Article

The identification of psychiatric illness by primary care physicians - The effect of patient gender

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115.
Journal of General Internal Medicine (Impact Factor: 3.45). 07/1990; 5(4):355-60. DOI: 10.1007/BF02600406
Source: PubMed

ABSTRACT

This study tested several hypotheses about why women are more likely than men to have psychiatric disorders noted by their primary care physicians.
Patients were screened for mental disorders using the General Health Questionnaire. A stratified sample was assessed using the Schedule for Affective Disorders and Schizophrenia. Information on utilization and identification of mental health problems was abstracted from the medical records.
The study was conducted at a multispecialty group practice in a semirural area of Wisconsin.
Study participants consisted of a stratified probability sample of 247 patients seeking primary care.
Patients with a psychiatric illness who were relatively frequent users of the clinic were most likely to be identified by a physician as having a mental health problem. When psychiatric illness and utilization rates were statistically controlled, men and women had comparable identification rates.

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    ABSTRACT: To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients. 410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress. Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%. The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods.
    No preview · Article · · Journal of General Internal Medicine
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  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective:To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients. Design:410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress. Main results:Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%. Conclusions:The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods.
    No preview · Article · Nov 1991 · Journal of General Internal Medicine
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