[The diagnosis of mental disorders by the primary care physician]. / Diagnóstico de trastornos psiquiátricos por el médico de atención primaria.

OBJECTIVES: To determine the percentage of psychiatric disorders recognised by primary care doctors and what influence the reason for consultation exerts on the psychiatric diagnosis. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed, with systematic sampling of one in every four visits. The GHQ-28 was used in the first phase and Goldberg's CIS in the second; a diagnosis was assigned in line with the criteria of the DSM-III-R. This diagnosis was compared with the general practitioner's, if this existed. SETTING: "Maluquer Salvador" Health Centre in Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the centre. 2.9% were lost (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: The GP diagnosed 36.7% of the psychiatric disorders of those attending his/her clinics, mainly because only half the patients "suggested" their problem. In 21.2% of the cases when patients "suggested" their psychopathology, they left the consultation without a diagnosis. This was particularly serious in the case of major depression. CONCLUSIONS: Given the high prevalence of psychopathology, the low diagnostic percentages of the general practitioner's and the difficulty the patient has in suggesting his/her problem, primary care clinics clearly require improvement in case-finding and the use of the GHQ-28 as an instrument in case-finding.

[Prevalence of psychopathology at a primary care center]. / Prevalencia de psicopatología en un centro de atención primaria.

OBJECTIVES: To determine the prevalence of psychopathology among those attending a primary care centre and discover its diagnostic distribution using the criteria of the DSM-III-R. DESIGN: A crossover study of the prevalence of psychopathology. A two-phase study was performed by systematic sampling of one of every four visits. In the first phase the GHQ-28 was used. For those with suspected psychopathology (cut-off point 5/6) a semi-structured interview, Goldberg's CIS, was performed. They were assigned a diagnosis from the DSM-III-R. SETTING: Maluquer Salvador Health Centre, Girona. PATIENTS: A sample of 400 patients between 15 and 65 who attended the Centre for any reason. There were only 2.9% losses (2.1% in the first phase and 0.8% in the second). MEASUREMENTS AND MAIN RESULTS: Overall prevalence of psychopathology was 38.8% (Cl 34.05-43.55), with depression accounting for 10.3% (major depression 6% and dysthymia 4.3%), anxiety 13.8% (generalised 7.3%, panic 3% and obsessive/compulsive 3%) and adaptive disorder 9.5%. CONCLUSIONS: One of every three patients attending a health centre suffers from some kind of psychiatric disorder.