The Psychiatric 'Caseness' of Clients Referred to an Urban Social Services Department

Correspondence should be sent to Dr. Peter Huxley, Mental Health Social Work Research Unit, Department of Psychiatry, Manchester University, Stopford Building, Oxford Road, Manchester M13 9PT. Summary Of 158 clients referred to two area offices and six generalpractice attached social workers, 141 weré interviewedusing standardized social and psychiatric research interviews.The General Health Questionnaire (GHQ) was completed by 138clients. Their social worker completed the Case Review Form.Scores of 5 or more on the PSE Index of Definition (for theclient) were used to indicate psychiatric caseness. Using IDscores of 5 or more, 53% of the sample were identified as ‘cases’.The GHQ (cut-off 4/5) identified 73% of the clients as cases;and the GHQ (cut-off 10/11) identified 51% cases. Morbidity was significantly greater in the general practicesetting. Social workers' judgement (about the presence or absenceof mental illness/emotional disorder) was not significantlybetter than chance in the identification of specific disorders,but was significant in relation to the whole sample. The results are discussed and further studies are being conductedusing more sophisticated judgements of ’caseness’,and extending the enquiry beyond an inner city population.     

Huntington's Chorea and the Young Person at Risk

Correspondence should be sent to J. R. Korer, Mental Health Research Unit, Manchester University, Department of Psychiatry, Stopford Building, Oxford Road, Manchester M13 9PT. Summary Social workers increasingly find themselves involved with familiesin which one or more individuals suffer from genetic disease.Huntington's chorea is such a condition and has serious implicationsfor other individuals, both in the nuclear and extended family.This paper explores some of the likely responses of young peoplein such families and how they can best be helped. A social workerneeds to be aware of the differing responses to varying degreesof risk and how young people in the situation can be advisedand helped. It follows on from an earlier study (Korer and Fitzsimmons,1985) which looked more specifically at family life within thesefamilies.     

The Effect of Huntington's Chorea on Family Life

Summary This paper examines the effect of Huntington's Chorea (H.C.)on family life with particular reference to the consequencesfor the spouse of the H.C. patient. It describes in some detailthe marital and parental difficulties encountered and confirmsthe severe familial disruption that occurs. It suggests thatfamilies or individuals segregating this disorder can be usefullydivided into two categories of behaviour which are referredto as ‘H.C.-orientated’ and ‘independently-orientated’.It is further suggested that for purposes of practical managementand in the hope of avoiding the process whereby families becomeH.C.-orientated, these families require and should be offeredon-going social-work support from the time a family is recognisedas being at risk of H.C.