Psychiatric Disorders among the Patients of General Practitioners and Internists

Abstract

ABOUT 10 to 60 percent of the people receiving care from a general practitioner or interniist during a year have a significant emotional or psychiatric problem-as perceived by the physician. But how perceptive is the average family physician in detecting mental illness, and what factors influence his perceptiveness? If the family physician is to function as a resource for early detection of mental illness, how must his training be altered? And how would the caseload for all the psychiatric services in a community be affected if the family physician referred all patients in whom he perceived a significant psychiatric problem to a psychiatric service? If we look toward the family physician for psychiatric care, we must know the kind of care he offers and how he must be educated to serve more effectively (1-16). Monroe County, N.Y. (including metropolitan Rochester), population 630,000 in 1964, afforded a unique opportunity for a study to obtain at least a partial answer to many of these questions. A centralized case register of all psychiatric services has been maintained there since January 1960. Almost all psychiatric services, Mr. Locke is acting chief of the center for epidemiologic studies,

Ability of internists to recognize and manage depression in the elderly

“…Prior studies have suggested that primary care medical practitioners diagnose the existence of mental illness in 2% to 16% of their patients (Shepherd et al, 1966;Hoeper et al, 1979;Eastwood, 1971;Patrick et al, 1978;Hankin et al, 1982;Locke and Gardner, 1969). Prevalence rates for diagnosable mental disorders in primary care patients range from 15% to 40% (Shepherd et al, 1966;Hoeper, 1979).…”

Social factors and neurotic symptoms in family practice.

“…The role of the family physician is particularly pivotal in this instance because he appears early in the career of the emotionally disturbed patient and is frequently the first professional consulted. 23 In sanctioning secondary deviance as genuine illness, the family physician may unwittingly confirm the symptomatic life style of many "labeled" patients. Until we improve our evaluational techniques to distinguish between legitimate and labeled symptomatology, it is possible that primary physicians are actually "sending on" as many patients as they deter from careers of symptomatic emotional illness.…”

“…The median age of these patients was 44 years and the majority were married (65 per cent). The distribution by social class was I-II, 23 Index.' 9 …”

Mental disorders among physical disability determination patients.

“…1,2 Patients with psychiatric problems typically come to the doctor with physical complaints.3'4 Nonetheless, it is known that physical complaints may be secondary to an underlying mental problem, and if the mental problem is recognized and successfully treated, the physical problems may be alleviated as well. 3,4 This pilot study was designed to investigate the extent and nature of mental disorders among those patients claiming physical disability.…”