PSYCHIATRIC ILLNESS IN GENERAL PRACTICE - A DETAILED STUDY USING A NEW METHOD OF CASE IDENTIFICATION
PSYCHIATRIC ILLNESS IN GENERAL PRACTICE - A DETAILED STUDY USING A NEW METHOD OF CASE IDENTIFICATION
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DOI：
10.1136/bmj.2.5707.439
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发表时间：
1970-01-01
影响因子：
105.7
通讯作者：
BLACKWELL, B
中科院分区：
文献类型：
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作者：
GOLDBERG, DP;BLACKWELL, B
一个自我管理的问卷（一般健康问卷），旨在检测当前的精神障碍，给予553连续出席全科医生的手术。其中200名患者的样本由精神科医生使用标准化的精神病学访谈对其精神状态进行独立评估。90%以上的患者被问卷正确地分为“好”或“病”，问卷得分与临床评估的障碍严重程度之间的相关性被发现是+0统计80。一个郊区的全科医生评估的“显着的精神病发病率”被发现是20%，他自己是一个精神科医生，并验证了独立的精神病评估。“隐藏的精神病发病率”被发现占所有精神病患者的三分之一。这些患者在六个月随访时的干扰程度和病程方面与“明显疾病”患者相似，但其区别在于他们对疾病的态度以及通常向全科医生表现出身体症状。当在索引咨询中被评估为精神病病例的87名患者在六个月后被召回进行随访时，其中三分之二的人在正常范围内运作。在索引consultation.It认为，轻微的情感性疾病和身体的投诉往往伴随着对方，通常有一个良好的预后严重程度，只有适度的关系，在手术后的六个月出席指数consultation.It的频率。
A self-administered questionary (the General Health Questionnaire) aimed at detecting current psychiatric disturbance was given to 553 consecutive attenders to a general practitioner's surgery. A sample of 200 of these patients was given an independent assessment of their mental state by a psychiatrist using a standardized psychiatric interview. Over 90% of the patients were correctly classified as “well” or “ill” by the questionary, and the correlation between questionary score and the clinical assessment of severity of disturbance was found to be +0·80.The “conspicuous psychiatric morbidity” of a suburban general practice assessed by a general practitioner who was himself a psychiatrist and validated against independent psychiatric assessment was found to be 20%. “Hidden psychiatric morbidity” was found to account for one-third of all disturbed patients. These patients were similar to patients with “conspicuous illnesses” in terms both of degree of disturbance and the course of their illnesses at six-month follow-up, but were distinguished by their attitude to their illness and by usually presenting a physical symptom to the general practitioner.When 87 patients who had been assessed as psychiatric cases at the index consultation were called back for follow-up six months later, two-thirds of them were functioning in the normal range. Frequency of attendance at the surgery in the six months following index consultation was found to have only a modest relationship to severity of psychiatric disturbance.It is argued that minor affective illnesses and physical complaints often accompany each other and usually have a good prognosis.