A Study of One Hundred Chronic Psychiatric Patients Identified in General Practice

¹ Research Assistant, Institute of Psychiatry, London, S.E.5

A group of 100 patients were interviewed in their G.P.s' surgeries, within one year of having been identified as chronic psychiatric cases in the course of a large-scale general practice survey. Case-identification was validated in 95 cases, of which 68 were judged to be still suffering from psychiatric disorder at the time of interview. The majority of cases were diagnosed as chronic neuroses, but psychophysiological disturbances were also common, and altogether nearly half the patients had some associated chronic physical illness. Current or recent environmental stresses were found in 38 cases. There was a clear family psychiatric history in 16 cases, and at least 52 of the patients had had an emotionally disturbed early environment. Thirty-two patients had been referred to psychiatrists at some stage of their illness, but only six were currently under psychiatric care at the time of interview. Most of the patients had had a variety of drugs prescribed by their G.P.s; psychotherapy had been attempted by the G.P. in only a handful of cases, and referral to social agencies had been equally uncommon. The duration of illness was often difficult to establish, but including cases of personality disorder at least 34 patients were thought to have exhibited symptoms continuously or with frequent recurrence for at least 10 years. The implications of these findings are discussed and some tentative conclusions drawn concerning the deployment of medical services.