Psychiatric clinics in primary care. The effect on general practitioner referral patterns.

A consecutive series of 176 referrals from family doctors to psychiatrists conducting their outpatient clinics im primary care was studied. The presence of psychological symptoms was the stated reason for referral in only half of the patients, although chronic illnesses and the psychotic disorders were well represented. Female sex, attending the GP with physical ill-health and the absence of personality disorder were influential but unacknowledged factors in the referral process. The implications of these findings for the development of community psychiatric services and the relationship between primary and secondary care is discussed.