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Br Med J. 1970 May 23; 2(5707): 439–443.
PMCID: PMC1700485

Psychiatric Illness in General Practice: A Detailed Study Using a New Method of Case Identification*


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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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Davies SWV. A year in General Practice. J Coll Gen Pract Res Newsl. 1958 Nov;1(4):315–329. [PMC free article] [PubMed]
  • HEWETSON JC, McEWAN JA, OLLENDORFF RH. The incidence of psychiatric disorders in gereral practice. Practitioner. 1963 Jan;190:127–132. [PubMed]
  • KILOH LG, GARSIDE RF. The independence of neurotic depression and endogenous depression. Br J Psychiatry. 1963 Jul;109:451–463. [PubMed]
  • KREITMAN N. The reliability of psychiatric diagnosis. J Ment Sci. 1961 Sep;107:876–886. [PubMed]
  • MOWBRAY RM, BLAIR W, JUBB LG, CLARKE A. The general practitioner's attitude to psychiatry. Scott Med J. 1961 Jul;6:314–321. [PubMed]
  • PAULETT JD. Neurotic ill health; a study in general practice. Lancet. 1956 Jul 7;271(6932):37–38. [PubMed]
  • Rawnsley K. Congruence of independent measures of psychiatric morbidity. J Psychosom Res. 1966 Jul;10(1):84–93. [PubMed]
  • YERUSHALMY J. The reliability of chest roentgenography and its clinical implications. Dis Chest. 1953 Aug;24(2):133–147. [PubMed]

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