Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification
Open accessAbstract
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.
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Items measuring the construct Affect were based on the Positive and Negative Affect Schedule and Stress items were based on the General Health Questionnaire.
“items measuring the construct Affect were based on the Positive and Negative Affect Schedule [49] and Stress items were based on the General Health Questionnaire [48]”
From Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research (2014) · cites this paper as [48]
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- Authors
- Goldberg, D. P., & Blackwell, B.
- ORCID
- Goldberg, D. P.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1970-05-23
- Volume
- 2
- Issue
- 5707
- Pages
- 439-443
- ISSN
- 0007-1447 (ISSN-L)
- 1468-5833
- PMC
- PMC1700485
- OpenAlex
- W2054517429
- Cited by
- 1,121
- References
- 13
- Citations by year
- 2026: 16 · 2025: 29 · 2024: 20 · 2023: 34 · 2022: 51 · 2021: 43 · 2020: 45 · 2019: 40 · 2018: 28 · 2017: 29 · 2016: 20 · 2015: 18 · 2014: 19 · 2013: 18 · 2012: 25
- FWCI
- 25.24
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- London School of Economics and Political Science
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- psychiatric morbidity, general practice, General Health Questionnaire, case finding, psychiatric disturbances, somatic symptoms, prognosis, follow-up, primary care mental health
- MeSH terms
- Adjustment Disorders, Mental Disorders, Depression, Family Practice, Female, Follow-Up Studies, Humans, Male, Neurotic Disorders, Personality Disorders, Surveys and Questionnaires
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