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Psychiatric morbidity in an Italian general practice

Published online by Cambridge University Press:  09 July 2009

Cesario Bellantuono ,
Roberto Fiorio ,
Paul Williams  and
Patrizia Cortina
Cesario Bellantuono*
Affiliation:
Cattedra di Psicologia Medica, Istituto di Psichiatria, Universit´ di Verona, VeronaInstitute of Psychiatry, London
Roberto Fiorio
Affiliation:
Cattedra di Psicologia Medica, Istituto di Psichiatria, Universit´ di Verona, VeronaInstitute of Psychiatry, London
Paul Williams
Affiliation:
Cattedra di Psicologia Medica, Istituto di Psichiatria, Universit´ di Verona, VeronaInstitute of Psychiatry, London
Patrizia Cortina
Affiliation:
Cattedra di Psicologia Medica, Istituto di Psichiatria, Universit´ di Verona, VeronaInstitute of Psychiatry, London
*
1Address for correspondence: Dr C. Bellantuono, Cattedra di Psicologia Medica, Instituto di Psichiatria, Università di Verona, 37134 Verona, Italy.
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Synopsis

A two-stage screening strategy was applied in a single-handed general practice in northern Italy. The study was designed so that all the second-stage psychiatric interviews were conducted during the first phase of the study (group A patients), while self-report questionnaire (GHQ) and GP assessments only were collected during the second phase (group B patients).

The estimated true case rate of psychiatric disorder (36%) did not differ between the two phases of the study, but there were marked differences in the general practitioner's diagnostic behaviour. During the first phase (when psychiatric interviews were being conducted in the practice), her behaviour was heavily biased towards diagnosing psychiatric disorder; 61% of the patients were regarded by her as psychiatric cases and the hidden psychiatric morbidity rate was only 9%. During the second phase of the study (no psychiatric interviews in the practice), only 37% of the patients were regarded as psychiatric cases by the GP, and the hidden morbidity rate was 59%.

The results are interpreted as demonstrating that the presence of a psychiatrist conducting a two-stage screening survey in the practice had a profound effect on the diagnostic threshold. They also provide support for the use of the GHQ as a case-finding instrument in general practice.

Type
Preliminary Communication
Information
Psychological Medicine , Volume 17 , Issue 1 , February 1987 , pp. 243 - 247
Copyright
Copyright © Cambridge University Press 1987

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References

Bellantuono, C., Fiorio, R., Zanotelli, R. & Tansella, M. (1986). Psychiatric screening in general practice in Italy; a validity study of the GHQ. Social Psychiatry (in the press).Google Scholar
Finlay-Jones, R. & Murphy, E. (1979). Severity of psychiatric disorder and the 30-item General Health Questionnaire. British Journal of Psychiatry 134, 609–616.CrossRefGoogle ScholarPubMed
Fontanesi, F., Gobetti, C., Zimmermann-Tansella, Ch. & Tansella, M. (1985). validation of the Italian version of the GHQ in a general practice setting. Psychological Medicine 15, 411–415.CrossRefGoogle Scholar
Goldberg, D. P., (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Goldberg, D. P., (1978). Manual of the General Health Questionnaire. NFER: Windsor.Google Scholar
Goldberg, D. P. & Blackwell, B. (1970). Psychiatric illness in general practice: a detailed study using a new method of case identification. British Medical Journal ii, 439–443.CrossRefGoogle Scholar
Goldberg, D. P. & Huxley, p. (1980). Mental Illness in the Community: the Pathway to Psychiatric Care. Tavistock: London.Google Scholar
Goldberg, D. P.Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardised psychiatric interview for use in community surveys. British Journal of Preventive and Social Medicine 24, 18–23.Google ScholarPubMed
Goldberg, D. P.Kay, C. & Thompson, L. (1976). Psychiatric morbidity in general practice and the community. Psychological Medicine 6, 565–569.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
Medico d'Italia. (04 1986). Special Dossier: I Medici Iscritti agli Albi Professionali al 31.12.1985.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C. & Kalton, G. W. (1966). Psychiatric Illness in General Practice. Oxford University Press: London.Google Scholar
Skuse, D. & Williams, P. (1984). Screening for psychiatric disorder in general practice. Psychological Medicine 14, 365–377.CrossRefGoogle ScholarPubMed
Tansella, M. & Bellantuono, C. (1986). The view from abroad – Italy. In Mental Illness in Primary Care (ed. Shepherd, M., Wilkinson, G. and Williams, P.), pp. 214–218. Tavistock Publications: London.Google Scholar