Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-03T00:42:55.005Z Has data issue: false hasContentIssue false
  • English
  • Français

Pathways of Specialist Referral of Depressed Patients from General Practice

Published online by Cambridge University Press:  29 January 2018

T. J. Fahy
T. J. Fahy*
Affiliation:
Department of Psychological Medicine, The Royal Victoria Infirmary and University of Newcastle upon Tyne. Now Clinical Director, St. Loman's Hospital, Dublin
Get access Rights & Permissions [Opens in a new window]

Extract

Of patients with ‘conspicuous psychiatric morbidity’ in British general practice, 5 per cent annually are seen by psychiatrists, roughly equal numbers are referred to non-psychiatric specialists (Shepherd, Cooper, Brown and Kalton, 1966), and cross-referral rates are low (Mezey and Kellett, 1971). The clinical, as opposed to the social, reasons why so few patients are referred to psychiatrists must be inferred from the indirect evidence of epidemiological surveys (Shepherd et al., 1966), studies of patients already referred to an out-patients clinic (Kreitman, Sainsbury, Pearce and Costain, 1965), doctors' referral letters (Mowbray, Blair, Jubb and Clarke, 1961), and surveys of doctors' attitudes (Shepherd et al., 1966; Mezey and Kellett, 1971). Few studies of referral have been prospective (Kaeser and Cooper, 1971) and none has been by interview of patients before referral has taken place. Meanwhile, detailed clinical studies of psychiatric illness continue to focus almost exclusively on patients already in care of psychiatrists. It follows that more knowledge is needed of the clinical factors which lead to specialist referral; otherwise the significance of hospital-based studies for the wider context of psychiatry in general medical practice cannot be properly appreciated. This need is particularly acute with respect to the so-called minor affective disorders which are common in general practice but of which only a minority come to the notice of psychiatrists (Watts, 1966; Taylor and Chave, 1964).

Type
Research Article
Information
The British Journal of Psychiatry , Volume 124 , Issue 580 , March 1974 , pp. 231 - 239
Copyright
Copyright © Royal College of Psychiatrists, 1974 

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

Cooper, B. (1966). ‘Psychiatric disorder in hospital and general practice.’ Social Psychiatry, 1, 7–10.Google Scholar
Dowling, R. H., and Knox, S. J. (1964). ‘Somatic symptoms in depressive illness: a problem of referral for general practitioners.’ British Journal of Psychiatry, 110, 720–22.Google Scholar
Fahy, T. J. (1969). ‘The phenomenology of depression in hospital and in the community.’ Unpublished M.D. Thesis, National University of Ireland, Dublin.Google Scholar
Fahy, T. J., Brandon, S., and Garside, R. F. G. (1969). ‘Clinical syndromes in a sample of depressed patients: a general practice material.’ Proceedings of the Royal Society of Medicine, 62, 331–6.Google Scholar
Fahy, T. J. (197-). ‘Depression in hospital and in general practice: a direct clinical comparison.’ British Journal of Psychiatry, 00, 000–00.Google Scholar
Goldberg, D. P., and Blackwell, B. (1970). ‘Psychiatric illness in general practice: a detailed study using a new method of case identification.’ British Medical Journal, ii, 439–43.Google Scholar
Hope, , Keith, (1968). In Methods of Multivariate Analysis, p. 11. University of London Press.Google Scholar
Kaeser, A. C., and Cooper, B. (1971). ‘The psychiatric patient, the general practitioner and the outpatient clinic: an operational study and a review.’ Psychological Medicine, 1, 312–25.Google Scholar
Kreitman, N., Sainsbury, P., Pearce, K., and Costain, W. (1965). ‘Hypochondriasis and depression in outpatients at a general hospital.’ British Journal of Psychiatry, 111, 607–15.Google Scholar
Mezey, A. G., and Kellett, J. M. (1971). ‘Reasons against referral to the psychiatrist.’ Postgraduate Medical Journal, 47, 315–19.Google Scholar
Mowbray, R. M., Blair, W., Jubb, L. G., and Clarke, A. (1961). ‘The general practitioner's attitude to psychiatry.’ Scottish Medical Journal, 6, 314–21.CrossRefGoogle ScholarPubMed
Paykel, E. S., Klerman, G. L., and Prusoff, B. A. (1970). ‘Treatment setting and clinical depression.’ Archives of General Psychiatry, 22, 11–21.Google Scholar
Shepherd, M., Cooper, B., Brown, A. C., and Kalton, G. W. (1966). Psychiatric Illness in General Practice. London: Oxford University Press.Google Scholar
Taylor, , Lord, , and Chave, S. (1964). Mental Health and Environment. London: Longmans.Google Scholar
Watts, C. A. H. (1966). Depressive Disorders in the Community. Bristol: John Wright.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.