In some fields, some terms have a certain casual currency – everybody knows them and nobody bothers to define them, but outside the field no one knows them and they’re not really transparent, even if they’re made of perfectly ordinary bits. They gain a sort of shibboleth status, but unconsciously.

I encountered one such today at work: caseness. It shows up in the psychiatric literature here and there, often in scare quotes:

“Caseness” for depression and anxiety in a depressed outpatient population: symptomatic outcome as a function of baseline diagnostic categories

The Psychiatric ‘Caseness’ of Clients Referred to an Urban Social Services Department

Psychiatric caseness is a marker of major depressive episode in general practice

Chronic fatigue syndrome-like caseness as a predictor of work status in fatigued employees on sick leave: four year follow up study

The scare quotes indicate some recognition that it’s somewhat casual in-group jargon; the lack of them in other instances indicates that it’s commonly used and is not inevitably seen as exceptional, odd, colloquial, or jargony.

Whatever a new word may be, for me seeing one is like a bit of Christmas. And this one has the added touch of a sound similarity to “Christmas”: a [k] at the start; in the middle, a [s] followed by a nasal; and another [s] at the end. But there’s no [r] in this word, and the first vowel is a diphthong and is longer and more open than the one in Christmas. Caseness is cold and hard and cutting in sound, like a knife breaking through a barrier and starting to sever (perhaps a box cutter cutting open a case), but it can also be heard as a kiss and a soft whisper in the ear. And it is a word of curves: the simple c, the doubles s ss, the twists e e, the ornamental a, the humped n. It has almost ceaseless caresses for the senses.

But what does it mean? Its parts seem obvious enough: case, from Latin casus “fall, chance, occurrence, case”, from cadere “fall”, and ness, that time-honoured West Germanic nominalizing suffix seen in darkness, kindheartedness, wildness, wilderness (odd one out, that), hotness, highness… I note that Case and Ness are also family names, so that it would be possible to be named Jack Case Ness or Jill Case-Ness. But that’s not our case here.

So put case and ness together and you have “condition of being a case” or “degree to which something is a case”. But does that really help? A case of what?

Ah, well, first, in the dehumanizing world of medical jargon, patients – what they call people who are on the other side of the treatment equation – are often equated with their conditions: the broken leg in cubicle 13, for instance, or the case of measles that came into the office this morning. And in psychiatry, where the border between normal and abnormal can be quite arbitrary and fuzzy, there is often a question of whether the person is or isn’t a case of depression, or of schizophrenia, or whatnot. This is also true of other tricky diagnoses such as chronic fatigue syndrome.

So if, in your doctor’s judgement, you are a case of something, then you have caseness. And, to add more depth, one may say that the extent to which you match the criteria of a particular condition is your degree of caseness. Some articles argue for determining caseness on the basis of a chosen cutoff in criteria, and in fact in many instances there are criteria that can be checked off to come up with a score: if you have three of these, you’re not a case; if you have four, you are. Does this seem arbitrary? Well, of course it is, but tell me: does a box containing eleven beers (or eleven bottles of wine) have caseness? Is it a case of beer (or wine) or not?

The remaining question is this: Is caseness a word? The answer might seem self-evident, given that I’ve just been using it, and I’ve defined it for you, and you now understand it. Moreover, it’s made of perfectly combinable parts. If I say “That cat has a certain dogness,” you don’t need to look up dogness even if you’ve never heard or seen it; you can tell what it means. But when you first encountered this word caseness, was its meaning obvious to you? If you tried to look it up in a dictionary, even in the Oxford English Dictionary, you would have come up empty.

So what is the criterion – what are the criteria – for wordness? I often say “I used it, you understood it, it’s a word.” But what if you didn’t understand it? Then it’s a word for me but not really for you. Or not fully: you may recognize that it’s been used as an independent lexical unit, but it doesn’t communicate to you any more than, say, There are three squedgels in the carmavery. And if you know it and can use it but the people you would use it with don’t understand it, does it have full wordness? But is there ever truly full wordness, in that case? In what context, for what users, does caseness attain sufficient wordness? As with psychiatric diagnoses, there is much in the individual judgement.

7 responses to “caseness

  1. My brain keeps jostling the two words ‘case’ and ‘-ness’ trying unsatisfactorily to force a concrete meaning out of its combined form like a child petulantly forcing two mis-matched jigsaw puzzle pieces together; it doesn’t fit well.
    It shouldn’t be much of a problem after all it’s only one word and a suffix to contend with not exactly the dizzying agglutinative complexity of Hungarian with a word like (sharp breath…):
    (…now breathe!) which makes English’s own jumble of prefixes, infixes and suffixes ‘incomprehensibility’ look like a rank amateur?

    • It feels uncomfortable because the normal template on which such words are formed is an adjective + ‘ness’, not a noun: ‘selfishness’, ‘dogginess’. Not that this template gives a good fit here: ‘casiness’, ‘caseyness’, ‘casishness’? All ugly lumps. The shrinks could probably have chosen ‘typicality’ anyway, which conveys the meaning fully enough.

  2. Anything suggested would be better than the awkward sounding ‘caseness’ …
    ‘casibility’, ‘casehood’, ‘caseship’, ‘patientness’, ‘patient status’ etc.

  3. Caseness wasn’t clear to me, and still isn’t quite. (I think I’d have better luck with the squedgels in the carmavery.) I’m comfortable enough with the word itself–its consonance and sibilance are quite pleasing, actually–but it seems to me an unnecessary word. If the objective is to dehumanize, then wouldn’t it be simplest just to refer to the patient by his/her affliction/malady/disease/injury/whatnot, then finite incantatem, as it were?

    • Well, that’s what ordinary medical doctors do anyway: ‘Nurse, will you tell the gall bladder in bed 6 I’ll be with him in a few minutes, I just have to see the tib and fib that came in this morning.’ Not sure it would work so well for psychiatric cases: ‘Hello, you must be the paranoid schizophrenic with grandiose delusions.’

  4. The term caseness is useful in fields like behavioral epidemiology when measuring the prevalence of various disorders in a defined population. Researchers often use self-report questionnaires to measure constructs like depression. When selecting which instrument to use the researcher will want to know if it provides caseness (i.e., can be used to differentiated the afflicted from the non-inflicted) and, if so, the accuracy with which it does so.

  5. After 25 years in scientific/medical writing/editing, I just encountered “caseness” for the first time. Thanks for the discussion, James. I’m going to suggest an alternative, as it strikes me as incomprehensible jargon, even in the jargon-laden document I’m working on. I kept thinking of Platonic forms — the chairness of chair and so on.

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