The US-UK Cross-National Project is conducting a series of trans-Atlantic comparisons of psychiatric practice and psychiatric disorders. The initial studies investigated the large US-UK cross-national differences reported in the public mental hospital statistics on adult admission rates of schizophrenia and the manic- depressive disorders. Three general strategies were adopted: (1) semi-structured interviews with hospitalized patients aged 20-59 years; (2) rating of videotapes by samples of psychiatrists; and (3) systematic examination of case records. The ' results showed that routine hospital diagnoses were based on differing criteria in the two countries and it was this that accounted for the reported cross-national differences in admission rates. A method of making internationally reliable diagnoses was demonstrated.
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