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current sets resulted in only modest agreement between them and ICD-10. Lack of extensive experience with the earlier and current criteria sets resulted in agreement between them and ICD-10 at the level of chance. The difference may again be traced to tiffany bracelet evaluator's interpretation of the three questions on health care utilization. No racial bias was identified among any of the criteria sets evaluated. Future planned analyses of this data base include the following: 1) symptom counts to identify the most efficient sequence of ascertaining the presence of criteria-based symptoms by use of the algorithm, 2) assessment of intersite and intrasite reliability, and 3) assessment of validators (e.., age at onset, patterns of health care utilization, number and type of physical complaints). REFERENCES 1. Cloninger CR: Somatoform and dissociative disorders, in

The Medical Basis of Psychiatry. Edited by Winokur G, Clayton PJ. Philadelphia, WB Saunders, 1986 2. Brown FW, Smith GR Jr: Diagnostic concordance in primary tiffany earring somatization disorder. Psychosomatics 1991; 32:191-195 3. Cloninger CR, Martin RL, Guze SB, Clayton PJ: A prospective follow-up and family study of somatization in men and women. Am J Psychiatry 1986; 143:873-878 4. Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD Jr, Regier DA: Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 1984; 41: 949-958 5. Woodruff RA Jr, Clayton PJ, Guze SB: Hysteria: studies of diagnosis, outcome, and prevalence. JAMA 1971; 215:425-428 6. Cloninger CR, Yutzy S: Somatoform tiffany necklace dissociative disorders: a summary of changes for DSM-IV, in Current Psychiatric Therapy. Edited by Dunner DL. Philadelphia, WB Saunders, 1993 7. Fleiss JL: Statistical Methods for Rates and Proportions, 2nd ed. New York, John Wiley & Sons, 1981, pp 217-225 Adult, Cohort Studies, Continental Population Groups, Educational Status, Evaluation Studies as Topic, Female, Humans, Marital Status, Middle Aged, Psychiatric Status Rating Scales -- statistics & numerical data (major), Reproducibility of Results, Somatoform Disorders -- diagnosis (major), Somatoform Disorders -- epidemiology, Terminology as Topic

This article describes the development of a 'key informant survey' to assess the performance of local systems of care for persons with a chronic mental illness. The measure yields ratings of: (1) the extent to which clients experience service delivery problems in 11 community support system elements, (2) tiffany ring performance of the community support system, and (3) the performance of local mental health authorities. Following pre-testing, the Table 4 presents data on the agreement among the various diagnostic systems when prior expertise was taken into account.[Table 4 omitted] A chi-square test with one degree of freedom, as described by Fleiss (7), was used to test for differences in agreement between expert and novice raters. The level of experience (expert versus novice) of the rater with earlier

survey was administered to 699 respondents in nine U.S. cities. Internal consistency coefficients were found to be within acceptable ranges for all of the scales across all nine cities. Analyses comparing mean values for performance ratings showed that the nine sites tiffany pendant be arranged into three groups representing high, medium and low system performance. These findings support observations from site visits conducted over several years and suggest that the survey is a valid instrument for assessing local systems of care.Community Mental Health Services (major), Comprehensive Health Care, Health Services Accessibility, Health Services Needs & Demand, Humans, Mental Disorders -- psychology, Mental Disorders -- rehabilitation (major), Patient Satisfaction (major), Program Evaluation, United States Author(s): Morrissey,