Skip to main content
NCBI home page
The Journal of the Royal College of General Practitioners logoLink to The Journal of the Royal College of General Practitioners
. 1988 Dec;38(317):542–545.

Psychological distress: outcome and consultation rates in one general practice

Alastair F Wright
PMCID: PMC1711680  PMID: 3267742

Abstract

This paper reports a one-year follow-up of random samples of 90 male and 96 female patients attending one general practitioner. There was no statistically significant difference between men and women in the total score on the 28-item general health questionnaire or any of the subscores. However, the diagnostic labels applied to the two sexes were strikingly different as was the prescribing of psychotropic drugs. Outcome of psychological distress was assessed in terms of change in total general health questionnaire score. Two thirds of the patients (65%) showed normal scores at the beginning and end of the follow-up period, 19% changed from abnormal to normal and 8% changed from normal to abnormal. The remaining 9% had persistently high scores though less than half had been given a psychiatric diagnosis. They had very high consultation rates persisting over several years and three-quarters were known to have chronic physical illness. It seems possible that some patients with persistently high consultation rates who present with chronic, mainly somatic, symptoms may be or may become psychologically distressed to a significant degree and that this psychological distress goes unrecognized in the presence of physical disease.

Full text

PDF
542

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Corser C. M., Philip A. E. Emotional disturbance in newly registered general practice patients. Br J Psychiatry. 1978 Feb;132:172–176. doi: 10.1192/bjp.132.2.172. [DOI] [PubMed] [Google Scholar]
  2. 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]
  3. Goldberg D., Bridges K. Screening for psychiatric illness in general practice: the general practitioner versus the screening questionnaire. J R Coll Gen Pract. 1987 Jan;37(294):15–18. [PMC free article] [PubMed] [Google Scholar]
  4. Goldberg D. Identifying psychiatric illness among general medical patients. Br Med J (Clin Res Ed) 1985 Jul 20;291(6489):161–162. doi: 10.1136/bmj.291.6489.161. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Goldberg D., Steele J. J., Johnson A., Smith C. Ability of primary care physicians to make accurate ratings of psychiatric symptoms. Arch Gen Psychiatry. 1982 Jul;39(7):829–833. doi: 10.1001/archpsyc.1982.04290070059011. [DOI] [PubMed] [Google Scholar]
  6. Goldberg D. Use of the general health questionnaire in clinical work. Br Med J (Clin Res Ed) 1986 Nov 8;293(6556):1188–1189. doi: 10.1136/bmj.293.6556.1188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Howie J. G. Diagnosis--the Achilles heel? J R Coll Gen Pract. 1972 May;22(118):310–315. [PMC free article] [PubMed] [Google Scholar]
  8. 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]
  9. Marks J. N., Goldberg D. P., Hillier V. F. Determinants of the ability of general practitioners to detect psychiatric illness. Psychol Med. 1979 May;9(2):337–353. doi: 10.1017/s0033291700030853. [DOI] [PubMed] [Google Scholar]
  10. Overton G. W., Wise T. N. Psychiatric diagnosis in family practice: is the general health questionnaire an effective screening instrument? South Med J. 1980 Jun;73(6):763–764. [PubMed] [Google Scholar]
  11. Short D. Why don't we use questionnaires in the medical out-patient clinic? Health Bull (Edinb) 1986 Jul;44(4):228–233. [PubMed] [Google Scholar]
  12. Sims A. C., Salmons P. H. Severity of symptoms of psychiatric outpatients: use of the General Health Questionnaire in hospital ang general practice patients. Psychol Med. 1975 Feb;5(1):62–66. doi: 10.1017/s0033291700007224. [DOI] [PubMed] [Google Scholar]
  13. 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]
  14. Tarnopolsky A., Hand D. J., McLean E. K., Roberts H., Wiggins R. D. Validity and uses of a screening questionnaire (GHQ) in the community. Br J Psychiatry. 1979 May;134:508–515. doi: 10.1192/bjp.134.5.508. [DOI] [PubMed] [Google Scholar]
  15. Widmer R. B., Cadoret R. J. Depression in primary care: changes in pattern of patient visits and complaints during a developing depression. J Fam Pract. 1978 Aug;7(2):293–302. [PubMed] [Google Scholar]
  16. Wright A. F., Perini A. F. Hidden psychiatric illness: use of the general health questionnaire in general practice. J R Coll Gen Pract. 1987 Apr;37(297):164–167. [PMC free article] [PubMed] [Google Scholar]

Articles from The Journal of the Royal College of General Practitioners are provided here courtesy of Royal College of General Practitioners

RESOURCES