.

Purpose To evaluate the curative effect of acupuncture on depressive neurosis.Method Sixty-two patients were randomly divided into a treatment group of 32 cases and a control group of 30 cases. The treatment group and the control group were treated with acupuncture and Fluoxetine, respectively. The curative effects were evaluated by HAMD.Results There was a significant difference between pretreatment and posttreatment in each group (P 0.05). But acupuncture had no side effects and was good in compliance.Conclusion Acupuncture is an effective method for treating depressive neurosis.

Catgut embedding therapy has been used for thousands of years in traditional Chinese medicine for the treatment of many conditions, such as perimenopausal syndrome, chronic urticaria, depressive neurosis, refractory insomnia, obesity, sciatica, etc. Treating obesity with catgut embedding is commonly believed to be effective and better than Western medical practice. It involves weekly infixing 10 to 15 surgical chromic catgut sutures into the subcutaneous tissue of the extremities and abdomen with a specialised needle under aseptic precautions. Even though this traditional treatment is considered safe, a complication has recently been reported in this journal.1 There is still no evidence-based consensus on the contribution of catgut embedding to the …

抗うつ薬・抗不安薬の投与により変化がなく, 六君子湯 (ツムラエキス顆粒7.5g/日, 分3食間内服) の投与により著明な改善をみた神経性無食欲症 (24歳・女性) と抑うつ神経症 (25歳・男性) の二症例を経験した。六君子湯の効果判定のための精神症状評価尺度にHDRS・BDI・MASを用い, 1週毎の評価を行った。その結果, 六君子湯は不安症状評価のためのMASではほとんど著変がなく, 抑うつ症状評価のためのHDRSとBDIで顕著な改善傾向を示した。それぞれの患者の背景に複雑な生活史に山来するパーソナリティ形成上の問題が示唆され, 六君子湯は2症例ともにパーソナリティに結びついた不安症状の軽減には効果がなく, 不安症状から2次的に派生した抑うつ症状 (食欲不振・疲労倦怠・不眠など) に奏効するとの印象が得られた。

The influence of culture on neurotic disorders and their epidemiology, incidence, clinical pattern and even their response to psychotropic drugs have been studied only sparingly. However, most of the cross-cultural differences in the incidence of mental illness pertain to the area of neurosis. But, after accounting for the various confounding variables, no true major difference in the prevalence of neurosis can be confirmed. There are apparently no ‘true' culturally unique neurotic disorders, though distribution of some neurotic disorders varies across cultures. There are also some differences in the psychopathology of neurosis between different cultures. Cultural factors seem to influence the presentation of depressive neurosis, anxiety and obsessive compulsive disorders. Hysteria seems to be becoming less prevalent all over the world, though at a slower rate in some cultures. Anxiety, phobia and neuresthenia have unique presentation in some of the cultural backgrounds, usually orientals. Cultural factor...

African Americans purportedly have a higher prevalence of mental illnesses but are often misdiagnosed and less likely to seek treatment. Delayed treatment has been associated with the stigma related to these disorders. The demographic characteristics, length of stay, most prevalent psychiatric diagnoses, and hospital admissions of African Americans were compared to other U.S. populations using a nationwide sample (N = 4,474,732). African American participants were younger, had significantly longer lengths of stay, and were admitted more often through the emergency room than the other groups in this sample. Psychosis, alcohol/drug dependence, and depressive neurosis were the most prevalent psychiatric diagnoses reported for African American participants. Research is needed to explain these results so that strategies can be instituted to improve the poor mental health outcomes often observed in African American populations.

SummaryCT findings in 17 patients and MRI in one patient with post partum psychiatric disorder (PPPD; psychosis: n = 17, depressive neurosis: n = 1) were compared with randomly selected CT scans in non-PPPD patients matched for age and sex. In the PPPD group, 13 examinations (controls: 8) revealed one or several abnormal findings such as sulcal widening, ventricular enlargement and asymmetry. There was a higher prevalence of abnormal CT/MRI findings in the PPPD group (trend, P < 0.1).

With Present State Examination (PSE)-12, PSE-54 and General Health Questionnaire-28, an epidemiological survey on neuroses in a sample aged 60 and over living in an urban area of Beijing showed that the prevalence of total neuroses was 20.56/1000 (35.27 in women and 3.98 in men), with the highest rate seen in those aged 60-64 years and a general decline in prevalence with increasing age. By subtype, it was 11.21/1000 for neurasthenia, 4.67/1000 for depressive neurosis and 2.80/1000 for anxiety neurosis. The onset age in the most patients was before the age of 60, with a course of 10 years or more. The implications of these findings and directions for the future study of neuroses in the elderly are also discussed.

All 79 patients who attended a University Systemic Lupus Erythematosus (SLE) Clinic over a 6 month period were assessed using the Clinical Interview Schedule for psychiatric disorder. Using the ICD-9 Classification, 40 were found to have psychiatric disorder, 26 having depressive neurosis, six anxiety neurosis, five endogenous depression and three dementia. The group with psychiatric disorder had significantly poor family support as well as lack of a confidant compared to the group without psychiatric disorder (P < 0.01). There was no difference between the group with psychiatric disorder and those without psychiatric disorder in terms of age, duration of illness, ethnicity and severity of SLE. Psychiatric disorder is common affecting more than half the subjects and depression was the most frequent diagnosis.

Data from a 1980 discharge survey of general hospitals were analyzed to determine the prevalence of cases with coexisting diagnoses of mental and substance abuse disorders. Twelve percent of total cases (or 208,000 episodes) had dual diagnoses, a proportion similar to that found in another analysis of 1985 data. Of these cases, 55.5 percent had a primary diagnosis of an alcohol or drug disorder, most commonly alcohol- or drug-induced organic brain syndrome. Thirty-four percent of cases with a primary diagnosis of mental disorder had depressive neurosis, 24 percent had psychosis, and 19 percent had personality disorder. An additional 18.9 percent of all cases had two or more mental or substance abuse disorders. Dual-diagnosis cases had a shorter mean hospital stay than cases with mental disorder only.

EDITOR,—Although depressive neurosis is equated with dysthymic disorder in the Diagnostic and Statistical Manual of Mental Disorders, owing to personal circumstances it can …

SummaryIn a four-week, double-blind, clinical trial thirty-one patients with depressive neurosis were treated with viloxazine, doxepin, or placebo. There were no differences among the three groups in therapeutic effects. Many depressed out-patients improve on placebo. Viloxazine hydrochloride is one of a series of compounds developed to explore the central nervous system activity of the aryloxypropanolamine type of β-adreno-receptor antagonists. Initial clinical studies support the hypothesis that viloxazine has antidepressant properties in man (Bayliss et al, 1974; Bereen, 1973; Pichot et al, 1975; Tsegos and Ekdawi, 1974).

Data from the South Verona Psychiatric Case Register were used to test hypotheses about the relationship between age, gender, marital status and the incidence of treated affective disorders. Analysis of the 5-year period 1983-1987 yielded overall rates of affective disorder per 10(5) of 57.7 for males and 78.4 for women. Incidence increased with age both for depressive neurosis and for affective psychosis. Married women had high rates compared with their single counterparts whereas the reverse was true for men. The very low values for incidence are likely to reflect the major role in the treatment of affective disorders carried out by Italian general practitioners, rather than a low population rate of these disorders.

A pulsed magnetic field (f = 260 Hz; t = 3 ms; induction B = 1.9 mT; gradient = 0.5 mT/cm) was applied at 40 patients with headaches of various etiology. The change of cephalea intensity was evaluated according the patients statements. These statements were further compared with the changes of the EEG. By means of frequency analysis of the EEG significant changes in percentages of delta and alpha 1 activities (7.5-9.5/s) were stated after the application of the real treatment regarding the sham treatment. Any treatment lasted one half hour. The retreat of subjective difficulties as well as the amelioration of EEG were stated accordingly at headaches, which were bounded with cerebral arteriosclerosis, with states after cerebral concussion, with depressive neurosis, or with tension headache. Pulsed magnetic field could be applied only there, where the visual evaluation stated EEG as physiological.

Data were collected among 159 consecutive new patients in a walk-in clinic. Patients were given an appointment for a subsequent visit after the initial clinical diagnostic interview, and 61% completed their referral. A long waiting list and a diagnosis of depressive neurosis were significantly associated with drop-out. Possible forms of follow-up are suggested. The demand for readily available psychiatric services is increasing, and psychiatric walk- in clinics are a major step in that direction; they are a fairly recent phenomenon in India, however, in contrast to the West. These clinics have encouraged early therapeutic interven tion, by abolishing the waiting list and providing easy accessibility of treatment. A patient, in our set-up, after immediate consultation and treatment advice, is called back for detailed evaluation on an appointed day. But the acceptance of this subsequent visit varies, and many do not turn up. Previous researchers have made several attempts to look into the problem of drop-out from psychiatric clinics; the percentage has varied between 64%2, 26%4, 58%5, 63%6, 30%7, 30%-45%10, 57%11 and 42%12. Among educated and upper social class patients, the rate was only 6% in one psychotherapeutic clinic.8 Patients who drop out probably have different expectations from those of the clinic, and gained little from their first visit. Previous studies have identified some of the factors associated with drop-out, such as long waiting lists,3,7 elaborate intake procedures,9 and par ticular characteristics of the patients themselves. 1,5,8,9,10,12 The present paper reports a prospec tive study which looked into some of these problems.

SummaryA history of life events in the three months before onset of illness was taken in a group of schizophrenic and a group of depressed neurotic in-patients. The Expressed Emotion (EE) of the patients’ key relatives was measured. There was no difference between the schizophrenic and depressed patients in the rate of events in the three month period before onset or in the proportion of undesirable events. However, the two groups exhibited significantly different patterns of interaction between life events and relatives’ EE. Schizophrenic patients living with high EE relatives had a low rate of life events compared with those living with low EE relatives, whereas depressives living with high criticism relatives had a high rate of events compared with those living with low criticism relatives. The implications of these findings are discussed in relation to schizophrenic and depressive patients’ differential vulnerability to environmental stress.

A total of 242 university students seen in an outpatient mental health clinic were evaluated for symptom changes during treatment using both a self-report inventory and chart notations. Specific clusters of major presenting and major improving symptoms, based on combined frequency and severity measures, were obtained for each of the largest diagnostic groups. Self-rated improvement on major symptoms ranged from 81.8 to 88.4% for patients with anxiety neurosis, depressive neurosis, and adjustment reaction, while personality disorder patients reported 54.5% improvement. Chart-based overall improvement rates were uniformly lower (36.4 to 77.3%) than corresponding self-report figures for each diagnostic group. The extent to which chart-rated overall improvement correlated with self-rated improvement on specific symptoms was analyzed.

We considered the long-term development of shinkeishitsu-type neurotics (hypochondriacal neurosis: 154 cases; anxiety neurosis: 122 cases; obsessive neurosis: 436 cases; depressive neurosis: 123 cases) treated by Morita therapy by using the Life Table analysis. We obtained the following results: (i) at least 90% of the patients improved greatly within at most 8 years after admission; (ii) the mean time required for the patients to improve greatly are 38.0 months in hypochondriacal neurosis, 34.8 months in anxiety neurosis, 50.0 months in obsessive neurosis, and 47.4 months in depressive neurosis.

Fifty-three depressed inpatients received placebo treatment as part of a multicenter double-blind placebo-controlled study of an investigational antidepressant, bupropion. Groups of placebo responders and nonresponders were identified based on percentage change on the Hamilton Depression Scale and validated against the Clinical Global Impression Scale. Although the diagnostic and demographic features of responders and nonresponders were generally similar, some differences emerged. Placebo nonresponders were more often associated with male gender, lack of college education, diagnosis of manic-depressive illness and greater lack of insight at baseline. Placebo responders largely consisted of females with a diagnosis of depressive neurosis. When the individual symptoms as measured by the Hamilton Depression Scale were examined, the nonresponders showed improvement only in psychological symptoms (i.e., lack of interest, guilt, and suicide). The responders showed consistent improvement in most symptoms except middle insomnia, loss of weight, and diurnal mood change. These results suggest that depressions of an endogenous nature are unlikely to respond to placebo and when they do respond, the vegetative symptoms are least likely to improve.

In Italy the 1978 Reform Law established that all psychiatric admissions had to take place in the General Hospital Psychiatric Wards (GHPW). In 1984 a national survey found a national rate of 0.05 GHPW beds per thousand population. However, for several reasons, in Italy very few studies have been carried out on the inpatient popula tion. In this paper we analyse all the patients admitted to the two GHPWs in Cremona, Lombardy Region, during 1986. Males were generally younger than females. The large majority of patients studied lived with relatives and had completed only elemen tary education; 1/3 of all the inpatients were employed, 1/3 retired or with social security disability and ¼ housewives. About 25% of them were at the first ever psychiatric admission, and a significant difference was found for the age of the first admission, being higher in females. Concerning the diagnosis, a significant sex difference was found only for depressive neurosis and alcohol related disorders. The need for a better understanding of the role and the functions of the new GHPWs in the Italian psychiatric scene is emphasized.

To illustrate the current status of outpatient psychiatry in a Nigerian university medical centre the records of patients seen over a 3-month period are reviewed. Of the 203 patients, 120 were male. Most patients were 40 years old or less and 56 per cent of the patients has a diagnosis of anxiety or depressive neurosis. Physical complaints dominated the symptomatology in most patients irrespective of degree of formal education. Clinical and social aspects of the findings are discussed with special reference to the role of a general hospitalbased psychiatric unit in a developing country with strictly limited psychiatric facilities.

This paper reports the results of a study on seasonal variation in new episodes of affective disorders, conducted using the South-Verona psychiatric case register. We found evidence for a cyclical pattern in the occurrence of affective psychosis, but this was statistically significant only for the males: there was no cyclical variation in depressive neurosis. The advantages are discussed of case register data over hospital admission statistics for the study of seasonal variation. These are particularly marked in case register areas where community psychiatric care is well developed, as in South-Verona.

A chronic neurotic syndrome among Muslim women in India with predominantly somatic multiple symptomatology is briefly described. It is suggested that the syndrome is distinctive in its clinical features and in the cultural background of the patients. Pending resolution of its nosological status it is referred to as Somatic neurosis. In an attempt to determine its nature a group of 20 Muslim women with the syndrome were compared on 6 variables with 20 women with anxiety neurosis and 20 with depressive neurosis. With the exception of age, on which they were similar to Depressive neurosis group, the Muslim group was significantly different from the comparison groups. It is concluded that the syndrome is distinctive enough to merit an intensive sociocultural study.

In a questionnaire survey, a list of 64 psychiatric diagnostic labels was presented to 20 randomly selected Japanese psychiatrists affiliated to a university department of psychiatry. For each label, they were asked (a) whether they used it in everyday practice, (b) whether they rarely used it but would do so if faced with such a case, or (c) whether they had never and would never use it. It was found that these Japanese psychiatrists used a relatively small number of diagnostic categories; in their classificatory system, functional mental disorders would be dichotomized into psychoses and neuroses with the former further divided into schizophrenic, atypical and manic-depressive psychoses, and the latter divided into seven subcategories, i.e., anxiety neurosis, hysteria, depressive neurosis, phobia, obsessive compulsive neurosis, depersonalization neurosis and hypochondriasis.

Serum cholinesterase activity was measured in 193 patients with different mental diseases. It was found that there is an increase in the serum cholinesterase activity in patients suffering from manic depressive psychosis, schizophrenia, psychosis psychogenica, anxiety neurosis, and depressive neurosis. The results confirm some of those found in the literature. The reason for the increase in the serum cholinesterase activity cannot be explained. Drug therapy seems to have no direct influence on the enzyme activity, our experiments having been carried out over a period of about 4 years, with many different drugs used. The values reported in this paper are results of examinations carried out on the patients without any regard to their immediate psychic or mental condition, making it impossible to report on the influence of mental condition on the serum cholinesterase activity. No effect on the serum cholinesterase activity was found following electroshock treatment.

The Taylor Manifest Anxiety Scale consists of 50 items of the MMPI which clinicians selected because they were indicative of manifest anxiety. The scale has positive items such as "I am a high-strung person" and negative items "I have very few headaches", and the patient indicates whether the statement is true or false. The scale has been used extensively in experimental and clinical research4,5.

Birth patterns of non-aboriginal, first admission, Western Australian psychiatric patients born between 1920 and 1950 were compared statistically with those of the general population. Three I. C. D. categories were examined: schizophrenia, anxiety neurosis, and depressive neurosis. For both categories of neurosis no deviations from normal birth patterns were observed. For males, marked excesses in schizophrenic births were observed in June, and for females a similar excess occurred in September. Possible explanations for this sex difference are examined.

The manpower and operating cost of home-based treatment was compared with the manpower and operating cost of hospital-based treatment during the second year and at the end of two years of treatment. Of the 155 patients destined to receive inpatient treatment, 76 were randomly assigned to home treatment, 79 to hospital treatment. The two groups were similar as to important social, demographic, and clinical characteristics, including psychiatric diagnosis. The manpower and operating cost of treatment, measured in two ways, was similar in the two groups during the second year. However, over the 2-year period hospital-based treatment of patients in each of the three diagnostic groups was more expensive than home-based treatment. Also, regardless of which treatment was given, the cost of treating schizophrenics was higher than the cost of treating manic-depressives which, in turn, was higher than the cost of treating individuals with depressive neurosis. Treatment failures were discussed. Over the 2-year period, failures in home-based treatment accounted for 39.1% of the total manpower and operating cost of home-based treatment, calculated according to Cost Model 1, and for 67.1% of the cost calculated according to Cost Model 2. The concept of failure in hospital-based treatment is also discussed.

SummaryPsychiatric manifestations were studied in 72 amputees in the post-operative period. All were right handed. Besides phantom limb phenomena, which were observed in nearly four-fifths of the cases and are described in another paper, nearly two-thirds had psychiatric symptoms in the form of depression (45 patients), anxiety (38), crying spells (38), insomnia (34), loss of appetite (23), suicidal ideas (21) and psychotic behaviour (2). Right arm amputees had phantom phenomena and insomnia significantly more often than left.Nearly one-fifth of the cases were diagnosed as having psychotic depressive reactions, two-fifths as having depressive neurosis and two, both with right upper limb amputations, as schizophrenic.

A study of 306 adult psychiatric outpatients visiting a CMHC during one month revealed that 55 per cent of those patients received a psychotropic medication and 45 per cent of the medication recipients used a minor tranquilizer as all or part of their treatment regimen. The most common diagnosis for patients receiving minor tranquilizers was depressive neurosis. The tranquilizers were prescribed in relatively high doses, and 57 of the 77 patients who received them had taken the drugs continuously for at least six months. The study also revealed that polypharmacy was widely practiced. The authors' suggestions for improving the quality of pharmacotherapy in a CMHC include instituting peer review of prescribing and recordkeeping practices and monitoring the effectiveness of medications through the application of quantitative mood scales at regular intervals.

SummaryA group of first-time mothers (119) were interviewed repeatedly at fixed intervals during their pregnancies and until their babies were a year old; they were then followed up at four years. A similar investigation was carried out on 38 other primiparae and 39 multiparae, but only postnatally.The incidence of depressive neurosis rose significantly in early pregnancy and in the first three months after delivery (10 per cent and 14 per cent of the main sample respectively). Subjects mainly suffered either from antenatal or postnatal depression, not both. Marital conflict and severe doubts about having the baby were associated with depression at either time. Bereavement and preterm birth were the only life events to relate with the onset of depression and bereavement had a greater impact during pregnancy.Depressed mothers were more likely to express negative or mixed feelings about their three-month-old babies. Many who had become depressed for the first time in their lives continued to experience psychological problems for up to four years after childbirth.

In a 4-week double-blind trial, 33 patients with depressive neurosis were randomly assigned to either viloxazine, imipramine or placebo. Statistically significant improvement was observed in all treatment groups. Imipramine exhibited significant improvement earlier in depressive symptoms, while viloxazine showed significant improvement earlier in anxious symptoms. The same frequency of treatment emergent symptoms occurred in the treatment groups. Premature termination as a consequence of adverse reactions was required in only 1 viloxazine and 1 placebo patient.

No single ICD-9 category corresponds to panic disorder (DSM-III). To investigate whether patients with panic attacks can be identified by means of ICD-9, 97 patients with three panic attacks within 3 weeks were recruited from various medical centers, and were classified independently according to DSM-III and ICD-9. The ICD-9 diagnoses were scattered over a broad range of categories, and it was impossible to identify patients with panic disorder in this manner. Anxiety state, affective psychosis, and depressive neurosis were the most frequent ICD-9 diagnoses. The boundary between affective psychosis on the one hand and anxiety state and depressive neurosis on the other hand was validated by present and previous symptomatology and by cluster analysis. The boundary between anxiety state and depressive neurosis could not be validated in this way. Correspondingly, modifications of the ICD-9 classifications are proposed.

In reviewing the medical literature on the association between affective illness and mental retardation (Sovner & Hurley, 1983), we were intrigued to find that, although there were many cases of major depression and depressive neurosis among people with Down's syndrome, there were no reports of mania in such individuals. This finding provoked us to pursue the hypothesis that Down's syndrome may preclude the development of mania.

The charts of 100 patients with a primary diagnosis of depressive neurosis were subjected to retrospective audit using a format adapted from the American Psychiatric Association's Model Criteria Sets. Nineteen of the 33 unjustified variations from the audit criteria involved variations from the 8-28 day length of hospital stay. The author raises the question of whether the lower limit of 8 days is sufficiently flexible to permit hospitalization of acutely suicidal patients who can be discharged to outpatient care in less than 8 days. Language: en

SummaryThis study compares the diagnostic terminology used for 592 consecutive discharges from a psychiatric unit before and after teaching psychiatric trainees the use of the ICD-9 classificatory system. The results show a marked increase in specificity of diagnostic labels, with a decrease of diagnoses with the term ‘not otherwise specified’, and an increase in the diagnoses of organic psychoses, paranoid and hebephrenic schizophrenia and depressive neurosis. The implications of this for training about diagnosis, clinical practice and recording of data for national statistics are discussed.

The therapeutic efficacy, plasma levels, and psychomotor effects of tryptophan (L-tryptophan), clomipramine hydrochloride, and doxepin were investigate in "neurotically" depressed outpatients. The tricyclic antidepressants were significantly more efficacious than tryptophan in inducing remission. The alleviation of depression was preceded by an improvement of the initially slow information-processing rates in the depressed patients. The plasma levels of the tricyclics that were associated with a therapeutic response were significantly lower than those reported in "endogenously" depressed inpatients.

Over the years, oxazepam has distinguished itself clinically from other benzodiazepines by virtue of its excellent tolerance. Recent research suggests that this is due to metabolic and pharmacokinetic differences rather than an intrinsically more favourable toxic-to-therapeutic dosage ratio. Because of its excellent tolerance, dosage is very flexible, and it is, therefore, possible to utilize oxazepam in a wide spectrum of anxiety-related disorders including the psychoses. The use of oxazepam in anxiety neurosis, depressive neurosis, psychotic disorders, alcoholism, and insomnia is discussed.

The psychiatric, psychosocial and medicolegal variables of 50 shoplifters and two comparison groups are described. The shoplifters were found to be an almost identical population when compared to general, (non-forensic) psychiatric outpatients, and differed significantly from a comparison group of general forensic patients excluding shoplifters. A high level of psychosocial stress antedating the shoplifting behaviour was a significant finding. A profile of a typical shoplifter referred for psychiatric examination is a 37 year old married female person, employed at the professional end of the occupational spectrum, who is suffering from a depressive neurosis and who steals an item of insignificant value or use to herself. The psychiatric diagnostic profile supports the lenient legal disposition by the courts.

Attitudes towards mentally ill people were studied in two Nicaraguan towns through interviews with key informants. They were presented 8 case histories originally developed in a World Health Organization collaborative study. Alcoholism and depressive neurosis were considered the most common disorders, while the schizophrenic case was generally judged as the most severe. The methodology was found useful and valid.