This survey examined Scottish psychiatrists' attitudes to physical examination and appropriate investigations in the routine assessment of new out-patients with a major depressive disorder. A discrepancy exists between current opinion towards and actual practice of physical examination in the assessment of new out patients with depression. Numerous obstacles to performing investigations were identified including lack of time, inadequate consulting rooms, lack of equipment and lack of chaperon. The many obstacles identified are considerable but not insurmountable. Missed diagnoses may have adverse consequences for patients as well as medico-legal implications.

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