Psychiatric Nosology and Midtown Manhattan Study

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To the Editor.— The Midtown Manhattan Study, now reporting on its third wave of interviews, was initiated in the 1950s by Rennie and continued by Srole and his colleagues. It is unarguably a major epidemiologic study of the possible impact of urban conditions on the mental health of a metropolitan population, uses very high standards in its methods, and pays attention to the representativeness of the sample selected for interviews and to the rate of response. Dr Srole and his coauthor now innovatively apply cohort analysis to data from the most recent reinterview in "The Midtown Manhattan Longitudinal Study vs 'The Mental Paradise Lost' Doctrine: A Controversy Joined" (p 209). Although their methodology met a high standard in 1950 and maintains this standard as we approach 1980, we must take issue with their current conceptual approach to mental health and illness. From our reading, the authors seem to hold to

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