PROBLEM
The Wittenborn (*) Psychiatric Rating Scales contain nine dimensions obtained from large samples of chronic mental hospital patients. The factor analysis and rotated dimensions were directed toward concordance with groups defined by current diagnostic labels. Individual scales entered into the final score of more than one dimension, implying that the factors were not defined sufficiently, or that the scales were not constructed so as to load on one dimension only. A considerable literature exists on these scales, including other factor analytic investigations of their characteristics. This paper reports a new factor scoring scheme derived from computer rotations without regard for diagnostic clam, appropriate to patients from the wards of general hospitals as well as patients in mental hospitals. Individual scales apply to the factor score of one dimension only, an approach consistent with modern practice in test construction.
METHOD
Subjects. The data were provided by an experiment by Smith, McKerracher and McIntyre(*) in which patients, certified to a mental hospital by a general practitioner, were diverted to a general hospital ward for treatment. A control group was selected from regular ward admissions. For this analysis, the two groups constituted an unselected sample of data from which all patients over 65 years were eliminated, thus omitting the seniles whose very abnormal ratings could introduce artifacts entirely due to age. The chief characteristics of the 137 patients were: 58 on mental hospital certificates (30 male, 28 female), average stay 37 days; 79 regular admissions (21 male, 58 female), average stay 34 days. Of these patients, 111 were discharged home, 8 were sent to mental hospitals and 6 to social agencies. Within the next year, 31 were readmitted to the ward and 17 others were readmitted to a mental hospital. Diagnostically, there were 11 alcoholics, 14 psychopaths, 7 organics, 4 mentally deficient, 16 paranoid schizophrenics, 20 other schizophrenics, 21 psychotic depressions, 3 manic-depressives, 18 neurotic depressions, 11 anxiety states, 11 psychoneurotics, and 1 of no diagnosis.
The psychiatric ratings were made by the resident during admission interviews, the form being returned to research for scoring, primarily to lessen the influence of diagnostic class on the ratings, although this could not be avoided completely when the rater also made the diagnosis (in association with the consultant). The rating form was not exactly that of the standard edition, 17 of the 52 items having slightly altered wording as advised by Wittenborn, and 7 items with less than the standard four rating points were brought up to four points to improve the statistical analysis. All alterations were quite minor and made no difference to the substance of the items.
Method of Analysis. Frequency distributions eliminated seven items because of few abnormal ratings: 3. unjustified sexual beliefs; 14. shouts, sings and talks loudly; 16. unclean due to negligence; 17. engrossed plans; 32. grandiose notions; 40. no concern for physical handicaps; 45. fear of committing abhorred acts. The re-*This project was supported b Canadian Mental Health Grants, 607-5-189, and 607-5185; data analysis was supported by Me&al Research Council Grant MA-1738. We are indebted to the residents and internes of the Department of Psychiatry, University Hos ital, Saskatoon, and to the nurses of the Ontario Hos ital, Kingston, for the rating of the patients. &mputer time for the factor analysis was contributed & the University of Toronto.