Abstract
This study compares the characteristics of general practitioners and a pen and paper test in the detection of psychiatric disorder in primary care settings. A psychiatrist interviewed a stratified sample of 283 patients drawn from 590 consecutive new illnesses seen in 15 general practices. Research diagnoses could be made in between one-quarter and one-third of the consecutive new illnesses. Two different research diagnostic systems agreed quite well with one another about who should be regarded as a psychiatric 'case' - although agreement between them for individual diagnoses was less impressive. Research diagnoses of psychiatric illnesses could be made in approximately 30% of new episodes of illnesses seen. If the DSM-3 system was used as a criterion of 'caseness', the specificity of the general health questionnaire was 75.4%, and the sensitivity was 87.1%. The general practitioners had fewer false positives than the questionnaire, but they were much more likely to miss psychiatric cases. Use of the general health questionnaire could increase their sensitivity from about 50% to 95%.
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- Bridges K. W., Goldberg D. P. Somatic presentation of DSM III psychiatric disorders in primary care. J Psychosom Res. 1985;29(6):563–569. doi: 10.1016/0022-3999(85)90064-9. [DOI] [PubMed] [Google Scholar]
- Casey P. R., Dillon S., Tyrer P. J. The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychol Med. 1984 Aug;14(3):673–681. doi: 10.1017/s0033291700015282. [DOI] [PubMed] [Google Scholar]
- Dean C., Surtees P. G., Sashidharan S. P. Comparison of research diagnostic systems in an Edinburgh community sample. Br J Psychiatry. 1983 Mar;142:247–256. doi: 10.1192/bjp.142.3.247. [DOI] [PubMed] [Google Scholar]
- Endicott J., Spitzer R. L. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978 Jul;35(7):837–844. doi: 10.1001/archpsyc.1978.01770310043002. [DOI] [PubMed] [Google Scholar]
- Goldberg D. P., Blackwell B. Psychiatric illness in general practice. A detailed study using a new method of case identification. Br Med J. 1970 May 23;1(5707):439–443. doi: 10.1136/bmj.2.5707.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldberg D. P., Cooper B., Eastwood M. R., Kedward H. B., Shepherd M. A standardized psychiatric interview for use in community surveys. Br J Prev Soc Med. 1970 Feb;24(1):18–23. doi: 10.1136/jech.24.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Johnstone A., Goldberg D. Psychiatric screening in general practice. A controlled trial. Lancet. 1976 Mar 20;1(7960):605–608. doi: 10.1016/s0140-6736(76)90415-3. [DOI] [PubMed] [Google Scholar]
- Sireling L. I., Paykel E. S., Freeling P., Rao B. M., Patel S. P. Depression in general practice: case thresholds and diagnosis. Br J Psychiatry. 1985 Aug;147:113–119. doi: 10.1192/bjp.147.2.113. [DOI] [PubMed] [Google Scholar]
- Skuse D., Williams P. Screening for psychiatric disorder in general practice. Psychol Med. 1984 May;14(2):365–377. doi: 10.1017/s0033291700003615. [DOI] [PubMed] [Google Scholar]
- Wing J. K., Nixon J. M., Mann S. A., Leff J. P. Reliability of the PSE (ninth edition) used in a population study. Psychol Med. 1977 Aug;7(3):505–516. doi: 10.1017/s0033291700004487. [DOI] [PubMed] [Google Scholar]