This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Patricia Cohen, PhD; Jacob Cohen, PhD

Arch Gen Psychiatry. 1984;41(12):1178-1182.

Abstract
• There are several diseases, including schizophrenia, alcoholism, and opiate addiction, for which the long-term prognosis is subject to disagreement between clinicians and researchers and also among researchers. Part of this disagreement may be attributable to a difference in the populations they sample. The clinician samples the population currently suffering from the disease (a "prevalence" or census sample), while research samples tend to more nearly represent the population ever contracting the disease (an "incidence" sample). The clinician's sample is biased toward cases of long duration, since the probability that a case will appear in a prevalence sample is proportional to its duration, hence "the clinician's illusion." The statistical mechanism of this bias is illustrated and its consequences detailed. Other sources of sampling bias in clinical and research samples are briefly described and partial remedies are suggested.

Author Affiliations
From the New York State Psychiatric Institute, Columbia University School of Public Health (Dr P. Cohen), and New York University (Dr J. Cohen), New York.

Footnotes
Accepted for publication May 1, 1984.

Reprint requests to New York State Psychiatric Institute, 722 W 168th St, New York, NY 10032 (Dr P. Cohen).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Predictive Value of Family History on Severity of Illness: The Case for Depression, Anxiety, Alcohol Dependence, and Drug Dependence
Milne et al.
Arch Gen Psychiatry 2009;66:738-747.
ABSTRACT | FULL TEXT  

Unmet Need for Mental Health Care in Schizophrenia: An Overview of Literature and New Data From a First-Admission Study
Mojtabai et al.
Schizophr Bull 2009;35:679-695.
ABSTRACT | FULL TEXT  

Comorbid Axis I and Axis II Disorders in Early Adolescence: Outcomes 20 Years Later
Crawford et al.
Arch Gen Psychiatry 2008;65:641-648.
ABSTRACT | FULL TEXT  

Population-Based Study of First Onset and Chronicity in Major Depressive Disorder
Eaton et al.
Arch Gen Psychiatry 2008;65:513-520.
ABSTRACT | FULL TEXT  

Cross-National Comparisons: Problems in Interpretation When Studies Are Based on Prevalent Cases
Bromet
Schizophr Bull 2008;34:256-257.
FULL TEXT  

A Replicated Molecular Genetic Basis for Subtyping Antisocial Behavior in Children With Attention-Deficit/Hyperactivity Disorder
Caspi et al.
Arch Gen Psychiatry 2008;65:203-210.
ABSTRACT | FULL TEXT  

Remission and Recovery in Schizophrenia: Practitioner and Patient Perspectives
Davidson et al.
Schizophr Bull 2008;34:5-8.
ABSTRACT | FULL TEXT  

The twain meet: distress, disorder and the continuing conundrum of categories (comment on Horwitz)
Wheaton
Health (London) 2007;11:303-319.
 

Depression and Generalized Anxiety Disorder: Cumulative and Sequential Comorbidity in a Birth Cohort Followed Prospectively to Age 32 Years
Moffitt et al.
Arch Gen Psychiatry 2007;64:651-660.
ABSTRACT | FULL TEXT  

Premorbid predictors of chronic fatigue.
Kato et al.
Arch Gen Psychiatry 2006;63:1267-1272.
ABSTRACT | FULL TEXT  

Assessing Gaps Between Policy and Practice in Medicaid Disenrollment of Jail Detainees With Severe Mental Illness
Morrissey et al.
Psychiatr. Serv. 2006;57:803-808.
ABSTRACT | FULL TEXT  

Profiling risk: the emergence of coronary heart disease epidemiology in the United States (1947-70)
Oppenheimer
Int J Epidemiol 2006;35:720-730.
ABSTRACT | FULL TEXT  

Prediction of heterogeneity in intelligence and adult prognosis by genetic polymorphisms in the dopamine system among children with attention-deficit/hyperactivity disorder: evidence from 2 birth cohorts.
Mill et al.
Arch Gen Psychiatry 2006;63:462-469.
ABSTRACT | FULL TEXT  

Diagnostic Stability Four Years After a First Episode of Psychosis
Whitty et al.
Psychiatr. Serv. 2005;56:1084-1088.
ABSTRACT | FULL TEXT  

ALCOHOL ABUSE AND DEPENDENCE CRITERIA AS PREDICTORS OF A CHRONIC COURSE OF ALCOHOL USE DISORDERS IN THE GENERAL POPULATION
DE BRUIJN et al.
Alcohol Alcohol 2005;40:441-446.
ABSTRACT | FULL TEXT  

Integration of psychiatric and physical health
Huyse
Br. J. Psychiatry 2005;186:263-264.
FULL TEXT  

Challenges in Operationalizing the DSM-IV Clinical Significance Criterion
Beals et al.
Arch Gen Psychiatry 2004;61:1197-1207.
ABSTRACT | FULL TEXT  

The Co-occurrence of DSM-IV Alcohol Abuse in DSM-IV Alcohol Dependence: Results of the National Epidemiologic Survey on Alcohol and Related Conditions on Heterogeneity That Differ by Population Subgroup
Hasin and Grant
Arch Gen Psychiatry 2004;61:891-896.
ABSTRACT | FULL TEXT  

Major Depression in 6050 Former Drinkers: Association With Past Alcohol Dependence
Hasin and Grant
Arch Gen Psychiatry 2002;59:794-800.
ABSTRACT | FULL TEXT  

Duration of major depressive episodes in the general population: results from The Netherlands Mental Health Survey and Incidence Study (NEMESIS)
SPIJKER et al.
Br. J. Psychiatry 2002;181:208-213.
ABSTRACT | FULL TEXT  

Measuring Trauma and Health Status in Refugees: A Critical Review
Hollifield et al.
JAMA 2002;288:611-621.
ABSTRACT | FULL TEXT  

Role of Genotype in the Cycle of Violence in Maltreated Children
Caspi et al.
Science 2002;297:851-854.
ABSTRACT | FULL TEXT  

Prevalence and correlates of personality disorders in a community sample
SAMUELS et al.
Br. J. Psychiatry 2002;180:536-542.
ABSTRACT | FULL TEXT  

Residual Symptoms and Impairment in Major Depression in the Community
Mojtabai
Am. J. Psychiatry 2001;158:1645-1651.
ABSTRACT | FULL TEXT  

IL-1 Genotype and Adult Periodontitis among Young New Zealanders
Thomson et al.
JDR 2001;80:1700-1703.
ABSTRACT  

Benefits of Linking Primary Medical Care and Substance Abuse Services: Patient, Provider, and Societal Perspectives
Samet et al.
Arch Intern Med 2001;161:85-91.
ABSTRACT | FULL TEXT  

CLINICAL RESEARCH: LEARNING RIGHT FROM WRONG
Marbach
Journal of the American Dental Association 2000;131:1535-1536.
FULL TEXT  

Mental Disorders and Violence in a Total Birth Cohort: Results From the Dunedin Study
Arseneault et al.
Arch Gen Psychiatry 2000;57:979-986.
ABSTRACT | FULL TEXT  

Congruence of Diagnoses 2 Years After a First-Admission Diagnosis of Psychosis
Schwartz et al.
Arch Gen Psychiatry 2000;57:593-600.
ABSTRACT | FULL TEXT  

Some Class-Participation Demonstrations for Introductory Probability and Statistics
Gelman and Glickman
JOURNAL OF EDUCATIONAL AND BEHAVIORAL STATISTICS 2000;25:84-100.
ABSTRACT  

Outcome of Anorexia Nervosa: A Case-Control Study
Sullivan et al.
Am. J. Psychiatry 1998;155:939-946.
ABSTRACT | FULL TEXT  

The Risk for Early-Adulthood Anxiety and Depressive Disorders in Adolescents With Anxiety and Depressive Disorders
Pine et al.
Arch Gen Psychiatry 1998;55:56-64.
ABSTRACT | FULL TEXT  

The `Clinician's Illusion': More Evidence?
Mordock
Clin Child Psychol Psychiatry 1997;2:579-590.
ABSTRACT  

Interpreting Differential Rates of Service Use: Avoiding Myopia
Summerfelt et al.
Clin Child Psychol Psychiatry 1997;2:591-595.
ABSTRACT  

Behavioral Observations at Age 3 Years Predict Adult Psychiatric Disorders: Longitudinal Evidence From a Birth Cohort
Caspi et al.
Arch Gen Psychiatry 1996;53:1033-1039.
ABSTRACT  

Identifying Offenders in Criminal Justice Research on Domestic Assault
STRAUS
American Behavioral Scientist 1993;36:587-600.
 

Depressive Symptoms as Relative and Attributable Risk Factors for First-Onset Major Depression
Horwath et al.
Arch Gen Psychiatry 1992;49:817-823.
ABSTRACT  

Contrast of Treatment-Seeking and Untreated Cocaine Abusers
Carroll and Rounsaville
Arch Gen Psychiatry 1992;49:464-471.
ABSTRACT  

Service Utilization and Social Morbidity Associated With Depressive Symptoms in the Community
Johnson et al.
JAMA 1992;267:1478-1483.
ABSTRACT  

Psychopathologic Precursors and Sociodemographic Risk Factors for the Schizophrenia Syndrome
Tien and Eaton
Arch Gen Psychiatry 1992;49:37-46.
ABSTRACT  

Panic Disorder, Comorbidity, and Suicide Attempts
Johnson et al.
Arch Gen Psychiatry 1990;47:805-808.
ABSTRACT  

Factors Associated With 1-Year Outcome of Major Depression in the Community
Sargeant et al.
Arch Gen Psychiatry 1990;47:519-526.
ABSTRACT  

Uncommon Troubles in Young People: Prevalence Estimates of Selected Psychiatric Disorders in a Nonreferred Adolescent Population
Whitaker et al.
Arch Gen Psychiatry 1990;47:487-496.
ABSTRACT  

Recurrent and Nonrecurrent Depression: A Family Study
Bland et al.
Arch Gen Psychiatry 1986;43:1085-1089.
ABSTRACT