Skip to main content
×
Home
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 121
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Muskin, Philip R. and Holoshitz, Yael 2015. Psychiatry.


    Topitz, Andrea Benda, Norbert Saumer, Gertraud Friedrich, Fabian König, Daniel Soulier, Nathalie and Freidl, Marion 2015. Prävalenz und Erkennen der Depression an nicht-psychiatrischen Krankenhausabteilungen. neuropsychiatrie, Vol. 29, Issue. 2, p. 63.


    Terluin, Berend and Oud, Marian J.T. 2014. Triage van psychische klachten bij de huisarts. Bijblijven, Vol. 30, Issue. 9, p. 13.


    Díaz-Martín, Alicia and González-Carpio Paredes, Óscar 2013. Seguimiento a pacientes con diagnóstico enfermero NANDA: baja autoestima situacional, en la consulta de Atención Primaria. Enfermería Clínica, Vol. 23, Issue. 5, p. 196.


    Muntingh, Anna DT De Heer, Eric W Van Marwijk, Harm WJ Adèr, Herman J Van Balkom, Anton JLM Spinhoven, Philip and Van der Feltz-Cornelis, Christina M 2013. Screening high-risk patients and assisting in diagnosing anxiety in primary care: the Patient Health Questionnaire evaluated. BMC Psychiatry, Vol. 13, Issue. 1,


    Meltzer, Ellen C. Averbuch, Tali Samet, Jeffrey H. Saitz, Richard Jabbar, Khelda Lloyd-Travaglini, Christine and Liebschutz, Jane M. 2012. Discrepancy in Diagnosis and Treatment of Post-traumatic Stress Disorder (PTSD): Treatment for the Wrong Reason. The Journal of Behavioral Health Services & Research, Vol. 39, Issue. 2, p. 190.


    Soegaard, Hans Joergen 2012. Undetected Common Mental Disorders in Long-Term Sickness Absence. International Journal of Family Medicine, Vol. 2012, p. 1.


    Joling, Karlijn J. van Marwijk, Harm W.J. Piek, Ellen der Horst, Henriëtte E. van Penninx, Brenda W. Verhaak, Peter and van Hout, Hein P.J. 2011. Do GPs' medical records demonstrate a good recognition of depression? A new perspective on case extraction. Journal of Affective Disorders, Vol. 133, Issue. 3, p. 522.


    Mitchell, Alex J. Rao, Sanjay and Vaze, Amol 2011. Can general practitioners identify people with distress and mild depression? A meta-analysis of clinical accuracy. Journal of Affective Disorders, Vol. 130, Issue. 1-2, p. 26.


    van den Boogaard, Th. Michael Verhaak, P.F.M. Dyck, Richard van and Spinhoven, Philip 2011. The impact of causal attributions on diagnosis and successful referral of depressed patients in primary care. Social Science & Medicine, Vol. 73, Issue. 12, p. 1733.


    Fassaert, Thijs Nielen, Mark Verheij, Robert Verhoeff, Arnoud Dekker, Jack Beekman, Aartjan and de Wit, Matty 2010. Quality of care for anxiety and depression in different ethnic groups by family practitioners in urban areas in the Netherlands. General Hospital Psychiatry, Vol. 32, Issue. 4, p. 368.


    Conradi, Henk Jan and de Jonge, Peter 2009. Recurrent depression and the role of adult attachment: A prospective and a retrospective study. Journal of Affective Disorders, Vol. 116, Issue. 1-2, p. 93.


    Cutler, Janis L. Harding, Kelli J. Mozian, Sharon A. Wright, Leslie L. Pica, Adrienne G. Masters, Scott R. and Graham, Mark J. 2009. Discrediting the notion “working with ‘crazies’ will make you ‘crazy’”: addressing stigma and enhancing empathy in medical student education. Advances in Health Sciences Education, Vol. 14, Issue. 4, p. 487.


    Ketterer, Mark W. and Knysz, Walter 2009. Screening, diagnosis & monitoring of depression/distress in CHF patients. Heart Failure Reviews, Vol. 14, Issue. 1, p. 1.


    Mitchell, Alex J Vaze, Amol and Rao, Sanjay 2009. Clinical diagnosis of depression in primary care: a meta-analysis. The Lancet, Vol. 374, Issue. 9690, p. 609.


    Norton, J. de Roquefeuil, G. David, M. Boulenger, J.-P. Ritchie, K. and Mann, A. 2009. Prévalence des troubles psychiatriques en médecine générale selon le patient health questionnaire : adéquation avec la détection par le médecin et le traitement prescrit. L'Encéphale, Vol. 35, Issue. 6, p. 560.


    Wang, Philip S. Simon, Gregory E. and Kessler, Ronald C. 2008. Making the Business Case for Enhanced Depression Care: The National Institute of Mental Health-Harvard Work Outcomes Research and Cost-Effectiveness Study. Journal of Occupational and Environmental Medicine, Vol. 50, Issue. 4, p. 468.


    Willmott, Sasi Boardman, Jed Henshaw, Carol and Jones, Peter 2008. The predictive power and psychometric properties of the General Health Questionnaire (GHQ-28). Journal of Mental Health, Vol. 17, Issue. 4, p. 435.


    Baldwin, David S and Ajel, Khalil 2007. Role of pregabalin in the treatment of generalized anxiety disorder. Neuropsychiatric Disease and Treatment, Vol. 3, Issue. 2, p. 185.


    Gilchrist, Gail and Gunn, Jane 2007. Observational studies of depression in primary care: what do we know?. BMC Family Practice, Vol. 8, Issue. 1,


    ×

Recognition, management and outcome of psychological disorders in primary care: a naturalistic follow-up study*

  • J. Ormel (a1), W. Van Den Brink (a1), M. W. J. Koeter (a1), R. Giel (a1), K. Van Der Meer (a1), G. Van De Willige (a1) and F. W. Wilmink (a1)
  • DOI: http://dx.doi.org/10.1017/S0033291700036606
  • Published online: 01 July 2009
Abstract
Synopsis

This article addresses the issues of recognition and labelling of psychological disorders (PDs) by general practitioners (GPs), and he association of recognition with management and outcome. Nearly 2000 attenders of 25 GPs were screened with the GHQ and a stratified sample of 296 patients was examined twice, using the Present State Examination (PSE) and Groningen Social Disability Schedule (GSDS).

Prevalence rates of PDs according to the GHQ, GP and PSE were 46%, 26% and 15% respectively. For the 1450 ‘new’ patients, i.e. patients who had no PD diagnosed by their GP in the 12 months prior to the enrolment visit, these rates were 38%, 14%, and 10%. GPs missed half of the PSE cases and typically assigned non-specific diagnoses to recognized cases. Depressions were more readily recognized than anxiety disorders, and the detection rates for severe disorders were higher than those for less severe disorders.

Recognition was strongly associated with management and outcome. Recognized as compared to non-recognized cases were more likely to receive mental health interventions from their GP and had better outcomes in terms of both psychopathology and social functioning. Initial severity, psychological reasons for encounter, recency of onset, diagnostic category, and psychiatric comorbidity were related to both better recognition and outcome. However, these variables could not account for the association of recognition with management and outcome, but some did modify the association. A causal model of the relationships is presented and possible reasons for non-recognition and for the beneficial effects of recognition are discussed.

Copyright
Corresponding author
1Address for correspondence: Dr J. Ormel, Department of Psychiatry, Academisch Ziekenhuis Groningen, Postbus 30.001.9700RB Groningen, The Netherlands.
Footnotes
Hide All

This article is a modified and extended version of a paper presented at the 5th European Symposium on Social Psychiatry, Manchester. March 1989.

Footnotes
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. E. Barrett , J. A. Barrett , T. E. Oxman & P. D. Gerber (1988). The prevalence of psychiatric disorders in a primary care practice. Archives of General Psychiatry 45, 11001119.

C. V. R. Blacker & W. Clare (1987). Depressive disorder in primary care. British Journal of Psychiatry 150, 737751.

W. Brink , Vanden, M. W. J. Koeter , J. Ormel , W. Dijkstra , R. Giel , C. Slooff & T. D. Wohlfarth (1989). Psychiatric diagnosis in an outpatient population: a comparative study of PSE-Catego and DSM-III. Archives of General Psychiatry 46, 369372.

R. Finlay-Jones , G. W. Brown , P. Duncan-Jones , E. Harris , E. Murphy & R. Prudo (1980). Depression and anxiety in the community: replicating the diagnosis of a case. Psychological Medicine 10, 445454.

D. P. Goldberg (1978). The concept of a psychiatric case in general practice. Social Psychiatry 17, 6165.

D. P. Goldberg (1979). Detection of and assessment of emotional disorders in primary care. International Journal of Mental Health 8, 3048.

E. W. Hoeper , G. R. Nycz , P. D. Cleary , D. A. Regier & I. D. Goldberg (1979). Estimated prevalence of RDC mental disorder in primary medical care. International Journal of Mental Health 8, 615.

S. F. Jencks (1985). Recognition of menial distress and diagnosis of mental disorder in primary care. Journal of the American Medical Association 253, 19031907.

A. C. Nielsen & T. A. Williams (1980). Depression in ambulatory medical patients. Archives of General Psychiatry 37, 991004.

E. H. Rand , L. W. Badger & D. R. Coggings (1988). Toward a resolution of contradictions utility of feedback from the GHQ. General Hospital Psychiatry 10, 189196.

H. C. Schulberg , M. Saul , M. McClelland , M. Ganguli , W. Christy & R. Frank (1985). Assessing depression in primary medical and psychiatric practices. Archives of General Psychiatry 42, 11641170.

H. C. Schulberg , M. McClelland , J. L. Coulehan , M. Bolck & G. Werner (1986). Psychiatric decision making in family practice. Future research directions. General Hospital Psychiatry 8, 16.

S. Shapiro , E. A. Skinner , M. Kramer , S. Steinwachs & D. A. Regier (1985). Measuring need for mental health services in a general population. Medical Care 23, 10331043.

S. Shapiro , P. S. German , E. A. Skinner , M. Von Korf , R. W. Turner , L. E. Klein , M. L. Teitelbourn , M. Kramer , J. D. Burke & B. J. Burns (1987). An experiment to change detection and management of mental morbidity in primary care. Medical Care 25, 327339.

G. E Vaillant & P. Schnurr (1988). What is a case? A 45-year study of psychiatric impairment within a college sample selected for mental health. Archives of General Psychiatry 45, 313319.

P. F. M. Verhaak (1988). Detection of psychological complaints by general practitioners. Medical Care 26, 10091020.

M. Von Korff , S. Shapiro , J. D. Burke , M. Teitlebaum , E. A. Skinner , P. German , R. W. Turner , L. Klein & B. Burns (1987). Anxiety and depression in a primary care clinic: comparison of DIS, GHQ and practitioner assessments. Archives of General Psychiatry 44, 152156.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×