Detection of Emotional Problems in the Primary Care Clinic

Abstract

Emotional problems are an important component of general morbidity in primary care settings. Research on the sensitivity of primary care physicians to such problems is, however, scanty. This study examines the prevalence of emotional problems among 776 patients in primary care clinics in Israel using the GHQ-28 and as detected by their physicians. Hypotheses were tested relating to physician and practice characteristics and the extent to which they affect the matching of the two methods of problem identification. Using the GHQ, 69% of the patients were classified as 'cases'; physicians identified 31% of the patients as 'cases'. Specialist status in family medicine, interest and belief in the importance of emotional health, good communication, a low patient load and familiarity with the patient all predicted a better match of physician classification to GHQ-defined 'caseness'. The implications of these findings for ongoing medical education are briefly discussed.

Validation of a screening instrument for posttraumatic stress disorder in a community sample of Bedouin men serving in the Israeli Defense Forces

“…Due to the myriad of comorbid physiological problems that accompany PTSD (Rosenbaum, 2004), it is especially recommended to use the SPTSS as a screen for routine assessment in settings such as primary health care clinics, where physicians are the natural agents for initial contact with persons suffering from trauma-related problems (Shiber, Maoz, Antonovsky, & Antonovsky, 1990). We hope that this research constitutes a step toward providing for the mental health needs of Bedouin servicemen.…”

Plaidoyer pour l’inclusion de psychologues dans les équipes de santé familiale en Ontario, Canada

“…Les problèmes physiques sont aussi souvent associés et/ou reliés à des problèmes d'ordre psychologique. Il n'est donc pas surprenant que les écrits mentionnent qu'environ 30 % à 70 % des consultations médicales en soins primaires relèvent de la sphère psychologique (Barrett, Barrett, Oxman, & Gerber, 1988 ;Creed, Gowrisunkur, Russell, & Kincey, 1990 ;Shiber, Maoz, Antonovsky, & Antonovosky, 1990 ;Craven, Cohen, Campbell, Williams, & Kates, 1997). On sait aussi que la majorité des médecins de famille décrivent la nature de leurs interventions psychologiques en soins primaires comme étant soit du support émotionnel soit du counselling (écouter et donner des conseils) plutôt qu'un traitement psychologique proprement dit (Craven et al, 1997).…”

Detection of patient psychological distress and longitudinal patient–doctor relationships: a cross-sectional study

“…In the US, Robinson and Roter reported that patient disclosure of psychosocial problems was associated with greater perceived physician familiarity with the patient. 27 Other studies conducted in Norway, 28 Israel, 29 and Jordan 30 have also linked the identification of patient distress to doctors' knowledge of patients. However, Spitzer et al 31 reported that nearly half of patients with a specific disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (Revised Third Edition), who were somewhat or fairly well known to their physicians, went unrecognised.…”