The General Practitioner and the Psychiatrist

Abstract

The introduction of the domiciliary visit has in many cases brought about a closer liaison between the general practitioner and the specialist. Visits to the patient's home and to the practitioner's surgery, and close acquaintance with the social structure of the district in which the practice lies, are of particular value when the specialty concerned is psychiatry. Since 1949 a relationship has developed between a group of four partners in a general practice and a psychiatrist which is believed to be mutually beneficial. We shall attempt to describe some of the experiences arising from this association.

Reasons against referral to the psychiatrist

“…This echoes the common finding that referral rates reflect the service available. Bodkin et al (1953) noted an increased referral rate from 4/10,000 in 1949 to 73/10,000 in 1951 as collaboration with a particular psychiatrist grew. With the establishment of a psychiatric unit in the general hospital serving the area, psychiatric referrals from a London borough increased by onethird in 3 years (Mezey & Evans, 1971).…”

Depressive Illness in a General Practice. A Demographic Study and a Controlled Trial of Imipramine

“…Depression is a "non-hospital disease" (Fry, 1961); only a small proportion of patients find their way to psychiatric outpatient departments (Bodkin et al, 1953;Leigh, 1955;Watts, 1956;Kessel, 1960;Taylor and Chave, 1964;Shepherd et al, 1966). Hence epidemiological studies of the disorder can be done only from general practice, for the hospital impression may often be distorted.…”

The Incidence and Prognosis of Endogenous Depression

“…Mayer-Gross (1954) described it as probably the commonest type of complaint in psychiatric patients to-day. Bodkin et al (1953), in a study of psychiatry in general practice, state that, " of the f6ur main types of cases that of depressive reactions looms the largest." From a purely general-practitioner point of view, Craddock (1953) groups endogenous depression with cancer and tuberculosis.…”