Hostname: page-component-77f85d65b8-45ctf Total loading time: 0 Render date: 2026-03-27T11:13:33.172Z Has data issue: false hasContentIssue false
  • English
  • Français

Labelling and illness in primary care: comparing factors influencing general practitioners' and psychiatrists' decisions regarding patient referral to mental illness services

Published online by Cambridge University Press:  09 July 2009

Anne E. Farmer  and
Huw Griffiths
Anne E. Farmer*
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine; and East Glamorgan General Hospital, Mid Glamorgan, Wales
Huw Griffiths
Affiliation:
Department of Psychological Medicine, University of Wales College of Medicine; and East Glamorgan General Hospital, Mid Glamorgan, Wales
*
1 Address for correspondence: Dr Anne Farmer, Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF4 4XN, South Wales.
Get access Rights & Permissions [Opens in a new window]

Synopsis

GPs and psychiatrists from South Wales were asked to make decisions based on the information included in each of 16 vignettes describing depressed and anxious subjects. This information contained randomly assigned sex, psychiatric label, good and bad psychosocial context and age as well as eight different severity ratings of depression and anxiety symptoms. Our results showed that both GPs and psychiatrists were influenced in their decision making by the severity of the illness, but that GPs alone were also strongly influenced by the presence of male sex and by the presence of a psychiatric label. Good or bad psychosocial context had no influence on the GPs' referral decision, and previous experience in psychiatry or other vocational training had no detectable effect, but this may be because of the sample size.

Information

Type
Original Articles
Information
Psychological Medicine , Volume 22 , Issue 3 , August 1992 , pp. 717 - 723
Copyright
Copyright © Cambridge University Press 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

Boardman, A. P., Bouras, N. & Craig, T. K. G. (1988). General practitioner referrals to an ambulatory psychiatric service. The effects of establishing an ease of access service. International Journal of Social Psychiatry 34, 172–183.CrossRefGoogle Scholar
Clare, A. (1976). Psychiatry in dissent, pp. 104–108. Social Science Paperbacks, Tavistock Publications: London.Google ScholarPubMed
Crombie, D. L. (1986). Classification of mental illness in primary care settings. In Mental Illness in Primary Care Settings (ed. Shepherd, M., Wilkinson, G. and Williams, P.), pp. 27–45. Tavistock: London.Google Scholar
Fahy, T. J. (1974). Pathways of specialist referral of depressed patients from general practice. British Journal of Psychiatry 124, 231–239.CrossRefGoogle ScholarPubMed
Feinberg, S. E. (1981). The Analysis of Cross-Classified Categorical Data (2nd edn). MIT Press: Cambridge, Massachusetts.Google Scholar
Goldberg, D. & Huxley, P. (1980). Mental Illness in the Community. Tavistock Publications: London.Google Scholar
Ingham, J. G., Rawnsley, K. & Hughes, D. (1972). Psychiatric disorder and its declaration in contrasting areas of South Wales. Psychological Medicine 2, 281–292.CrossRefGoogle ScholarPubMed
Jenkins, R., Smeeton, N. & Shepherd, M. (1988). Classification of Mental Disorder in Primary Care. Psychological Medicine. Monograph Supplement 12.Google Scholar
Kessel, W. I. N. (1960). Psychiatric morbidity in a London general practice. British Journal of Preventative and Social Medicine 14, 16–22.Google Scholar
Marks, J. N., Goldberg, D. P. & Hillier, V. F. (1979). Determinants of the ability of general practitioners to detect psychiatric illness. Psychological Medicine 9, 337–353.CrossRefGoogle ScholarPubMed
Rawnsley, K. & Loudon, J. B. (1962). The attitude of general practitioners to psychiatry. In Sociological Review Monograph 5: Sociology and Medicine Studies Within the Framework of the British National Health Service. University of Keele: Keele.Google Scholar
Rosenhan, D. L. (1973). On being sane in insane places. Science 179, 250–258.CrossRefGoogle ScholarPubMed
Scheff, T. J. (1966). Being Mentally Ill: A Sociological Theory. Aldine: Chicago.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. W. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.Google Scholar
Wilkinson, G. (1988). A comparison of psychiatric decision-making by trainee general practitioners and psychiatrists using a simulated consultation model. Psychological Medicine 18, 167–177.CrossRefGoogle ScholarPubMed
Wilkinson, G. (1989). Referrals from general practitioners to psychiatrists and paramedical mental health professionals. British Journal of Psychiatry 154, 72–77.CrossRefGoogle ScholarPubMed
Wing, J. K. & Sturt, E. (1978). The PSE-1D-CATEGO System Supplementary Manual. Mimeograph. MRC Social Psychiatry Unit, Institute of Psychiatry: London.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). The Measurement and Classification of Psychiatric Symptoms. Cambridge University Press: Cambridge.Google Scholar