OBJECTIVES: To determine the percentage of psychiatric disorders recognised by primary care doctors and what influence the reason for consultation exerts on the psychiatric diagnosis. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed, with systematic sampling of one in every four visits. The GHQ-28 was used in the first phase and Goldberg's CIS in the second; a diagnosis was assigned in line with the criteria of the DSM-III-R. This diagnosis was compared with the general practitioner's, if this existed. SETTING: "Maluquer Salvador" Health Centre in Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the centre. 2.9% were lost (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: The GP diagnosed 36.7% of the psychiatric disorders of those attending his/her clinics, mainly because only half the patients "suggested" their problem. In 21.2% of the cases when patients "suggested" their psychopathology, they left the consultation without a diagnosis. This was particularly serious in the case of major depression. CONCLUSIONS: Given the high prevalence of psychopathology, the low diagnostic percentages of the general practitioner's and the difficulty the patient has in suggesting his/her problem, primary care clinics clearly require improvement in case-finding and the use of the GHQ-28 as an instrument in case-finding.
OBJECTIVES: To determine the percentage of psychiatric disorders recognised by primary care doctors and what influence the reason for consultation exerts on the psychiatric diagnosis. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed, with systematic sampling of one in every four visits. The GHQ-28 was used in the first phase and Goldberg's CIS in the second; a diagnosis was assigned in line with the criteria of the DSM-III-R. This diagnosis was compared with the general practitioner's, if this existed. SETTING: "Maluquer Salvador" Health Centre in Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the centre. 2.9% were lost (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: The GP diagnosed 36.7% of the psychiatric disorders of those attending his/her clinics, mainly because only half the patients "suggested" their problem. In 21.2% of the cases when patients "suggested" their psychopathology, they left the consultation without a diagnosis. This was particularly serious in the case of major depression. CONCLUSIONS: Given the high prevalence of psychopathology, the low diagnostic percentages of the general practitioner's and the difficulty the patient has in suggesting his/her problem, primary care clinics clearly require improvement in case-finding and the use of the GHQ-28 as an instrument in case-finding.
Authors: M Beltran Vilella; N Salleras Marcó; C Camps García; P Solanas Saura; E Igual Massalles; M García-Oria Journal: Aten Primaria Date: 2001-06-15 Impact factor: 1.137