[A psychiatric morbidity study of the population attending the Basauri Health Center]. / Estudio de morbilidad psiquiátrica en la población atendida en el centro de salud de Basauri.

OBJECTIVE: To calculate the probable prevalence of mental illness in our clinics and to evaluate how it is detected by Primary Care (PC) doctors. DESIGN: Crossover study in two parts. SITE. Basauri Health Centre (Vizcaya). PARTICIPANTS: A sample made up of patients who attended the clinic without prior appointment during ten days in February and Marc, 1990. MAIN MEASUREMENTS AND RESULTS: In the first part, 10 PC doctors distributed the GHQ-28 questionnaire to 500 patients. In the second part, qualified staff administered the standardised psychiatric interview (SPI) to a sub-sample. 41.55% were possible psychiatric cases (GHQ-28 > 6). 17.94% were diagnosed by the doctors (SD) as psychiatric cases. Prevalences adjusted to the SPI were 19% and 21% for the GHQ-28 and SD respectively. CONCLUSIONS: The GHQ-28 obtained high sensitivity (0.82%) and low specificity (60%), which characterises it as a good screening test, but a bad diagnostic method. The doctors obtained low sensitivity (0.29) and high specificity (89.7%); thus underdiagnosing mental illness, but being more accurate in their diagnoses.

[The care of the terminal patient as viewed by the family physician]. / Cuidado del enfermo terminal visto por el médico de familia.

We made a survey among physicians of primary care teams (PCT) from Vizcaya to assess their opinion about the care of the patient with cancer in the terminal period. A total of 85% of the surveyed physicians responded; 70% considered that the care given was inadequate; 90% thought that the patients wishes to die at home. 50% felt that the patient should know the diagnosis, although 85% believed that it was virtually always unknown to him in practice. The most commonly found symptoms were anorexia, asthenia, pain, depression and anxiety, which resulted in serious management difficulties for 25-45% of physicians. 65% were assisted by nurses. The participation of the rest of the team and of specialists was irrelevant. Most felt frustration (59%) and dissatisfaction (78%) with those patients. The physicians find great difficulty to communicate with the patient, and need more information, training and cooperation. Is should be clear that the aim is the well being of the patient, thus diminishing the frustration of the professionals.