Document Detail

Psychiatric disorders in primary care: physician judgements of prevalence and management.
MedLine Citation:
PMID:  3678674     Owner:  NLM     Status:  MEDLINE    
Primary care physicians underdiagnose depression, anxiety, and other psychiatric disorders. Decision analysis suggests that subjective estimates of the probability of a condition and the utility (severity and treatability) of identifying that condition play a role in diagnosis. We asked 108 internists (IM) and family practitioners (FP) to rank 25 conditions on ten-point scales for probability, severity, and treatability. FPs ranked depression significantly higher than IMs did on all three scales, anxiety reactions higher in probability and severity, and both alcoholism and drug dependency higher on the severity scale. Ranks for schizophrenia and personality disorder did not differ between specialties. Thirty-eight physicians completed the scales a second time after six to eight weeks. Test-retest agreement ranged from 47% to 100% for different conditions on different scales. Some common psychiatric disorders tended to have low test-retest agreement in probability and severity. With further refinement, this instrument may contribute to the investigation of psychiatric decision making in primary care.
J L Coulehan; M R Block; H C Schulberg; V C Arena
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Family medicine     Volume:  19     ISSN:  0742-3225     ISO Abbreviation:  Fam Med     Publication Date:    1987 Sep-Oct
Date Detail:
Created Date:  1987-12-21     Completed Date:  1987-12-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8306464     Medline TA:  Fam Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  351-5     Citation Subset:  IM    
Department of Community Medicine, University of Pittsburg School of Medicine, PA 15261.
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MeSH Terms
Family Practice
Internal Medicine
Mental Disorders / diagnosis,  therapy*
Physician-Patient Relations*
Referral and Consultation*

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