Psychological Medicine

Original Articles

Normality, deviance and minor psychiatric morbidity in the community

A population-based approach to General Health Questionnaire data in the Health and Lifestyle Survey

Jeremy Andersona1 c1, Felicia Hupperta1 and Geoffrey Rosea1

a1 Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London; and Department of Psychiatry, University of Cambridge


This paper investigates factors affecting the distribution of psychiatric morbidity in the community. It identifies a close relationship between mean Chronic General Health Questionnaire (CGHQ) scores in subdivisions of a large random sample of the community (the Health and Lifestyle Survey, N = 6317) and the prevalence in these groups of abnormal, above-threshold CGHQ scores. The frequency distributions of CGHQ scores in these different populations move up and down as a whole: like other physiological and behavioural attributes, these mental health outcomes in individuals are associated with characteristics of the populations in which they arise. Populations thus carry a collective responsibility for their own mental health and well-being. This implies that explanations for the differing prevalence rates of psychiatric morbidity must be sought in the characteristics of their parent populations; and control measures are unlikely to succeed if they do not involve population-wide changes.


c1 Address for correspondence: Dr Jeremy Anderson, Department of Psychological Medicine, University of Otago, Private Bag, Dunedin, New Zealand.