Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-20T04:50:25.763Z Has data issue: false hasContentIssue false
  • English
  • Français

Determinants of general practitioner recognition of psychological problems in a multi-ethnic inner-city health district

Published online by Cambridge University Press:  02 January 2018

S. M. Odell ,
P. G. Surtees ,
N. W. J. Wainwright ,
M. J. Commander  and
S. P. Sashidharan
S. M. Odell*
Affiliation:
University of Birmingham, Department of Psychiatry
P. G. Surtees
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR
N. W. J. Wainwright
Affiliation:
MRC Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR
M. J. Commander
Affiliation:
University of Birmingham, Department of Psychiatry
S. P. Sashidharan
Affiliation:
University of Birmingham, Department of Psychiatry
*
S. M. Odell, Academic Unit, Northern Birmingham Mental Health Trust, Trust Headquarters, 71 Fentham Road, Erdington, Birmingham B23 6AL
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

With few exceptions, evaluation of the capacity of general practitioners (GPs) to recognise psychiatric disorder in their patients has failed to consider the role of ethnic diversity in the consultation process and whether such knowledge can improve understanding of the degree to which psychiatric morbidity is recognised within GP settings.

Methods

This research was completed in five general practices representative of all those within an inner-city health district. Psychiatric morbidity in patients consecutively attending the practices was then assessed using the General Health Questionnaire; in addition, GPs were asked to complete a checklist of current problems identified during each consultation.

Results

Analysis suggested that Asian and Black patients were less likely than White patients to have psychological problems identified; that social problems and a psychiatric history facilitated recognition; and that current physical illness hindered recognition.

Conclusions

GP recognition of psychological problems varies according to patient ethnicity but can be substantially masked by both the physical and social circumstances of patients at consultation.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 6 , December 1997 , pp. 537 - 541
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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.)

References

Bal, S. S. (1987) Psychological symptomatology and health beliefs of Asian patients. In Clinical Psychology Research and Developments (ed. Dent, H.), pp. 101–110. London: Croom Helm.Google Scholar
Boardment, A. P. (1987) The General Health Questionnaire and the detection of emotional disorder by general practitioners – a replicated study. British Journal of Psychiatry, 151, 373–381.Google Scholar
Bridges, K. W. & Goldberg, D. P. (1985) Somatic presentation of DSM–III psychiatric disorders in primary care. Journal of Psychosomatic Research, 29, 563–569.Google Scholar
Bucks, R. S., Williams, A., Whitfield, M. J., et al (1990) Towards a typology of general practitioners' attitudes to general practice. Social Science and Medicine, 35, 537–547.CrossRefGoogle Scholar
Chambers, J. M. & Hastie, T. J. (1992) Statistical Models in S. Pacific Grove, CA: Wadsworth and Brooks-Cole.Google Scholar
Clare, A., Gulbinat, W. & Sartorius, N. (1992) A triaxial classification of health care problems presenting in primary health care. Social Psychiatry and Psychiatric Epidemiology, 27, 108–116.Google Scholar
Cochrane, R. & Sashidharan, S. P. (1996) Mental health and ethnic minorities: a review of the literature and implications for services. In Ethnicity and Health, pp 105–126. York: University of York.Google Scholar
Dale, A. & Marsh, C. (1993) The 1991 Census User's Guide. London: HMSO.Google Scholar
Freeling, P., Rao, B. M., Paykel, E. S., et al (1985) Unrecognised depression in general practice. British Medical Journal, 290, 1880–1883.Google Scholar
Giel, R., Koeter, M. W. & Ormel, J. (1990) Detection and referral of primary-care patients with mental health problems: the second and third filter. In The Public Health Impact of Mental Disorders (eds Goldberg, D. P. & Tantam, D.). pp. 25–34. New York: Regrefe & Huber.Google Scholar
Goldberg, D. & Williams, P. (1988) A User's Guide to the General Health Questionnaire. Windsor: NFER–Nelson.Google Scholar
Goldberg, D. & Huxley, P. (1992) Common Mental Disorders. London: Routledge.Google Scholar
Hoeper, E. W., Nycz, G. R., Kessler, L. G., et al (1984) The usefulness of screening for mental illness. Lancet, i, 33–35.Google Scholar
Marino, S., Bellantuono, C. & Tansella, M. (1990) Psychiatric morbidity in general practice in Italy. Social Psychiatry and Psychiatry Epidemiology, 25, 67–72.CrossRefGoogle ScholarPubMed
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
Sashidharan, S. P., Odell, S. M., Commander, M. J., et al (1995) West Birmingham Psychiatric Epidemiology Research Project Report 3: Mental Health and Primary Care. Birmingham: Northern Birmingham Mental Health Trust.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C., et al (1988) Psychiatric Illness in General Practice. Oxford: Oxford University Press.Google Scholar
Wells, K. B., Stewart, A., Hays, R. D., et al (1989) The functioning and well-being of depressed patients. Journal of the American Medical Association. 282, 914–919.CrossRefGoogle Scholar
Wilmink, F. W. (1989) Patient, Physician, Psychiatrist. PhD Thesis, Groningen University.Google Scholar
Wilson, M. & Maccarthy, B. (1994) GP consultation as a factor in the low rate of mental health service use among Asians. Psychological Medicine, 24, 113–119.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.