Measurement and Classification in Socio-Psychiatric Epidemiology: Midtown Manhattan Study (1954) and Midtown Manhattan Restudy (1974).

This article presents information on a study on socio-psychiatric epidemiology in midtown Manhattan. Determination of frequencies of mental disorders has long been an extremely complex and refractory problem of men- suration in socio-psychiatric epidemiology. Such measurement at its 17th Century beginnings was essentially a census-type reckoning of admissions and discharges to mental institutions. .compiled for administrative purposes. By the end of the 18th Century, such institutional census counts escalated from a routine, bureaucratic bookkeeping chore, to become the empirical basis for professional inferences and speculations about nothing less complex than the social etiology of mental disturbance. The Schwabs note that this new interest was precipitated by the political revolutions in America and France and by England's Industrial Revolution. The enormously influential theory that the three social upheavals were responsible for an increase in the frequency of "mental derangement" emerged from these patient census data. But a number of more sophisticated, early 19th Century investigators, pointing out the in- adequacies of such head-count totals, suggested that "there had been only an apparent, not an actual, increase in the number of [hospitalizedj insane," or that they bore no correspondence to "the actual [hospitalized and unhospitalized] number of insane persons in Great Britain.