Document Detail

Physician characteristics and the recognition of depression and anxiety in primary care.
MedLine Citation:
PMID:  8057696     Owner:  NLM     Status:  MEDLINE    
We examined physician characteristics associated with the recognition of depression and anxiety in primary care. Fifty-five physicians treating a total of 600 patients completed measures of psychosocial orientation, psychological mindedness, self-rating of sensitivity to hidden emotions, and a video test of sensitivity to nonverbal communication. Patients were classified as cases of psychiatric distress based on the CES-D scale and the Diagnostic Interview Schedule. Physician recognition was determined by notation of any psychosocial diagnosis in the medical charts over the ensuing 12 months. Of 192 patients scoring 16 or above on the CES-D, 44% (83) were recognized as psychiatrically distressed. Three findings were central to this study: 1) Physicians who are more sensitive to nonverbal expressions of emotion made more psychiatric or psychosocial assessment of their patients and appeared to be over-inclusive in their judgments of psychosocial problems; 2) Physicians who tended to blame depressed patients for causing, exaggerating, or prolonging their depression made fewer psychosocial assessments and were less accurate in detecting psychiatric distress; 3) False positive labeling of patients who had no evidence of psychiatric distress was rare. Surprisingly, more severe medical illness increased the likelihood of labeling and accurate recognition. Physician factors that increased recognition may indicate a greater willingness to formulate a psychiatric diagnosis and an ability notice nonverbal signs of distress.
J M Robbins; L J Kirmayer; P Cathébras; M J Yaffe; M Dworkind
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medical care     Volume:  32     ISSN:  0025-7079     ISO Abbreviation:  Med Care     Publication Date:  1994 Aug 
Date Detail:
Created Date:  1994-09-09     Completed Date:  1994-09-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  795-812     Citation Subset:  IM    
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
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MeSH Terms
Anxiety Disorders / classification,  diagnosis*,  psychology
Attitude of Health Personnel*
Clinical Competence*
Depressive Disorder / classification,  diagnosis*,  psychology
Introversion (Psychology)
Multivariate Analysis
Nonverbal Communication
Physician-Patient Relations*
Physicians, Family / education,  psychology*,  statistics & numerical data
Reproducibility of Results
Sensitivity and Specificity
Videotape Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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